Please Stop Believing These Prostate Cancer Inaccuracies

Key Points

• Prostate cancer is one of the most common cancers men may face during their lifetime.
• If diagnosed and treated early, the disease has a very high survival rate.
• There are plenty of internet myths and misconceptions about prostate cancer that need to be corrected.

For a patient to hear the word "cancer" in a clinical setting must presumably be one of the most memorable, chilling moments of their lives. When you learn more about what modern medicine can do, though, you can gain a different perspective—especially when it comes to advances in prostate cancer diagnosis and treatment.

Still, prostate cancer inaccuracies abound. Getting the truth about prostate cancer in the internet age can prove challenging. Here, we'll debunk some of the more common myths.

What is the prostate gland?

The prostate gland is a vital component of the male reproductive organs. The walnut-sized gland sits just below the bladder and in front of the front wall of the rectum.

That's why some preliminary prostate exams begin with the provider palpating the gland with a gloved and lubricated finger inserted in the anus.

The prostate has several crucial functions for reproduction. It produces most of a man's seminal fluid and helps push it out via muscular contractions when the man ejaculates. You can live without it, but having the prostate removed can have significant downstream consequences for sexual health.

Now, let's get into some of the mythology of prostate cancer inaccuracies.

Inaccuracy #1

Prostate cancer treatment is always invasive.

It's difficult to overstate how far prostate cancer diagnosis and treatment have come in the past few decades. Not too long ago, the tiniest sign of prostate cancer likely meant a recommendation to go under the knife or get radiation treatment immediately.

These days, however, the testing has gotten so thorough and precise that clinicians and pathologists can accurately identify the location and size of a cancerous mass, determine the type of cancer, and find out whether it's aggressive or dangerous or can just left alone and monitored.

Enter active surveillance, a prostate cancer treatment that involves rigorous, ongoing evaluation of the cancer but doing nothing more invasive until a potential status change is confirmed at some later date.

"Active surveillance is for someone who we really don't know if they're going to need treatment, or if we can delay treatment for a while, meaning four or five years," said Scott D. Miller, M.D., the medical director of Wellstar Urology in Atlanta.

"That may sound kind of strange for cancer, but if it's indolent, there are some patients you can follow almost indefinitely. I have patients I've followed for 10 years now on active surveillance," Miller said.

Inaccuracy #2

No one needs to be screened for prostate cancer anymore.

Prostate cancer is among the most survivable types of cancer, but detecting it early really increases your chances of survival. The five-year relative survival rate overall is 97.1 percent, which is slightly down from the all-time high of 99.83 percent in 2007, according to a 2023 report.

This success rate is likely due to increased precision in diagnosis and treatment and decades of ongoing awareness campaigns targeting men in higher-risk groups for screening.

It's not entirely clear why the five-year relative survival rate has declined recently. Some clinicians and studies point to the United States Preventive Services Task Force (USPSTF) report several years ago that recommended ending all screening for prostate-specific antigen (PSA), a standard test for prostate health.

Some people believe the decline in PSA screening may have contributed to an uptick in men presenting with advanced prostate cancer. Many clinicians and medical societies have since pushed back against this recommendation.

"That's a hard bell to unring, but [the USPSTF] has backed off on that, and that's definitely not the mainstream recommendation," Miller said. "All the different organizations—the American Cancer Society (ACS), the Prostate Cancer Foundation (PCF), American Urological Association (AUA)—they all differ somewhat, but they definitely differ from not doing anything."

For example, in the AUA guidelines on prostate cancer screening, the top recommendation is to engage with the patient in "shared decision-making." The second guideline recommends clinicians use the PSA test as a first-line screening tool.

Recommended

• How Common Is Recurrent Prostate Cancer and How Is it Treated?: If the disease comes back, your treatment might depend on the initial therapy.
• Do More to Prevent Prostate Cancer: It's possible to reduce your risk of prostate cancer with minor lifestyle changes.
• Symptoms and Diagnosis of Prostate Cancer: How can you avoid prostate cancer? Understand the risk factors and screening options.

Inaccuracy #3

Testosterone replacement therapy (TRT) causes prostate cancer.

One concern for men seeking TRT has traditionally been the idea that boosting their testosterone might trigger prostate cancer growth.

You can see why this theory might make sense: Endogenous testosterone, the kind we make in our bodies naturally, is linked to the rate at which prostate cancer grows. One type of prostate cancer treatment is hormone therapy, which stops the body from producing testosterone.

The link between TRT and prostate cancer may not be so neat or direct and may even be non-existent, a 2020 study suggested.

"There is a common misconception that testosterone replacement therapy can cause prostate cancer or increase the risk of recurrence in men who have been treated for prostate cancer," said Amy Pearlman, M.D., a men's health specialist and co-founder of Prime Institute in Fort Lauderdale, Florida. "However, current research suggests that there is no clear evidence linking TRT to the development of prostate cancer or an increased risk of recurrence in those with a history of the disease.

"Men with a history of prostate cancer considering TRT should undergo thorough evaluation and monitoring to make informed decisions about the potential risks and benefits."

The takeaways

In a world plagued by TikTok and Instagram "doctors" recommending all kinds of wildly inaccurate and even dangerous medical information, people who want to begin by doing research on sexual health topics should stick with vetted sources. Don't let social media become your first and last stop in your search for knowledge.