Every year, over 300,000 men are diagnosed with prostate cancer in the U.S., and more than 35,000 die from the disease, making it the second-deadliest cancer in men.

If caught early, the disease is highly treatable, but patients rarely experience symptoms in the early stages—which is why screening is so important.

However, 80% of Americans are unaware that early-stage prostate cancer often shows no symptoms, according to a recent survey commissioned by The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).

“This is, unfortunately, not surprising,” Jairam Eswara, MD, chair of urology at Tufts Medical Center, told Health. “It is really important for everyone to realize that prostate cancer is asymptomatic until late stages, and that almost no one who has early-stage prostate cancer has any symptoms at all.”

The purpose of the survey, according to Edmund Folefac, MD, medical oncologist at the OSUCCC – James, was to “gauge Americans’ awareness of the signs and symptoms of prostate cancer,” which can inform experts about the need for disease education.

“The more men are aware of and open about their health concerns, the better,” said Folefac.

In early August, research firm SSRS surveyed 1,004 adults aged 18 and older in the U.S. and weighted the data to represent the general population of American adults.

Results showed that 80% of respondents don’t know that early-stage prostate cancer often presents with no physical symptoms.

The survey also revealed that:

  • 59% didn’t realize that sexual dysfunction can be a sign of prostate cancer.
  • Black adults were more likely to identify some of the lesser-known symptoms of prostate cancer, like fatigue (33% of Black adults vs. 24% of white adults) and weight loss (30% vs. 20%).
  • Black adults were less likely than other racial/ethnic groups to identify that early-stage prostate cancer often has no symptoms (12% vs. 21%).

In the early stages of prostate cancer, the disease is generally confined to the prostate, so the tumor does not block or compress any nearby organs—nor cause any symptoms, Eswara explained.

“Because it is deep within your body, it is not easy to determine whether someone has prostate cancer or not,” he added. Screening typically involves a blood test or rectal exam.

The absence of symptoms makes healthcare providers worry: “[It] causes people to think they are not at risk for prostate cancer when, in fact, they are, therefore leading to reluctance to get screened,” said Eswara.

Though most men do not show symptoms of prostate cancer, there are some signs to watch for which can indicate later stages of disease, including:

  • Difficulty starting urination.
  • Weak or interrupted flow of urine.
  • Urinating often, especially at night.
  • Trouble emptying the bladder completely.
  • Pain or burning during urination.
  • Blood in the urine or semen.
  • Pain in the back, hips, or pelvis that doesn’t go away.
  • Painful ejaculation.

Many of these symptoms, however, may also be caused by conditions other than prostate cancer.

According to the American Cancer Society, men should consider prostate cancer screening starting at age:

  • 50, if they have an average risk of the disease.
  • 45, if they are African American or have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than 65).
  • 40, if they have more than one first-degree relative who had prostate cancer at an early age.

However, there is no blanket screening recommendation. Patients should talk to their healthcare providers about their individual risk for the disease and the potential benefits and risks of screening.

Eswara said men may put off screening because of fears about the procedure or actually having prostate cancer—but given the lack of symptoms, screening is “critical.”

“I would strongly encourage anyone with a prostate to talk to their doctors about prostate cancer screening,” he said. “This is a quick, painless process that could potentially save their life and impact their family.”



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