September is Prostate Cancer Awareness Month. Although prostate cancer is the most common cancer in men after skin cancer, far too many men are still unclear about their risk for the disease and when or whether to start screening. The experts at St. Luke’s Health have the answers you need.

What Is Prostate Cancer?

The prostate is a small gland that is part of the male reproductive system. Your prostate is just below your bladder and in front of your rectum, and it makes the fluid that is part of your semen. In young men, the gland is usually the size of a walnut, but it grows larger in most men as they age. This condition, benign prostatic hyperplasia (BPH), affects half of men over 60 and 90 percent of men by age 85. BPH does not increase your risk for the disease.

Prostate cancer is caused by malignant cells forming in your prostate and growing into a tumor. Cancer in its earliest stages often has no symptoms, but as the tumor grows, it can cause problems with urination, such as needing to go more frequently or trouble going. These symptoms are similar to BPH, as both conditions cause your growing prostate to press against your urethra. If you are experiencing any problems with urination, it’s important to talk to your doctor for a correct diagnosis.

Are You at Risk for Prostate Cancer?

Every man with a prostate is at risk for prostate cancer—1 in 8 men will develop the condition, and around 300,000 men in the U.S. are diagnosed every year. However, certain things can increase your risk of the disease, including:

• Age. Your risk of developing prostate cancer rises as you age, especially after age 50.

• Family history and genetic makeup. If you have a family history of prostate cancer or certain inherited genetic mutations, such as variants of BRCA1 or BRCA2 or Lynch syndrome, you are at a higher risk.

• Race and ethnicity. Prostate cancer is more common in African American men, and it is more likely to affect them at a younger age. White men are more likely to develop prostate cancer than Hispanic or Asian American men.

If you have a family history of prostate cancer or known genetic mutations (such as a sister who has a BRCA1 mutation), you should ask your primary care provider (PCP) whether genetic testing could be helpful. 

The Facts About Screening for Prostate Cancer

Unlike screenings for other types of cancer, there is no single recommendation for who should get screened for prostate cancer or at what age to start screening. In general, every man should discuss his risk factors with his PCP or urologist and make a personal decision about screening. The American Cancer Society recommends starting these discussions:

• At age 40 (or earlier) for men who know they are at very high risk or who have two or more close relatives who developed prostate cancer at a young age

• At age 45 for men who are African American or have one family member who developed prostate cancer under age 65

• At age 50 for men at average risk

Screening for prostate cancer is usually done with a simple blood test that checks levels of your prostate-specific antigen (PSA). If levels are normal, you may need two years between screenings. If they are high, you may need testing more frequently.

According to a recent survey, 77 percent of men did not know their complete family history of urological problems. It may be an awkward conversation to have with your father, grandfathers, uncles and brothers, but it’s important to learn if you could be at higher risk so you can make an informed decision about screening.

Prostate Cancer Is Treatable

Regular PSA screenings may help detect prostate cancer in its earliest stages, before it has spread. Although common prostate cancer treatments include surgery, radiation and chemotherapy, there are more treatments for prostate cancer than ever before. SLH offers both standard and advanced treatment options for prostate cancer, including access to clinical trials.