What We All Need to Know About Prostate Cancer

Joe Cala, an active 75-year-old shares his journey with prostate cancer. Learn about symptoms, risk factors, and the importance of early screening for men's health from Dr. Theodore Manny, a urologist in the Triad and member of the Cone Health Medical and Dental Staff, in this 2 Your Well-Being conversation with WFMY.

Joe Cala, a golf enthusiast and active "busy body" around his home, experienced a sudden and unexpected shift in his life in March 2024. A routine doctor's visit, prompted by a feeling of low energy, led to a shocking diagnosis: prostate cancer.

Joe had been monitoring his PSA levels for years, and while they had been slowly rising, the news of cancer came as a complete surprise. A biopsy revealed a low-grade tumor with a Gleason score of 7, and he opted for brachytherapy, a procedure that uses radioactive seeds to kill the cancer cells.

For nearly eight weeks, Joe was cancer-free. But in November, while walking, he felt a pain he thought was a pulled hamstring. The pain didn't go away, and a hospital visit revealed a devastating turn of events: the cancer had returned and spread aggressively throughout his hips, pelvis, three vertebrae, four lymph nodes, and even to his skull and a lung. Doctors were shocked at how quickly the cancer had metastasized.

With the unwavering support of his wife, Pamela, Joe navigated four rounds of chemotherapy. While he's still living with the disease and continues to see his doctors, Joe is back to his favorite activities, taking each day as it comes. His story highlights a crucial message: prostate cancer, the most common cancer among men, can be a formidable opponent, but early detection and advanced treatments offer hope.

Who's at Risk?

The two biggest risk factors for prostate cancer are race and family history.

• African-American men.

  This population has a significantly higher incidence of prostate cancer—over twice as likely as men of other races. The disease also tends to be more aggressive and fatal in this group.

• Those with a family history. Men with a brother, father, or uncle who has had prostate cancer are at an increased risk.

Because of these risk factors, men should be mindful of when to start getting screened. Dr. Manny recommends men in higher-risk groups, such as African-Americans or those with a family history, begin screenings between the ages of 40 and 45. For all other men, age 50 is the recommended starting point.

Signs and Symptoms to Watch For

While the goal is to find the cancer before symptoms appear, men should be aware of the signs. These can include:

• Changes in urination.

  Difficulty passing urine, urgency, frequency, or blood in the urine.

• Unexplained bone pain.

  Prostate cancer often spreads to the bones.

Joe Cala's story is a powerful example of this, as his initial symptom of a "pulled hamstring" was actually a sign of the cancer's spread.

Overcoming Misconceptions

Dr. Manny addresses common misconceptions about prostate cancer:

• It's only a disease of older men.

  This is not true. While more common in older men, there's a trend of more aggressive cases being diagnosed in younger men in their 40s.

• A diagnosis always means terrible treatment is necessary.

  Not every man diagnosed with prostate cancer needs immediate, aggressive treatment. About 50% of cases can be managed through active surveillance, where the cancer is monitored closely. For those who do need treatment, surgery and radiation technologies have become less invasive and have fewer side effects.

The most important takeaway is that screening saves lives. Since the introduction of the PSA blood test, the number of metastatic prostate cancer cases has dropped by 70%.

Steps to Lower Your Risk

While not as responsive to lifestyle changes as some other cancers, men can take steps to help lower their risk:

• Quit smoking.

  Smoking has been shown to influence prostate cancer risk.

• Drink alcohol in moderation.

  High concentrations of alcohol can increase the risk of prostate cancer.

Next Steps

Dr. Manny emphasizes that finding prostate cancer early, before symptoms appear, is the best chance for a cure. Screening, which involves a simple blood test and exam, is pain-free and can save lives.