Prostate cancer has emerged as the most frequently diagnosed cancer among men, following skin cancer. This disease affects approximately 1 in 8 men over their lifetime. The prostate, a small gland about the size of a walnut located below the bladder and in front of the rectum, plays a crucial role in producing seminal fluid. As the urethra passes through the prostate, any changes in this gland can significantly impact a man’s health.
Age stands out as a primary risk factor for prostate cancer, with the chances of developing the illness increasing significantly as men grow older. According to the American Cancer Society, around 60% of new prostate cancer cases are diagnosed in men aged 65 and older, with the average diagnosis occurring at age 66. While prostate cancer is uncommon in men under 40, the risk escalates sharply after 50. By the age of 80, nearly 60% of men may develop prostate cancer.
Family history and genetic predispositions also contribute to the likelihood of developing this disease. Men with a father, brother, or son diagnosed with prostate cancer face a risk that is two to three times higher than those without such a family history. Consequently, medical professionals often recommend that men with a family history begin screening as early as ages 40 to 45.
Race and ethnicity further influence prostate cancer risk. African American men are particularly vulnerable, being 1.7 times more likely to be diagnosed and 2.1 times more likely to succumb to the disease compared to non-Hispanic white men. Regions such as the U.S. and the Caribbean report the highest incidence of prostate cancer globally among Black men.
While screenings can detect most prostate cancers early, many men opt out of regular testing. Recognizing the signs and symptoms of prostate cancer is vital, even in the absence of screening. Early-stage prostate cancer may not present any noticeable symptoms, but as the disease advances, symptoms can include difficulties with urination and the presence of blood in urine or semen.
A Prostate-Specific Antigen (PSA) blood test is commonly used to identify prostate cancer. PSA is a protein produced by both normal and cancerous prostate cells, with elevated levels in the blood indicating a higher probability of cancer. However, no definitive PSA cutoff exists to confirm or rule out the disease.
If screening tests suggest the possibility of prostate cancer, further diagnostics are necessary. The definitive diagnosis is made through a prostate biopsy, which involves extracting tissue samples for laboratory analysis. Pathologists examine these samples under a microscope, assigning a grade based on the appearance of the cancerous cells. The traditional Gleason Score, developed by Dr. Donald Gleason in the 1960s, categorizes cancer cells on a scale from 1 to 5, with the lowest scores resembling normal tissue. Today, pathologists typically focus on grades 3 to 5 to determine the Gleason score, which can range from 6 to 10. Lower Gleason scores indicate less aggressive cancer, while higher scores suggest a more severe form of the disease.
Understanding the stage of prostate cancer is crucial for developing an effective treatment plan. Stage 1 cancer is confined to the prostate and typically features a Gleason score of 6 or lower, with PSA levels under 9. Stage 2 remains localized but has a higher Gleason score of 7 or above and PSA levels between 10 and 20. At Stage 3, cancer may still be limited to the prostate, though PSA levels reach 20 or higher. Conversely, Stage 4 signifies a spread to nearby lymph nodes, adjacent tissues, or distant organs, with PSA levels and Gleason scores varying widely.
The determination of cancer stage significantly influences treatment options, which may include surgery, radiation therapy, hormone therapy, chemotherapy, targeted therapy, or immunotherapy. Factors such as cancer size, spread, growth rate, and the patient’s overall health and preferences guide doctors in crafting a tailored treatment approach.
Despite the severity of prostate cancer, the survival rates remain promising. The disease typically grows slowly and responds well to treatment. According to the American Cancer Society, the five-year survival rate for localized prostate cancer is nearly 100%, while those diagnosed at more advanced stages face a survival rate of approximately 32%.
In recent news, former President Joe Biden is undergoing treatment for an aggressive form of prostate cancer. Announced in May 2025, Biden’s diagnosis included a high Gleason score of 9 and confirmed metastasis to his bones. Currently, he is receiving radiation and hormone therapy in Philadelphia.
As awareness of prostate cancer continues to grow, understanding the risks, symptoms, and treatment options remains essential for early detection and effective management of the disease.
