Setting Aside Prostate Cancer Myths

Although more men are being cured of prostate cancer and more cases are being found in younger men, myths about the disease continue. Learn the truth.

 

Myth #1: Men die with prostate cancer and not because of it.
Reality:
While one man in six will get prostate cancer during his lifetime, only one in 35 will die from it. Most end up dying of other causes. Although men with less aggressive forms of prostate cancer may live with the disease for years, it is still the second-leading cause of cancer death in men.

Many of the 200,000-plus cases of prostate cancer diagnosed in the U.S. this year will be aggressive and will cause serious illness.

Myth #2: Screening isn't worth the trouble because doctors can't agree on how useful it is.
Reality:
The goal of prostate cancer screening is to find the disease early, when it can be treated more effectively. There are two types of prostate screening tests: the PSA blood test and the digital rectal exam (DRE). Doctors agree that both should be used together to get the most information. Medical experts disagree, though, on whether all men should be screened for prostate cancer. This is because the screening tests are not precise.

For example, tests results can come back positive in a person who may have an enlarged prostate due to a benign (noncancerous) condition called prostatic hypertrophy. Evidence has even shown that screening can be harmful, leading to unneeded surgery and associated side effects, like erectile dysfunction. But screening can also save lives, especially if an aggressive form of prostate cancer is found. Experts do agree that every man should make his own decision about prostate screening together with his doctor.

The American Cancer Society recommends that doctors discuss prostate cancer screening options with you starting at age 50. If you have a close relative (father, brother or son) with prostate cancer, or if you are African American, this talk should start at age 45. The U.S. Preventive Services Task Force (USPSTF) states that there needs to be more evidence to help doctors and patients know when and what type of screening is best. They do not advise screening in men who are age 75 or older. The bottom line is that you and your doctor should decide whether or not screening is right for you.

Myth #3: All men have erectile dysfunction after prostatectomy.
Reality:
Prostatectomy is the removal of a cancerous prostate gland. The procedure can damage nerves that control erections. During the first few months after surgery, most men have some degree of erectile dysfunction (ED). Whether ED lasts longer depends on your age, extent of the cancer, your erectile function before surgery and the type of surgery you have.

A nerve-sparing prostatectomy is an option that may reduce the chances of ED. Medications or penile injections or devices can help restore erectile function for many men if needed.

Myth #4: All men have incontinence after prostate cancer surgery.
Reality:
Urinary incontinence (not being able to control urination) is one of the major side effects of prostate cancer surgery. For most men, it goes away weeks to months after surgery. One large study reports that five years after prostate surgery, about one third of men still have some stress incontinence. This means that urine can leak out when you cough, exercise, laugh or sneeze. Leaking was considered severe in only about 5 percent of these cases.

Large cancer treatment centers and doctors who perform a lot of prostate cancer surgery report lower rates of incontinence.