Prostate cancer affects 1 in 8 men and, outside of skin cancer, is the most common cancer among men in the United States according to the American Cancer Society.

It’s also the second leading cause of cancer death among men in the United States.

So, when should you get screened for it? What testing is appropriate and when? Is it curable? Do all cases need to be treated?

“Prostate cancer is recognized as a highly curable and manageable disease, but being screened is key,” said Udit Singhal, M.D., a urologic oncologist from the University of Michigan Health Rogel Cancer Center. 

Singhal answers top prostate cancer questions below. 

When should you get screened for prostate cancer? 

Singhal: Prostate cancer screening should be based upon shared decision making between the patient and physician.

Prostate specific antigen, commonly known as PSA, is the preferred initial screening test and is recommended as a baseline test for those 45-50 years old. If you’re at an increased risk of developing prostate cancer, it’s recommended you be screened at age 40.

Common risk factors include Black ancestry, strong family history and known germline mutations. 

After initial screening, regular screening is usually thereafter every 2-4 years until age 70. 

How is prostate cancer diagnosed? 

Singhal: Prostate cancer is usually initially detected using screening tests, such as PSA. 

An elevation in PSA, however, is not definitive proof of the presence of prostate cancer, and additional testing, like a prostate MRI or prostate biopsy, is required.  

What concerns should you have if diagnosed with prostate cancer?  

Singhal: Prostate cancer is largely a slow growing disease, though some forms are more aggressive and have the potential for metastatic spread. 

The main concerns when diagnosed are determining the aggressiveness of the disease, whether it is localized or already metastatic, and whether treatment (and which treatment) is needed. 

How do you treat prostate cancer? 

Singhal: Treatments for prostate cancer depend on the stage, grade and presence of localized versus metastatic disease. 

There are multiple proven treatments for prostate cancer, but deciding which one is best for a given patient requires a detailed discussion with an expert. 

These treatments can include hormone therapy, radiation therapy, surgery (radical prostatectomy) or focal ablative therapies. 

Is prostate cancer curable? 

Singhal: Prostate cancer is the leading cancer-related diagnosis and the second leading cause of cancer-related death in American men. 

However, most prostate cancers are slow growing and unlikely to spread.  

When prostate cancer is lower risk, active surveillance is the preferred option.  

This approach involves closely monitoring the cancer without immediate treatment, thereby avoiding or delaying the side effects of treatment. 

What’s the latest in prostate cancer detection and treatment? 

Singhal: There are many ongoing advances in prostate cancer detection and treatment, and it’s a highly active area of research and study.  

There have been advances in prostate cancer early detection (using biomarkers other than, or in combination with, PSA), diagnosis (biopsy technique, ultrasound), imaging (PSMA-PET), surgical approach (single-port robotics), radiation delivery (proton beam therapy), focal therapies, targeted therapies, and prostate cancer genetics, which are all continually evolving the field and our knowledge on the area. 

Get more information on localized prostate cancer and metastatic disease. 

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