A look at prostate cancer

GLENN ELLIS | 3/26/2018, 7:31 p.m.
Dealing with the prostate is often the first significant experience many Black men have with the medical system. Typically, our ...
Top image shows the prostate and nearby organs: urethra, penis, testicle, bladder, lymph nodes, seminal vesicle, and rectum as labeled. Lower images is an inset providing a closer view of the prostate and nearby organs. – National Institute of Health

Strategies for Well-Being

Dealing with the prostate is often the first significant experience many Black men have with the medical system. Typically, our decisions on how to handle it are often grounded in fear or mistrust and tend to be made with little or no information.

When you hear the devastating news that you have cancer of the prostate, a small gland the size of a plum found in men below the bladder, it can be difficult to decide which of many treatment options are right for you. But the choice is vital: The prostate is responsible for making 10–30 percent of a man’s semen and is involved in sexual performance and urination. When it malfunctions, it can cause a variety of health problems, from infection to severe back pain. The worst is prostate cancer.

Each treatment – from hormone therapy to radiation to surgery/outright removal – has a different set of benefits and risks. Yet because men panic and do what the diagnosing doctor says, many will think of questions to ask only after they’ve already undergone a treatment and are dealing with its side effects. By then it is usually too late to pursue a different strategy.

Men also act out of another fear: impotence. They may do whatever the doctor says because they fear that if they don’t, the condition will keep them from getting an erection. But prostate disease doesn’t cause impotence – the treatments do.

Unlike many other cancers, prostate cancer generally progresses relatively slowly. More men die with prostate cancer than of it because some tumors are small and grow very slowly, never endangering the man’s life. In fact, according to the National Cancer Institute, almost every man diagnosed with lung cancer dies of it, but only 226 out of every 100,000 men over the age of 65 with prostate cancer die of prostate cancer.

For most men diagnosed with prostate cancer, the cancer is found while it's still at an early stage – it's small and has not spread beyond the prostate gland. These men often have several treatment options to consider.

Not every man with prostate cancer needs to be treated right away. If you have early-stage prostate cancer, there are many factors such as your age and general health, and the likelihood that the cancer will cause problems for you to consider before deciding what to do.

If you're older or have other serious health problems and your cancer is slow growing (low-grade), you might find it helpful to think of prostate cancer as a chronic disease that will probably not lead to your death but may cause symptoms you want to avoid. You may be more inclined to consider watchful waiting or active surveillance, and less inclined to consider treatments that are likely to cause major side effects, such as radiation and surgery. Of course, age itself is not necessarily the best basis on which to make your choice. Many men are in good mental and physical shape at age 70, while some younger men may not be as healthy.