Prostate cancer facts can change

What are facts? According to a definition, a fact is something that is known or proved to be true. If I ask you what color are your eyes, what date were you born, how old you are, etc. you would give me facts about yourself. However, over time facts can change as new information becomes available. The date of your birth won’t change, but how old you are is not a fixed number because each day adds to your age.

Thus, facts about prostate cancer (PCa) can change as time goes by. For instance, up until about 20 years ago, it was widely held that PCa is always a multifocal disease. This undisputed “fact” was the basis for radical (whole gland) treatments. Nowadays, with advances in science and technology, experts accept that some PCa is unifocal (single location, no evidence of life-threatening cells elsewhere in the gland).

10 prostate cancer facts for today

Today’s facts are from a March 2025 published review of PCa that provides “a valuable and thorough synthesis of current evidence in prostate cancer.”^[i] These facts may be modified as time goes by. However, the information they present has been shown to be true as of this writing. Here are 10 important facts you should know, with my comments about each.

1. Prostate cancer is the most common nonskin cancer in U.S. men. As of 2024, there were an estimated 299,010 new cases and 35,250 deaths. Although not covered in the review, according to the Lancet Commission on prostate cancer, by 2040 new cases globally will surge from 1·4 million in 2020 to 2·9 million by 2040. This is attributed primarily to population aging.
2. The most common type of prostate cancer is adenocarcinoma (≥99%). There are rare types of PCa that tend to be more aggressive and do not respond well to treatment. However, when adenocarcinoma of the prostate is detected early and diagnosed when it is low-risk and contained in the gland, the 5-year biochemical disease free rate (no rise in PSA) after treatment is at least 90%.
3. The average age at diagnosis is 67. Before the development of the PSA screening test, the average age was higher at roughly 72. Thanks to screening, the average is now lower because we are able to find PCa earlier. Somewhat alarming, however, is a trend toward new PCa diagnosis in very young males (teens and young adults under age 40). According to a 2019 global analysis published in the journal Cancer, in this demographic the incidence of PCa has increased globally at a steady rate of 2% each year since 1990. Compare the 5-year overall survival rates reported in this analysis:
   

   Age group	5-year overall PCa survival rate
   40-80 years old	95-100% survival
   25-34 years old	80% survival
   20-20 years old	50% survival
   15-24 years old	30% survival

   It is thought that in part, the biology of PCa in younger men differs from that in older men. Also, survival rates vary among countries and regions due to factors like obesity, physical inactivity, exposure to environmental carcinogens, HPV infection, etc. as well as differences in PSA screening and possible diagnostic errors.

4. At diagnosis, about 75% of patients have cancer localized to the prostate. In fact, Johns Hopkins says up to 80% of cases are still localized. This is good news, because the highest treatment success rates (cancer control) occur when PCa is diagnosed early and is still confined within the prostate.
5. Cases of early stage localized PCa almost never shows symptoms. Without symptoms, it’s hard to know you have PCa. Although the PSA test is not perfect because several noncancerous conditions can cause a higher-than-normal test result, it is still the earliest warning sign. Thankfully, multiparametric MRI before biopsy has high accuracy in determining significant PCa is present. This helps avoid an unnecessary needle biopsy.
6. The nature of prostate cancer varies. Not all PCa cell lines are alike. They range from very low risk tumors that have no symptoms and may never progress, to more dangerous cell lines that require the aggressive forms of treatment that come with risks of urinary, sexual or bowel side effects. Careful, thorough diagnosis identifies each patient’s unique disease for optimal treatment plans.
7. The most common risk factors for developing PCa are older age, genetic factors, and Black race. Environmental factors also play a part. At the same time, lifestyle choices (diet, exercise, stress management) and overall wellness help reduce the risk of developing PCa.
8. 12% of patients with metastatic PCa are found to have specific germline alterations in genes involved in DNA damage repair. Thanks to genomic and biomarker tests, treatments are being developed in order to tailor and target therapeutic interventions to counteract the effects of gene mutations, though many years of research and clinical tests still lie ahead.
9. It is important to match treatment to disease. Now that we know so much about PCa, choosing a treatment for localized PCa depends on its risk level based on clinical factors. Options vary in terms of side effect risks, and NO treatment option comes with a 100% guarantee of cure.
10. Early detection is of the utmost importance. When PCa is detected and diagnosed in its earliest stages, and is still localized, today’s patients have a broad menu of choices. Treatment planning can include a patient’s disease factors as well as his lifestyle and quality of life. Doctor-patient discussion is very important, and patients should do their own research.

Now that you know today’s 10 important prostate cancer facts, you are armed with general knowledge. At our Center, which specializes in MRI-based early detection, diagnosis, and MRI-guided focal therapies, we make every effort to personalize knowledge regarding the nature of each patient’s disease and which treatment choices would be a good fit. Let’s not be in the dark about prostate cancer. Facts may evolve over time, but being informed powerfully increases the chances of successful treatment that also preserves quality of life.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

References

[i] Roldan-Testillano R, Sanchez-Salas R. Re: Ruben Raychaudhuri, Daniel W. Lin, R. Bruce Montgomery. Prostate cancer: a review. JAMA 2025;333:1433-46.