What’s Driving the Surge in Advanced Prostate Cancer Cases Worldwide?

Prostate cancer is the second leading cancer in men across the world. While rates for some types of prostate cancer may have declined, advanced cases have increased significantly. There is much more awareness

about prostate health than they did ten years ago, but experts believe that has not translated much into catching the disease early. “More men are showing up when the cancer has already moved beyond the prostate, and that’s a real problem, for their outcomes, their lives, and for the healthcare system,” said Dr Amit Saple, Executive Director and senior consultant urologist, Asian Institute of Nephrology and Urology.

Why are we not catching it sooner?

A big reason? Fewer men are getting PSA tests. “Not long ago, experts worried about too many men being overdiagnosed and getting treatments they didn’t really need. So, the recommendations for routine screening got stricter. The intention was good, but now, less screening means more early cancers are slipping by, completely silent,” Dr Saple added. So, what happens? Instead of catching prostate cancer before it spreads, doctors are meeting men only after they notice symptoms like bone pain, trouble peeing, or even kidney issues – all of which are signs that the cancer has already advanced.

Quiet symptoms bring delayed action

Early prostate cancer barely makes a peep. If there are symptoms, most guys chalk them up to getting older or something harmless, like an enlarged prostate. On top of that, plenty of men hesitate to see a doctor. A few very early signs of prostate cancer include:

• Frequent, sometimes urgent need to pee, especially at nighttime
• Weak urine flow
• Pain or burning when you pee
• Loss of bladder control
• Loss of bowel control
• Painful ejaculation
• Blood in semen
• Pain in your low back, hip, or chest

Also read: Unusual Signs of Prostate Cancer Most Men Overlook

How does a PSA test work?

The prostate-specific antigen test detects the amount of PSA in your blood – a higher level means you could have cancer. PSA screenings have led to fewer men living with and dying from prostate cancer, including the metastatic form of the disease. In 2008, a health and medicine panel of experts suggested that men over age 75 should stop having routine PSA screenings. Four years later, the guidance was expanded to include all men, as it was found that while prostate cancer screening has many benefits, there are also drawbacks. Experts are concerned about the harm men face from false positive PSA results, which happen when your test shows a higher PSA level, but you do not actually have prostate cancer.

If your result comes back with a false positive, your doctor will likely suggest a prostate biopsy, a test you don’t need when you’re cancer-free. In that biopsy, your doctor removes some prostate tissue to test it for cancer cells. Older men face more potential problems after a prostate biopsy, like:

• Pain
• Blood in the seminal fluid
• High chances of infection

Better scans are needed

According to doctors, new imaging like PSMA PET-CT scans are much better at showing just how far the cancer has spread. “So, part of the reason we’re seeing more 'advanced' cases is that we’re finally able to see what was always there,” said Dr Saple. There is a need for smarter screening, not just testing, but tailoring it to the individual. “That means PSA checks at the right age, paying attention to family history, real conversations between patients and doctors, and referring men to specialists sooner. These steps make all the difference in spotting cancer early,” he said.