In the next year, 1.1 million men — including many across Tennessee and several in Scott County — will be diagnosed with prostate cancer.

That number sounds scary. Indeed, prostate cancer is the second most common cancer in American men, trailing only skin cancer. But the good news is that prostate cancer is one of the most treatable cancers known to doctors, with a 5-year survival rate of 99 percent.

September is Prostate Cancer Awareness Month in America, a time set aside by health professionals to educate men on the disease: its symptoms, and when they should be screened.

What is prostate cancer?

Prostate cancer is a cancer of the prostate gland. Found only in men, the prostate gland is located just below the bladder and is a part of the male reproductive system. It’s about the size of a walnut in younger men, though it can grow much larger in older men.

According to the American Cancer Society, almost all prostate cancers are adenocarcinomas — cancers that develop from the gland cells. While some prostate cancers grow quickly, many grow slower. In fact, autopsy results have shown that many older men who died of other causes had prostate cancer that neither them nor their doctors knew about. It is thought that most men who live to the age of 80 have or will develop prostate cancer.

The statistics

There will be about 174,650 new cases of prostate cancer diagnosed in the United States this year, according to the American Cancer Society, and about 31,620 American men will die from the disease.

About 1 in 9 men will be diagnosed with prostate cancer during his lifetime. Although it is a disease that can impact younger men, it’s primarily a disease of the middle-aged and elderly. Ninety-nine percent of cases are diagnosed in men over the age of 50, and 60 percent are diagnosed in men who are 65 or older. The average age at diagnosis is 66. Prostate cancer in men younger than 40 is considered rare.

Prostate cancer is the second-leading cause of cancer death in American men, trailing only lung cancer. About 1 in 41 men will die of prostate cancer. However, the disease is highly treatable. The 5-year survival rate for men who are diagnosed when the disease is still localized to the prostate is nearly 100 percent. Even when the disease has spread outside the prostate but has not spread to distant parts of the body, the 5-year survival rate is nearly 100 percent.

Unfortunately, survival rates drop sharply once the disease spreads to distant organs and lymph nodes. Only 30 percent survive five years once that happens. That’s why healthcare professionals encourage screening for prostate cancer.

Risks and causes

The primary risk factor for prostate cancer is age, with the number of cases rising rapidly after the age of 50. About 6 in 10 cases of prostate cancer are found in men older than 65.

Race is another factor; prostate cancer is more common in African-American men and in Caribbean men than in other races. It happens less often in Asian-American men and Hispanic men than in non-Hispanic whites.

A family history of prostate cancer is important; while most prostate cancers occur in men without a family history of the disease, researchers believe there is a genetic factor to prostate cancer. For example, having a father or brother with prostate cancer more than doubles a man’s risk of developing the disease. The risk is higher for men who have a brother with the disease than for those who have a father with it.

Gene changes carry an increased risk for prostate cancer. Inherited mutations of the BRCA1 or BRCA2 genes have been linked to an increased risk for prostate cancer, as well as breast and ovarian cancers. Additionally, men with Lynch syndrome have an increased risk for prostate cancer.

Though the links aren’t clear, it is thought that men who eat a lot of red meat or high-fat foods, such as dairy products, have an increased risk for prostate cancer. Men who have received a vasectomy may have a slightly increased risk for the disease, as do firefighters who have been exposed to certain chemicals. Prostatitis — inflammation of the prostate gland — has also been linked to an increased cancer risk.

Obesity and smoking have not been linked to prostate cancer.

Symptoms and screening

Early prostate cancer does not usually cause symptoms, which is why many doctors recommend screening for middle-aged and elderly men. Once symptoms begin to occur, the disease is often advanced, which limits treatment options.

Some of those advanced symptoms include problems urinating, including a slow or weak urinary stream, blood in the urine or semen, erectile dysfunction, pain in the hips, back or chest areas, and weakness or numbness of the legs or feet. Rarely, loss of bladder control or bowel control is seen due to the cancer pressing on the spinal cord.

Most symptoms that are linked to prostate cancer are actually caused by something else. Trouble urinating is perhaps the No. 1 symptom of prostate cancer, but it is usually caused by prostatic hyperplasia, a non-cancerous growth of the prostate. Nevertheless, experts say, men who have any of those symptoms should tell their healthcare provider so that they can be tested, if their doctor believes it’s necessary.

Most prostate cancers are first found as a result of screening with a specific blood test or a digital rectal exam. Studies have not conclusively proven that screening for prostate cancer lowers the overall death rate, which has caused controversy. The official stance of the American Cancer Society is that it “recommends that men thinking about getting tested for prostate cancer learn as much as they can so they can make informed decisions based on available information, discussions with their doctor, and their own views on the possible benefits, risks and limits of prostate cancer screening.” The ACS recommends that “you and your doctor should decide whether you should be screened or prostate cancer.”

The ACS recommends that doctors have a discussion with male patients about screening for prostate cancer when they have reached the age of 50 and are expected to live at least 10 more years, or at the age of 45 if they’re at a high risk of developing prostate cancer. If they’ve had more than one first-degree relative who had prostate cancer at an early age, those discussions should take place at age 40, the ACS says.

This story is the September 2019 installment of Focus On: Health, presented by Brennan’s Foot & Ankle Care, Big South Fork Medical Center, Roark’s Pharmacy and Danny’s Drugs on the second week of each month as part of the Independent Herald’s Focus On series. A print version of this story can be found on Page A5 of the September 12, 2019 edition of the Independent Herald.