Originally published in the Norwich Bulletin

Prostate cancer is the most common cancer among men in the United States, with about one in seven receiving the diagnosis in his lifetime. The good news is that in most cases prostate cancer is highly treatable – but early detection and treatment are key to a positive outcome.

The five-year relative survival rate for men diagnosed with prostate cancer that hasn’t yet spread to distant parts of the body is nearly 100%. However if the cancer advances to stage four and spreads beyond the pelvic region, that survival rate drops to just 29%. That’s why it’s so important that all men know what symptoms to look for. 

Early prostate cancer often causes no symptoms, but as the cancer enlarges and begins to press on nearby organs some of the more common symptoms can include: a weak stream when urinating; the need to urinate more frequently (especially at night); loss of bladder or bowel control; blood in the urine or semen; and erectile dysfunction. Other symptoms that may appear as the cancer spreads, which you may not immediately associate with prostate cancer, include weakness or numbness in the legs and feet as well as hip, back or rib pain.

If you experience any of these symptoms you should see your primary care provider immediately for an evaluation. But what if you don’t have symptoms? Should you be screened at your annual physical in order to catch the disease as early as possible? Well, that depends.

Screening for prostate cancer includes a digital rectal exam as well as a blood test that measures the amount of prostate-specific antigen (PSA) in the blood. If either of these tests finds an abnormality, further testing can be done to determine if cancer is present. 

However it is controversial whether or not screening for prostate cancer in men with no symptoms is beneficial. Many cases of prostate cancer are not aggressive enough to require treatment. Screening asymptomatic men often leads to detection and treatment of cancers that may never have caused a problem, in that case the risks of treatment outweigh the benefits. For that reason, there are differing opinions in the medical field about whether or not screening is always necessary.

Ultimately, the decision to get screened or not is a personal one that should be made based on your own risk factors and discussion with your doctor. The risk of developing prostate cancer is greater for men who are over 50 years old, African American men and those with a family history of prostate cancer or breast cancer, among other factors. The impact of environmental or behavioral contributors is less clear, but may include a diet heavy in red meat or fat, obesity, smoking and exposure to certain chemicals.

The bottom line is that while it’s not possible to ensure prevention of prostate cancer, it IS possible to ensure excellent odds of a full recovery by knowing the symptoms and being quick to have them evaluated if they occur.

Dr. Richard Wilcon is an Internal Medicine physician with Day Kimball Medical Group and medical director of the Hospitalist program at Day Kimball Hospital.