Common myths about prostate cancer everyday health endometrial biopsy side effects

However, given that about 164,000 men in the United States will be diagnosed with the disease in 2018, according to the American Cancer Society (ACS), it’s likely that you or someone you know will be affected. Prostate cancer is the second leading cause of death from cancer in American men, right behind lung cancer.

“The diagnosis [of prostate cancer] almost always hits people out of the blue,” Dr. Sartor says. “It’s not what you plan on, and of course it’s very disruptive. For many men, prostate cancer creates a general cognitive dissonance: Why me? What did I do wrong? What am I going to do about it now that my life is being threatened?”

When talking about prostate cancer, high emotions often kick in. “What I see all the time,” Sartor says, “is people overestimating the deadliness of prostate cancer.

There are some pretty bad cancers out there, and I’m not saying prostate cancer can’t be bad. But people don’t tend to discriminate about what their prognosis might be compared to someone else with the ‘big C.’ There is sort of a sense of impending doom that certain patients may have — which may or may not be true.”

Hopefully we can help people understand that prostate cancer is not a death sentence for the majority of us, Sartor says. In the end, most men die with prostate cancer, not of prostate cancer. One way to clarify things — bust the myths and beat prostate cancer — he says, is to learn more about what prostate cancer is, how it’s treated, and who’s at risk for it.

Fact: Some prostate cancer experts recommend against regular PSA testing, but not necessarily because of the test itself — which is just a simple blood test. PSA screening certainly isn’t perfect, but it doesn’t pose any actual danger to your health. The real hazard is anxiety and sometimes faulty decision-making when it comes to interpreting and acting on PSA results. According to the ACS, PSA levels usually go above 4 when prostate cancer develops. However, a PSA level between 4 and 10 results in a prostate cancer diagnosis only about 25 percent of the time.

Causes of a high PSA can range from things like bicycling to ejaculation. As a result, some men are given invasive biopsies that aren’t needed. Or, if they do have cancer, they may be treated aggressively for slow-growing tumors that might never have caused any issues.

Which is not to say that PSA tests aren’t valuable or that they can’t save lives. In the years since they’ve been widely used, says Dr. Wei, prostate cancer diagnoses have gone up — but “the death rate is going down.” This is at least in part because PSA tests lead to more investigation, which can find cancer early when it’s more receptive to treatment. Talk with your doctor about whether — and how often — you should be screened for prostate cancer.•

Fact: PSA levels can be useful in diagnosing prostate cancer, but they’re really only one piece of the larger puzzle. The PSA test is far from perfect, Sartor says. He draws a parallel between low PSA readings and negative mammograms in women. “If you have a negative mammogram, it’s not 100 in terms of excluding cancer. The probability is less, but likewise just because your PSA is relatively low, you can’t interpret that to mean that there is no cancer present.”

However, the opposite can also occur: Sartor described a different scenario in which one of his patients — a very bright and accomplished attorney — has a biopsy after getting an elevated PSA, and the biopsy came back negative. “After this negative result he figured he didn’t have cancer, and waited three to four years before having his PSA tested again,” Sartor says. Now he has prostate cancer that has spread to other parts of his body. In other words: metastatic disease. “He took the negative biopsy as literally meaning he doesn’t have cancer, and it turned out badly for him.”

To get the most complete picture of your prostate health, you need to get other diagnostic tests as well. This may mean getting a biopsy. But that standard is changing, says Sartor, citing a major study published in The New England Journal of Medicine in March 2018 and The Lancet in February 2017 that point to the value of a special type of MRI imaging called multiparametric magnetic resonance imaging.

“While the biopsy is still the gold standard when it comes to the diagnosis of cancer, this MRI can add localization and help streamline the efficiency of the biopsy,” he explains. “It can tell you where to put the needle and also, in some patients, tell you that a biopsy is not required because the probability of cancer is very low.”•