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The prostate is a small walnut shaped gland in males that is located below the bladder and in front of the rectum. Its purpose is to secrete a fluid that is mixed with semen and is responsible for keeping the sperm in tip-top shape. This is important for conception and pregnancy. Most men rarely think of this gland.
September is Prostate Cancer Awareness Month. Prostate cancer unfortunately is a disease that we see all too commonly. The American Cancer Society estimates that 333,830 new cases of prostate cancer will be diagnosed in this country this year of 2026. They also predict that in 2026, 36,320 men that will die from prostate cancer. The goal of this awareness month is to highlight prostate cancer risks and urge men to take an active role in scheduling regular screenings.
Most times there are no symptoms, especially in early prostate cancer. This is why surveillance is so important. As the cancer progresses one may start to see symptoms. This may begin as a frequent and sometimes urgent need to urinate, especially at night. There may also be changes in urine flow which may manifest as a so-called weak stream or flow with a start and stop manner. Some men may experience pain or discomfort with urination.
We can see the symptoms escalating as the cancer is growing such as a loss of bladder control, loss of bowel control, painful ejaculation, blood in semen or even pain in the lower back, hip or chest.
Most prostate cancers grow slowly and are highly treatable when caught early and the cancer has not spread beyond the prostate. But surveillance is a must.
As one gets older, the chances of developing prostate cancer are greater, with the majority of these cancers diagnosed after age 65.
There is a higher incidence of prostate cancer in men who are Black or of African descent. Also, we see more aggressive cancers in this group of men so surveillance is a must.
If you have a family history of prostate cancer, it’s important to be aggressive in your surveillance as this increases your chances of the disease.
Testing is your friend and may save your life. I tend to be on the aggressive side and feel that all men should start testing at age 40. The screening often includes both a PSA blood test and the widely dreaded—but quick—digital rectal exam. A prostate-specific antigen (PSA) blood test measures a protein produced by the prostate gland. While elevated levels can indicate prostate cancer, they may also stem from noncancerous conditions like infection or an enlarged prostate.
This test must be interpreted with your healthcare provider. This test should be done minimally every year. You are looking to see what the number is and also the rate of increase in this number. If there are questions, an MRI or ultrasound may be done to provide clarity. If there is a high suspicion that this is cancer, a biopsy should be conducted to definitively get the answer.
There is disagreement from my point of view when testing should be stopped. For most of my patients it is forever though some of the recommendations are age 70.
Prostate cancer, in most cases if caught early, is a highly treatable disease. The stigma comes with the fear of loss of sexual ability by some men and thus they often ignore the need to even test or refuse treatment.
If caught early and still inside the prostate, options for treatment include Xray beam radioactive seeds, or removal of the prostate using robotics or by a physician who is a urologist.
If the cancer has spread outside the prostate, here again, there is good treatment such as chemotherapy, hormonal therapy, therapy targeted to the immune system and genetic therapy. There are other newer therapies that include using cold, photo therapy or even laser therapy. Each therapy and its possible side effects will be weighed out with the patient and his healthcare provider to find the therapy that is best for him.
Know your family history as far as prostate cancer is concerned. If positive, start to test early and every year. Be intentional with prostate cancer prevention.
Dr. Veita Bland is a board-certified Greensboro physician and hypertension specialist. Dr. Bland’s radio show, “It’s a Matter of Your Health,” can be heard live on Wednesdays, 5:30 p.m. on N.C. A&T State University’s WNAA, 90.1 FM. Listeners may call in and ask questions. The show is replayed on Sirius 142 at 5 p.m. on Wed. Email Dr. Bland at ideas@blandclinicpa.com.
