‘I don’t have any symptoms; can I still have prostate cancer?’

Just like breast cancer in women, prostate cancer is an aggressive form of cancer in men. It should be noted that prostate cancer is a spectrum of disease, and not all men diagnosed with prostate cancer require treatment. According to Dr Niti Raizada, director, medical oncology and hemato-oncology, Fortis Group of Hospitals, Richmond Road, Bangalore, the detection of early prostate cancer includes detecting both slow-growing and aggressive or fast-growing prostate cancer.
“The challenge is to minimise over-treatment of indolent cancers biologic characterisation. Identification and selective treatment of aggressive cancers should result in a significant decrease in morbidity and mortality, while limiting adverse effects on quality of life,” she says.
For Prostate Cancer Awareness Month, the doctor debunks eight common myths that men ought to know; read on.

Myth 1: ‘I don’t have any symptoms, so I cannot have prostate cancer’
Fact: Often, prostate cancer cases have minimum or no symptoms. Routine screening is recommended for all men over 45 years of age, which includes DRE (Digital Rectal Examination) and sometimes Serum PSA levels, which is a tumor marker in blood. Screening is recommended for men with a family hory of prostate cancer (or even other types of cancer).
If you experience any of the following symptoms, please speak to your primary care physician:
* Increased frequency of micturition* Difficulty in starting or holding back urine* Painful or burning urination* Difficulty achieving an erection/painful ejaculation* Blood in urine or semen* Unexplained weight loss or decreased energy levels

Myth 2: ‘No one in my family has had cancer, how can I?’
Fact: Often, there is no family hory of cancer when one is diagnosed. Only about 10-20 per cent cases will have someone in the family with prostate or other cancer. Prostate cancer is a common cancer, but also remarkably treatable.
“In recent years, there are several newer biologic therapies that work well with certain mutations noted with hereditary cancers, including prostate,” the doctor says.
Myth 3: Surgery is the only treatment option for prostate cancer
Fact: “When one is diagnosed, first we stage the patient with certain scans and then based on the stage information, a treatment plan is made, which is after taking inputs from all sub-specialities in oncology. This plan could include surgery, radiation, hormonal therapy, chemotherapy or biologic therapy.”

Myth 4: ‘Prostate cancer will end my sex life, and cause impotence’
Fact: Certain type of treatment can disrupt sexual functions, but this is often not the case.
Myth 5: Treatment will cause incontinence/urinary dribbling
Fact: Some types of procedures can have incontinence as a side effect. But often, modalities are chosen in which incontinence does not happen.
Myth 6: Only elderly men get prostate cancer
Fact: Age is often the most common risk factor for all cancers. Prostate cancer can happen in the younger population, too. Often, people with hereditary syndromes and strong family hory need to be screened early on. “Certain ancestries like African-Americans need to be evaluated from an early age. Younger patients with cancer can also have a more aggressive course, and so need to be identified at the right time,” says Dr Raizada.

Myth 7: A high PSA means prostate cancer
Fact: This is not always true. An infected or inflamed prostate can increase PSA value, too. Serum PSA is an indicator if further test is required to confirm prostate cancer. PSA number rising or declining over time is of value, too. If on the rise, it could be a sign of a problem. Further, for a patient who is on prostate cancer treatment, doctors use Serum PSA values to monitor response to treatment.
Myth 8: If you have prostate cancer, you will die of the disease
Fact: Untrue. Often, patients of localised prostate cancer do very well on treatment. A subset of patients may require observation alone and no active treatment. Others respond based on the stage, tumor characterics and treatment. The key here is the right diagnosis at the right time.
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