May 2024

Prostate Cancer: Understanding Your Options

Although quick actions may save lives in the emergency room, rapid decisions aren’t always right for other patients—including men with prostate cancer.

Prostate cancer is most often found in men ages 65 and older. This cancer affects the gland located below the bladder and in front of the rectum. It also wraps around part of the urethra. This is why symptoms can include a frequent need to urinate and a weak stream of urine.

Know when to be screened

Screening tests, such as a digital rectal exam or prostate-specific antigen (PSA) blood test, can check for prostate cancer before it causes symptoms. You should discuss the potential advantages, risks, and limitations of screening with your healthcare provider.

The U.S. Preventive Services Task Force recommends these conversations take place between the ages of 55 and 69. The American Cancer Society (ACS) recommends they begin at age 50, unless you have a higher than average risk for prostate cancer. According to the ACS, African American men or those with a first-degree relative who had prostate cancer before age 65 should begin speaking with their providers at age 45. Men with 2 or more first-degree relatives who had cancer before age 65 should talk with their provider at age 40.

Learn about available treatments

Many treatment options are available for men with prostate cancer, including surgery and radiation therapy. Other choices include watchful waiting or active surveillance. Watchful waiting means monitoring a person’s condition until signs or symptoms change. Active surveillance means having certain exams and tests to check if the cancer is growing. By choosing watchful waiting or active surveillance, men may avoid potential treatment complications, such as impotence and incontinence.

Here’s why watchful waiting or active surveillance can be an option: Unlike some other cancers, prostate cancer usually advances slowly. It can take up to 30 years for a tumor to grow large enough to produce symptoms.

Watchful waiting or active surveillance aren’t for everyone, though. Surgery remains a common way to try to cure prostate cancer that hasn’t spread to other parts of the body. While some procedures focus on the tumor, the surgery most often performed removes the entire prostate gland.

Some questions to consider when reviewing treatment options are:

• If I choose active surveillance, how often would I need to have tests?

• How do I feel about potential side effects of treatment versus knowing I have cancer in my body?

• If I have treatment, how comfortable am I with waiting to know the results? Am I more comfortable with well-established options or open to the latest technology?

Remember, there’s usually no need to rush into a decision. As you consider your options, it may help to talk with your family or friends, as well as others who currently have or previously faced prostate cancer.