Understanding Prostate Cancer: A Silent Threat to Men’s Health

May 22, 2025

Recently, former President Biden announced that he has stage 4 prostate cancer. Prostate cancer is one of the most common cancers among men worldwide, yet many are unfamiliar with the organ it affects or the potential consequences of late detection. This blog breaks down the essentials of prostate cancer, from what the prostate is to how this disease is screened, diagnosed, and treated. It also examines the implications of limiting screening based on age.

The prostate is a small, walnut-sized gland in the male reproductive system. It sits just below the bladder and in front of the rectum, surrounding the urethra. The prostate produces seminal fluid, a component of semen that nourishes and transports sperm during ejaculation (National Cancer Institute).

While any male can develop prostate cancer, some are at higher risk due to several key factors:

• Age: Risk increases significantly after age 50. Roughly 60% of cases are diagnosed in men over age 65.
• Ethnicity: African American men face a higher incidence and are more likely to develop aggressive forms of the disease.
• Family History: Having a first-degree relative with prostate cancer more than doubles a man’s risk.
• Genetics: Inherited mutations in genes like BRCA1, BRCA2, or HOXB13 can increase risk.
• Lifestyle: Diets high in red meat and low in vegetables, obesity, and lack of physical activity may contribute to higher risk. American Cancer Society (ACS): https://www.cancer.org

Prostate Cancer Screening

Two types of prostate cancer screening are available. A PSA (Prostate-Specific Antigen) test, which is a blood test that measures PSA levels. High levels may indicate cancer but can also result from benign conditions like an enlarged prostate or infection. Digital Rectal Exam (DRE), which is a physical exam in which a healthcare provider feels the prostate for abnormalities.

If you are at average risk, discuss PSA screening with your healthcare provider starting at age 50.

If you are at higher risk (African American men or have a family history), discuss screening with your provider between ages of 40 and 45. It is important to note, the U.S. Preventive Services Task Force (USPSTF) recommends shared decision-making for men aged 55 to 69, and discourages routine screening after age 70.

While limiting screening after age 70 is meant to prevent overdiagnosis and overtreatment, it also introduces serious risks:

• Many men over 70 are still in excellent health and may benefit from early detection.
• Aggressive cancers can still occur in older men and may go undetected without screening.
• A blanket cutoff ignores biological age and life expectancy, which often differ from chronological age.

In fact, a study published in JAMA Oncology found that a significant number of men over 70 who were diagnosed with high-risk prostate cancer were initially missed due to the age guideline (JAMA).

If initial tests indicates cancer, further diagnostic testing will be done to determine severity including:

• Prostate Biopsy: Tissue samples are analyzed under a microscope.
• Gleason Score: A scale (6–10) that grades cancer cells based on how abnormal they look.
• Staging: Determines if the cancer is localized, regional, or has spread (metastatic).
• Imaging Tests: MRI, CT, and bone scans may be used for staging and monitoring (Mayo)

Treatment varies based on the severity (stage) of the cancer, the Gleason score, PSA levels, and the patient’s health and preferences. Common treatments include:

• Active Surveillance: Regular monitoring for low-risk cancers.
• Surgery: Radical prostatectomy to remove the prostate gland.
• Radiation Therapy: External beam or internal (brachytherapy).
• Hormone Therapy: Suppresses testosterone to slow cancer growth.
• Chemotherapy: For advanced or hormone-resistant cancer.
• Immunotherapy & Targeted Therapies: Newer options for advanced cases.

Prostate cancer is highly treatable—if caught early. But many men, especially older adults, may miss the opportunity for timely diagnosis due to rigid screening guidelines. Instead of a one-size-fits-all approach, screening decisions should consider overall health, risk factors, and personal values.  If you’re a man over 40—or have loved ones who are—talk to your healthcare provider about prostate cancer screening. President Biden’s prostate cancer may have been missed, as he is over 70 and has aged out of the screening recommendations. Our prayers go out to the former President, his loved ones and all those battling prostate cancer. We recommend advocating for yourself at all ages, age, and knowing when you should be screened. Screening can save lives.

 

1. American Cancer Society – Prostate Cancer: https://www.cancer.org
2. CDC – Prostate Cancer Risk Factors: https://www.cdc.gov
3. USPSTF Guidelines: https://www.uspreventiveservicestaskforce.org
4. JAMA Oncology – Screening in Men Over 70: https://jamanetwork.com
5. NCCN Guidelines: https://www.nccn.org
6. Mayo Clinic – Prostate Cancer Diagnosis & Treatment: https://www.mayoclinic.org