According to a study by the University of Florida, the “Sunshine state” has the second highest incidence of prostate cancer in the country. With the number of elderly choosing to retire in Florida, that stat shouldn’t be a shock to anyone in the medical profession. Prostate cancer is often portrayed as an unimportant disease of the elderly, fraught with over-diagnosis and over-treatment. When caught early, prostate cancer has a nearly 100% five-year relative survival rate. That fact alone underlines how important it is for men to receive early screenings.
But in Florida, there are significant health disparities between rural and urban populations and across ethnic and racial groups. Men in rural areas are either under-diagnosed or diagnosed at later stages, receiving different management, being under-insured and having less desirable outcome .This also means, many don’t bother to check for prostate cancer since early stages of prostate cancers usually do not cause symptoms.
That said, if you live long enough in the U.S., you’re almost guaranteed to grow a couple of prostate cancer cells somewhere in your prostate, but the majority of these never amount to anything. Prostate cancer kills very few men compared to most other cancers. The flip side though is that because prostate cancer is so common, there are a minority of prostate cancers that are branded ‘high risk’ and those high-risk prostate cancers still kill. So the challenge now is really finding the ones that need to be treated and treating them appropriately and aggressively while trying to minimize over-treating low-risk prostate cancers that really don’t need to be treated.
When caught early, prostate cancer is very treatable and beatable. So how does one confirm the presence of prostate cancer cells? Most prostate cancers are first found during screening with a prostate-specific antigen (PSA) blood test and or a digital rectal exam (DRE). PSA screenings are part of regular physical exams that look for warning signs of prostate cancer. But it is important for a patient to know multiple PSA screening isn’t essential and can sometimes have an adverse effect if overdone. It is well-known in the industry that there is a lot of over-screening in older men. Some studies showed that 30% of men in their 80s were getting PSA screening even when they had other health problems. So men diagnosed with high-risk prostate cancer, even at older ages, will die of prostate cancer quite a significant proportion of the time when they are not treated.
Generally, 60% of non-palpable cancers detected at screening are low-risk and may do well with active surveillance. 40% of prostate cancers in the general population would not be detected without screening and are intermediate to high risk cancers requiring active treatment. The reason to screen is not merely to find more prostate cancer. The point is to find high-risk prostate cancers, high-grade prostate cancers.
So the next time you get your prostate checked, it is advisable to also ask your doctor to check for early signs of prostate cancer. Early detection of prostate cancer will make treatment of the same easier and far less painful. Not to mention it could save your life.