I’m writing as a semi retired (pediatric) oncologist
I think that the statement that prostate cancer is common is true but misleading
The truth is that cancer in any organ or tissue is inevitable as part of human aging, and so almost every old folk has some cancer somewhere in his/her body
but no need to worry, as most of these cancers are silent, meaning that most do not cause any symptoms or harm to the body - they are just there, either not growing or growing very slowly, and not spreading to other organs
This is contrary to most people’s idea of cancer as ravenous creatures - grow fast, eating up our bodies relentlessly . It’s not really so
They are not easily detected, partly because they are so small (often microscopic) , asymptomatic, partly because there are no easy, cheap and convenient tests to detect small amounts of such cancers
I am 75 years old now and I am sure that there are small amounts of cancer in many organs in my body, but which remain undetected.
That’s OK
Now back to prostate cancer
The issue is rather that prostate cancers are detected more commonly than other cancers for two main reasons
1 The prostate gland surrounds the urethra, which is a very narrow passage, and so it is easily obstructed by an enlarged prostate (either due to prostate cancer or benign prostate hyperplasia)
So the patient would complain of difficulty in passing urine etc
2 There is a cheap, convenience test for prostate cancer - the PSA, which is often done as routine screening for prostate cancer in elderly men
Unfortunately, the test is rather nonspecific and raised level can be due to other things than prostate cancer
This test has caused a lot of unnecessary problems for older folks, resulting in unnecessary anxiety, unnecessary investigations , some of which can be rather traumatic, for example, biopsies or even resections and also unnecessary treatment whether it is surgery, Radiotherapy or medications (which often have rather terrible side effects).
When I was admitted to the hospital recently for treatment of an ankle fracture, my orthopedic surgeon did some investigations (ECG, blood tests to quantitate levels of “cardiac enzymes” to make sure that my heart is in a good state, which I agreed to.
He also asked me whether I would like to have a PSA test done.
I said no
Even if there is prostate cancer, a good proportion is likely to remain quiescent or grow so slowly that it won’t cause any problem over years and even decades
I would like to stress that this is a contentious issue . The above only reflects my personal opinion….
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