Incidence of Prostate Cancer
According to the National Cancer Institute (NCI), approximately 191,930 men in the United States will be diagnosed with prostate cancer in 2020. This accounts for over 20% of all new cancer cases in men and makes it the most common cancer to affect men. It is estimated that approximately 1 in 9 men will be diagnosed with prostate cancer at some point during their lifetime.
Importantly, prostate cancer is actually much higher than these rates reflect. Studies of men who passed away from other causes suggest that cancers are commonly found at very high rates. A man aged 60-70 has as high as a 60% chance of having prostate cancer in the prostate; most are quite small and slow-growing. Men in their 80's may have a 70-80% chance of having similar cancer. By contrast, about 2-3% of men in the U.S. die from prostate cancer, demonstrating that a small fraction of cancers will cause harm.
Survival Rates with Early Diagnosis
With early diagnosis of prostate cancer, the 5-year survival rate exceeds 99%. Unfortunately, without screening, as prostate cancer rarely has any symptoms to indicate its presence, the first symptoms to develop are usually after spread of the disease has occurred. When such spread occurs, most commonly to bones, the five-year survival drops to 30%. It is for this reason that many experts agree on the importance of early diagnosis of the disease.
Assessing the Long-Term Cancer Risk
Because the majority of prostate cancer cases progress slowly, many prostate cancers don't need immediate treatment. To help doctors assess how aggressively to treat your newly diagnosed prostate cancer, they need to assess the risk. They do this by categorizing the tumors into three general risk groups based on the amount of cancer present, prostate-specific antigen (PSA) blood test results, and prostate biopsy findings. Tumors are often categorized as "low-risk", "intermediate-risk" or "high-risk".
Treating Localized Prostate Cancer
Although localized prostate cancer has a very high chance of being cured with treatment, traditional treatments have risks of complications or side effects. Because of the range of risk of different types of cancer, treatment recommendations are tailored to the cancer risk and to the medical condition and priorities of the patient. There are three traditional approaches to treating localized prostate cancer: active surveillance, surgery and radiation therapy.