Men's health and prostate cancer: knowledge is power

The recent announcement that former President Joe Biden has been diagnosed with an aggressive form of prostate cancer highlights the need for early screening and detection.

President Biden’s office shared he has been diagnosed with stage IV prostate cancer that has spread to his bones.

Prostate cancer is the most commonly diagnosed cancer in men and the second deadliest after lung cancer. The American Cancer Society estimates that, in 2025, more than 300,000 men will be diagnosed with prostate cancer. More than 35,000 will die from it.

June is Men’s Health Month, when there are renewed calls to action for men to take charge of their health. While the news of Pres. Biden’s cancer diagnosis could cause concern, it can also serve as a reminder that awareness, prevention, early detection, and education around prostate cancer can increase the survival rate.

Sentara Health Community Health Educator Betsy Carroll said while prostate cancer is a common diagnosis, it is also typically managed well with treatment.

“Most men, as they age, the prostate changes, and cancer is common,” Carroll said. “But testing for it is very easy. The PSA blood test is your first line of defense and can be done at your annual well check.”

The prostate-specific antigen (PSA) blood test was approved by the FDA in 1986 and is now the first step to getting screened for prostate cancer. PSA testing involves analyzing a blood sample for a specific protein that is only made by the prostate.

Early detection can save lives

Getting screened for prostate cancer is an easy way to protect yourself from the disease.

PSA tests are typically performed by your general practitioner and are often done as part of a broader panel of blood tests. If your test results show elevated PSA levels – a possible indication that cancer is present – then your doctor can refer you to a urologist for additional testing.

Why is early detection such a game-changer? Catching cancer when it’s still localized in the prostate – before it has a chance to spread to other parts of the body – gives you the best chance of successfully treating it. In fact, over 3 million men who have been diagnosed with prostate cancer at some point in their lives are still alive today.

Early detection is critical for prostate cancer, because often early stages of this cancer go unnoticed.

“That’s where it’s a little bit hard and that’s why the PSA screening is so important,” Carroll said. “Early symptoms are actually no symptoms — that’s the most common symptom in stage 1 and stage 2 prostate cancer.”

“But symptoms that you could see in more advanced prostate cancer are trouble with urination, blood in your urine, pain in your abdomen, and even pain in your hips and legs. Some of those are with advanced disease, so you’re hoping not to get those,” Carroll said.

Who should get screened?

If early detection can save lives, it’s logical to assume that every man should get tested annually. In reality, there’s more nuance to it than that.

First, prostate cancer is very rare in men under the age of 40, so younger men typically don’t need to be tested. Second, not everyone has the same risk factors for prostate cancer. For example, African-American men are twice as likely to die from prostate cancer than white men, and people with a family history of prostate cancer are also at increased risk.

Third, prostate cancer is often, but not always, a relatively slow-moving form of cancer. If you’re not expected to live at least 10 more years because of other health factors, then treating prostate cancer might do more harm than good.

With all this in mind, the Sentara recommends yearly testing for men who are:

• Age 40-45 for Black men and those who are at high risk, specifically those with several first-degree relatives (father, son, or brother) with a history of prostate cancer. 
• Age 45 to 50 for those with one first degree family member diagnosed with prostate cancer before age 65.
• Age 50 and older, who are at average risk of developing prostate cancer, have no family history or personal risk factors, and are expected to live 10 years or more.
• Men over aged 70 who have previously undergone prostate screening are encouraged to speak with their provider about continuing prostate screenings. This can be based on age, life expectancy, overall health, family history, and past PSA results.

Have a conversation with your doctor

Ultimately, you should have a conversation with your doctor about prostate cancer screening. Factors that may affect the timing of your screening may include personal risk factors, your values and preferences, and the risks/benefits of screening.

Your doctor may encourage earlier testing based on your personal health history.

Learn more about prostate cancer and PSA testing.