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Prostate cancer: Expert addresses some common misconceptions

Prostate cancer remains one of the least talked about cancers in the general public, at least in India. Hence there remains a great deal of confusion surrounding this disease,” said Dr Anish Kumar Gupta, andrologist, urologist, urological surgeon and sexologist who consults on Practo.

He added that most men, when asked about the disease will either have “notions of their own, unsubstantiated by medical information, or change the topic or just joke about it.”

“Most men who have ever heard about a Prostate Specific Antigen (PSA) will say that the PSA is the benchmark for Cancer Prostate diagnosis for them and their physicians,” he said as he went on to address some misconceptions about the disease.

1. Prostate cancer is an old man’s disease. Wrong!

65 per cent of cases are diagnosed in men who are 65 or older, while 35 per cent men are diagnosed at an early age.

Age Wise incidence:
< 40 Years: 1 in 10,000 men
40 – 50 Years: 1 in 40 to 60 men.
60 – 69 Years: 1 in 15 men.

There are many risk factors to consider – race, family history, physical health, lifestyle and even geographic location.

2. No symptoms means no prostate cancer. Wrong!

“Prostate cancer is one of the most asymptomatic cancers in oncology, meaning not all men experience symptoms. Many times, symptoms can be mistaken or attributed to something else,” said Dr Gupta.

Signs of prostate cancer are often first detected by a doctor during a routine check-up. Common symptoms include a need to urinate frequently, difficulty starting or stopping urination, weak or interrupted flow of urination, painful or burning urination, difficulty having an erection, painful ejaculation, blood in the urine or semen, or frequent pain and stiffness in the lower back, hips or upper thighs. If you experience any of these symptoms, be sure to tell your doctor.

3. Prostate cancer is a slow growing cancer; I don’t need to worry about. Sometimes, yes. Sometimes, no.

“Aggressiveness can be commented upon only after biopsy keeping in mind the patient’s age and health status. Patients need to understand the complexity of this disease and make treatment decisions that are right for them in consultation with a trusted urologist,” he stressed.

4. Prostate cancer doesn’t run in my family, so the odds aren’t great that I will get it. Wrong!

Not entirely true, but family history doubles a man’s odds of being diagnosed to 1 in 3. This compares to 1 in 8 women who will be diagnosed with breast cancer. Family history and genetics do play a role in a man’s chances for developing prostate cancer. A man whose father or brother had prostate cancer is twice as likely to develop the disease. The risk is further increased if the cancer was diagnosed in a family member at a younger age (less than 55 years old), or if it affected three or more family members.

5. The PSA test is a cancer test. Wrong!

The PSA test measures levels of prostate-specific antigen in the prostate, not cancer. PSA is produced by the prostate in response to a number of problems that could be present in the prostate including an inflammation or infection (prostatitis), enlargement of the prostate gland (benign prostatic hyperplasia) or, possibly, cancer.

Think of it as a first alert smoke alarm, instead of a fire alarm. The PSA test may be the first step in the diagnostic process for cancer. It has made detection of cancer in its early stages, when it is best treated, possible. Experts believe the PSA test saves the life of approximately 1 in 39 men who are tested.

The flip side is also the fear of over-detection of cancer, which may not affect the patient in his lifetime. This is supported by various Cancer Watchdog Organizations world over.

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