Ask a man about prostate cancer and most likely there will be awkward silence or a few wisecrack or random remarks on a vague notion of what it is.  September is Prostate Cancer Awareness Month and one way to get men talking about this second leading cause of cancer death in American men is to tell them what they think they know about this disease may be wrong.  When men have preconceived notions or misconceptions on this deadly disease, it does have an impact on a disease that is estimated to claim the lives of more than 26,000 men in the U.S. this year.

Misconception #1: Only old men get prostate cancer

Prostate cancer does mainly occur in older men with the average age at the time of diagnosis around age 66.  The old saying goes “if a man lives long enough, he will develop prostate cancer.” Yet, 1 in 38 men between ages 40 and 59, will develop prostate cancer. For the year 2016, it is estimated 180,890 new cases of prostate cancer will be diagnosed with 35% of those diagnosed or more than 76,000 will be under the age of 60.

Prostate cancer can and does develop in younger men and when it does, it is often more aggressive and deadly.

Misconception #2:  No symptoms means no prostate cancer

We all want to believe that being symptom free automatically means cancer free but prostate cancer can be one of the most asymptomatic cancers out there.  Not all men experience symptoms and if they do they can vary from man to man. 

Common symptoms include frequent urination, difficulty starting or stopping urination, weak or interrupted flow of urination, painful or burning sensation while urinating, erectile dysfunction, painful ejaculation, blood in the urine or semen, or frequent pain and stiffness in the lower back, hips or upper thighs.  Any of these symptoms a man is experiencing needs to see his doctor right away.

Misconception #3: Prostate cancer grows so slow so I don’t need to worry about it

It depends.  Prostate cancer is often slow growing but then it can also be very aggressive and more likely to spread or metastasize.  The only way to tell is to do a biopsy of the prostate gland to confirm the presence of cancer and to determine the potential aggressiveness of it. 

Based on the findings from a biopsy, a doctor will decide the recommendation for treatment based on many factors including a patient’s age and health status.  Each man’s prostate cancer is different and a one size fits all approach is not appropriate for each case. 

The good news is there are several options a doctor can base his decision on for the best treatment method resulting in the very best outcome for each individual man. 

Misconception #4:  No man in my family has ever had prostate cancer so I don’t need to worry about it

It is true that a man’s odds of being diagnosed with prostate cancer doubles if he has a close relative such as his father or a brother who had prostate cancerand the risk further increases if the cancer was diagnosed in a family member less than 55 years of age or if it affected three or more family members.

But the fact remains that 1 out of 6 American men will be diagnosed with prostate cancer in their lifetime.  Compare this to women who have a 1 in 8 chance of being diagnosed with breast cancer.  Men who are African American are 60% more likely to be diagnosed with this disease and 2.4 times more likely to die from it.

Misconception #5: Vasectomies cause prostate cancer

At one time it was thought that vasectomies increased a man’s risk of prostate cancer.  Now it is known through research that a man who has had a vasectomy is not at an increased risk of developing prostate nor is it linked with its development.

Misconception #6:  A high PSA test always means prostate cancer

The PSA (prostate specific antigen (PSA) test is used primarily to screen for prostate cancer.  The test measures the amount of PSA which is a protein produced by cells of the prostate gland.  It is true a low PSA number– usually 4 nanograms per milliliter of blood or less - is considered good and suggests that a man does not have prostate cancer.

But having a higher PSA does not automatically mean it is always prostate cancer as there are many factors that can influence PSA and a single test is not enough to diagnosis prostate cancer.   Other factors that can raise PSA number is benign prostatic hyperplasia or an enlarged prostate, a common condition affecting men as they age, or it could be due to swelling of the prostate gland, a urinary tract infection, prostatitis, age, and even recent ejaculation. 

If the PSA is elevated, your doctor will want to do further investigation of what the determining cause is. 

Misconception #7:  Impotence or urinary incontinence always occur with prostate cancer treatment

Impotence or erectile dysfunction and urinary incontinence can occur after surgery and radiation treatments for prostate cancer but it is not true for all men as it depend on a man’s age and physical condition at the time of diagnosis and treatment.

It is imperative that a man chooses a highly qualified and skilled doctor inquiring them of their outcome’s for these conditions as well as the number of surgical procedures they have performed.

Misconception #8: Sex increases the risk of developing prostate cancer

This one is not true.  There was a time when it was believed that frequent ejaculations were linked to prostate cancer.  Studies have debunked this belief by showing that men who report frequent ejaculations – up to 21 times a month or more – appear to have a lower risk of developing prostate cancer. 

It is not completely understood why frequent ejaculation seems to have this protective effect but one theory is that the prostate accumulates carcinogens or other harmful substances which are maybe eliminated during ejaculation.