Advanced Prostate Cancer Cases On The Rise After Years Of Decline

Authored by Cara Michelle Miller via The Epoch Times (emphasis ours),

U.S. Defense Secretary Lloyd Austin was recently diagnosed and is being treated for prostate cancer. He is one of the nearly 290,000 American men who will be diagnosed with the condition this year.

Nearly all types of cancer have become less deadly over the last 30 years, with one notable exception: advanced-stage prostate cancer, according to a recent report from the American Cancer Society (ACS).

“We have had more men diagnosed with more advanced prostate cancer over the last decade,” Dr. Sam S. Chang, the Chief Surgical Officer at the Vanderbilt Ingram Cancer Center, told The Epoch Times in an email. “The good news, many men with prostate cancer can be monitored safely and never require treatment.”

Survival Rates Are High, But Concerns Grow Over Advanced Cases

One in eight men will be diagnosed with prostate cancer—the second leading cause of cancer death among men in the U.S. after lung cancer—in their lifetime, according to ACS.

While concerning, the vast majority do not die from it. In fact, this type of cancer has one of the highest survival rates. The 5-year relative survival rate, which refers to the percentage of people with a prostate cancer who will still be alive five years after diagnosis, compared to people without that cancer, is over 90 percent.

However, advanced prostate cancer rates, after declining for decades, are rising again.

The Debate Around PSA Screenings for Prostate Cancer

Overall prostate cancer rates grew 3 percent annually between 2014-2019, per the ACS report. Meanwhile, advanced cases have increased 4-5 percent yearly since 2011, likely due to decreased screenings, according to Dr. Chan.

“The American Urology Association (AUA) guidelines recommend screening people for prostate cancer through bloodwork, which is obtained with a prostate-specific antigen (PSA) test,” Dr. Adnan Dervishi, a urologist with Ascension Saint Thomas Hospital specializing in urologic cancers, told The Epoch Times. Elevated PSA levels can be an indicator of potential prostate cancer. A “biopsy is needed to look at specimens under a microscope to get an accurate diagnosis,” he added.

In the past, PSA screenings posed health risks, yielding false positives or prompting unnecessary, potentially harmful procedures. This is why, in 2008 the U.S. Preventive Service Task Force advised against routine PSA testing for men 70 years and older.

False positives are when the test indicates high PSA levels, but there is no prostate cancer. Because some men with prostate cancer live for decades without any problems, there are concerns about over treatment. Cancer treatments, like surgery or radiation, may result in other health issues, including loss of bladder and bowel control, and erectile dysfunction.

“My standard practice is to recommend getting an MRI prior to proceeding with a biopsy,”  Dr. Dervishi said. “It is more comprehensive.” A 2017 study in The Lancet suggests that 27 percent of men at low risk who get a prostate MRI may be able to avoid a biopsy.

Still, screenings can prevent advanced disease and death, which is why the AUA recommends them for men ages 55-69 on a case-by-case basis.

Researchers attribute rising advanced cancer rates to multiple factors, including improved diagnostic tools, more screenings, an expanding and aging population.

Risk of Developing Prostate Cancer

The risk factors for developing prostate cancer vary based on a man’s age and ethnicity. For example, men with obesity, older men, and African American men, as well as Caribbean men of African ancestry, are more prone to prostate cancer. Men of this ethnic background have a 70 percent higher likelihood of developing prostate cancer compared to white men.

The National Comprehensive Cancer Network recommends that patients in this higher risk ethnic group or anyone with a family history of prostate cancer receive bloodwork testing beginning at age 40.

The risk of prostate cancer starts to increase significantly after the age of 55 and reaches its highest point between the ages of 70 and 74. Prostate cancer is still rare in men under 40. The average age for a first diagnosis is about 67.

With patients who are categorized as low-risk prostate cancer, doctors use a wait and see approach called “active surveillance.” It delays treatment until there are indications that the cancer has progressed.

What to Know About Prostate Health

The prostate, a small walnut-sized gland in the male reproductive system situated below the bladder, surrounds the urethra—the tube carrying urine from the bladder. With age, the prostate may enlarge, exerting pressure on the urethra and causing a slower urine flow. This “benign enlargement of the prostate is very common and results in urinary symptoms such as hesitance, frequency, nocturia (waking up at night to void) and urgency to void,” Dr. Chan said.

The most prevalent form of prostate cancer is adenocarcinoma, where cells in the gland lining grow uncontrollably, Dr. Chan added. Prostate cancer often goes unnoticed in its early stages, lacking symptoms. Currently, an estimated 2.9 million men are living with prostate cancer.

At later stages, prostate cancer can obstruct the kidneys and the bladder. Advanced prostate cancer spreads to the bone which can be very painful and even cause bone fractures, Dr. Chan noted.

When symptoms are serious, surgery is recommended to remove the section of prostate tissue causing the most harm. However, he stresses that while “many men live without sequala (complications that exist from a pre-existing illness) it is important to remember that there is no cure for prostate cancer once it has become metastatic and spread to the bones.”

While there are no clinically proven dietary methods to reduce prostate cancer risk, men from Asian countries exhibit lower incidences compared to their Western counterparts—attributed to genetic and dietary differences, according to some research.

Natural Ways to Keep the Prostate Healthy

Some scientific evidence has shown several natural methods for maintaining prostate health, promoting overall well-being, and preventing potential complications.

Eat a nutritious diet

Eating nutritious foods with healthy fats, antioxidants, and good quality proteins is beneficial for one’s overall health. In a 2009 study, scientists found that consuming a diet high in omega-3 fatty acids (found in salmon, nuts and plant-based oils) was associated with a decreased risk of aggressive prostate cancer.

Additionally, studies indicate that regular consumption of lycopene, an antioxidant found in tomato and watermelon, can contribute to lowering the risk of prostate cancer.

Maintain vitamin D levels

Some studies have shown that vitamin D may be effective with more aggressive forms of prostate cancer.

Vitamin D plays a role in regulating cell growth and preventing the formation of abnormal cells. Adequate levels of vitamin D may help control the growth of prostate cells, reducing the risk of cancer.

Exercise regularly

A sedentary lifestyle, such as prolonged periods spent working at a computer, can be detrimental and may contribute to inflammation in the prostate. To counteract this, incorporating regular exercise is essential to mitigate the negative effects of extended sitting.