Please Stop Believing These 7 Prostate Cancer Treatment Inaccuracies
Prostate cancer is one of the most prevalent cancers in the United States. The disease will affect about 1 in every 8 American men at some point, according to the American Cancer Society (ACS).
Myths and misconceptions about the disease, and its treatment, are about as pervasive as the condition itself. Receiving a cancer diagnosis of any kind is sure to provoke a whirlwind of emotions, but misinformation, whether it comes from well-meaning family members or social media, may make feelings of fear and anxiety worse.
However, knowing the facts about the condition and your options may help you feel more in control of your prostate cancer treatment.
Only older men get prostate cancer
Prostate cancer is more common in older men and rare in those under 40, true, but it's critical to keep in mind that about 4 in 10 diagnoses occur in men younger than 65, per the ACS, and 10 percent occur in men younger than 55, according to research published in Current Urology.
The misconception that it's an "old man's disease" can lead younger guys to put off screenings and delay diagnoses, said Scott Miller, M.D., the medical director at Wellstar Urology in Alpharetta, Georgia.
He added the disease has been trending younger over the last decade, although the reason for that is unclear.
"This could be due to evolving methods of detection," he said. "Other possible explanations include increasing exposure to environmental toxins and viruses."
Research has also found that early-onset prostate cancer has a more significant genetic component. Because of this, men with a family history of the disease should begin screenings younger than the recommended age of 50, according to the ACS.
Screenings are particularly crucial because prostate cancer is often asymptomatic, even in its later stages, explained Marilin Nicholson, M.D., a urologist at GenesisCare in Bradenton, Florida.People often put off going to the doctor until there are clear signs of trouble, such as changes in urination or pain. But such symptoms are more likely to arise as cancer progresses, Nicholson said.
Radiation will affect way more than my prostate
Any exposure to radiation carries some risk of side effects. However, thanks to advances in medical technology, doctors can precisely target cancerous cells while minimizing the risk to surrounding tissues.
Research shows that prostate cancer radiotherapy is unlikely to contribute to secondary cancers, and the overall risk of permanent complications is less than 5 percent, according to the Prostate Cancer Foundation.
Medications and lifestyle modifications can relieve temporary side effects such as nausea, fatigue, constipation and erectile dysfunction. Although they're uncommon, if you experience long-term complications, a doctor may recommend treatments such as physical therapy, medication, dietary changes or surgery.
Immediate treatment is mandatory
Some forms of prostate cancer progress very slowly and don't produce any symptoms. In these instances, the potential complications of treatment may outweigh the benefits, and a doctor might not recommend treatment immediately, or at all.
Instead, they might recommend active surveillance, or a "wait and see" approach, with regularly scheduled tests. Typically, doctors recommend treatment for young patients and those with fast-growing or metastatic cancers.
"Active surveillance is a conservative management approach used for men with low-risk prostate cancer with a goal of avoiding long-term adverse side effects," said Judith Paller, M.D., the director of prostate cancer clinical research and an associate professor of oncology at Johns Hopkins Medicine in Baltimore and Washington, D.C. "This approach focuses on quality of life and avoids overtreatment or treating a cancer that might not cause symptoms or death."
Surgery is the only treatment option
There are several ways to treat prostate cancer, and many patients may not need any treatment, according to John Sylvester, M.D., a radiation oncologist at GenesisCare in Bradenton, Florida.
Some hormone therapies block testosterone production and slow prostate tumor growth, for example, and anti-androgen drugs block a specific receptor that helps testosterone bind to prostate cancer cells.
"These therapies are usually used along with radiation therapy to improve survival and cure rates in high-risk patients," Sylvester said. "For more advanced prostate cancer, such as metastatic prostate cancer, chemotherapy is an option to destroy cancer cells as they spread beyond the prostate. As far as radiation therapies, there are a variety of advanced techniques designed to deliver highly targeted, effective treatment with minimal side effects."
Commonly used radiation therapies include external-beam radiation, brachytherapy, proton therapy, intensity-modulated radiation therapy, stereotactic body radiation therapy or stereotactic ablative radiation therapy, and radium 223 therapy, according to Johns Hopkins Medicine.
Miller and Sylvester said determining the best treatment depends on factors such as if the cancer has spread, how aggressive it is and the patient's overall health.
If I opt for noninvasive treatment now, I'll need invasive treatment later
Not everyone with prostate cancer needs to go under the knife. Noninvasive treatments, including external radiation and brachytherapy, are about as equally effective as surgery in curing early-stage prostate cancers, according to the ACS.
This is why regular screenings are essential. Any cancer has a chance of recurrence, which could necessitate more aggressive treatment. About 20 percent to 30 percent of men experience recurrence, and it is most likely in people with extensive and aggressive forms of the disease, according to Johns Hopkins Medicine.
No matter how they treat it, I'll experience ED
Both surgery and radiation have the potential to cause erectile dysfunction because the nerves responsible for erections are very close to the prostate, said Miller and Mohamad Allaf, M.D., the urologist-in-chief and a professor of urology at The Johns Hopkins Hospital in Baltimore.
However, it's far from inevitable.
"In most cases, these nerves can be spared," Miller explained. "Early rehabilitation with oral medications and other nonsurgical treatments are essential to maintain and restore function as deemed necessary. In men with good pre-treatment erectile function, the prognosis is usually good. However, in men with more extensive or aggressive disease, the risk of dysfunction is higher. When pills don't work, other medications and devices are available to allow a return to intimacy."
Prostate cancer surgery always causes incontinence
Incontinence can occur with prostate cancer treatment because men have two mechanisms to control urine flow: an external sphincter and an internal one within the prostate gland, according to Allaf. Any damage or removal of these structures, he said, could produce permanent incontinence. But that's rare, particularly when working with an experienced surgeon.
When incontinence occurs after treatment, it's usually temporary; if it persists, exercises to strengthen the pelvic floor may help. Miller said corrective surgery is an option for the few who experience more severe urinary incontinence.
Are you nearing the age at which you should begin prostate cancer screenings but you've managed to put off regular visits to a doctor? It's easier than it used to be to find a healthcare professional and begin a beneficial relationship. Many providers have added telephone and video visits to their practices, so the initial appointment takes less effort and is less intimidating.
Giddy telehealth makes it easy to get connected to qualified doctors, therapists and other professionals, many of whom offer same-day appointments and affordable rates.