What are facts? According to a definition, a fact is something that is known or proved to be true. Each one of us has things we know about ourselves and hold as true. If I ask you what color are your eyes, what date were you born, how old you are, how many years of school did you have, etc. you would give me facts about yourself. I would then feel like I know some things about you that are true because you had shared these facts.

Of course, over time facts can be edited as new information either disproves earlier facts, or enlarges upon the facts we already know. 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) do change as time goes by. For instance, up until the end of the twentieth century, it was universally accepted that PCa is a multifocal disease, meaning if you find a small clump of tumor cells in one place, there must be microscopic cancer cells elsewhere. This undisputed “fact” was the justification for radical (whole gland) treatments. However, with advances in science and technology, by the first decade of the new millennium it was proven that some PCa cases were unifocal, or only in one location with no evidence of any other focus of PCa cells.

This brings me to the latest published review^[i] of PCa, a dense assembly of current, state-of-the-art knowledge about the world of PCa. At no time do the authors claim that their statements are the universal truth that will never change. However, the information they present is known and proven to be true…so far.

I have pulled out 10 important points that I think my readers should know:

1. Prostate cancer is the most common nonskin cancer in U.S. men, with an estimated 299,010 new cases and 35,250 deaths in 2024.
2. The most common type of prostate cancer is adenocarcinoma (≥99%).
3. The average age at diagnosis is 67.
4. At diagnosis, about 75% of patients have cancer localized to the prostate.
5. Cases of early stage localized PCa almost never shows symptoms—you can be walking around with localized PCa and not know it.
6. The nature of prostate cancer varies, ranging from screen-detected lesions that have no symptoms and may never progress, to an aggressive cancer that is a leading global cause of treatment side effects that impact quality of life, as well as PCa-related death.
7. The most common risk factors for developing PCa are older age, genetic factors, and Black race.
8. 12% of patients with metastatic PCa are found to have specific germline alterations in genes involved in DNA damage repair.
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.
10. Early detection is of the utmost importance, and when treated, localized PCa has a 5-year survival rate of nearly 100%.

When PCa is detected and diagnosed in its earliest stages, and is still localized, today’s patients have a broad menu of choices. Keeping in mind that treatment should be matched not only to the physical aspects of the disease but also to a patient’s lifestyle and quality of life preferences, there is no one-size fits-all treatment. That in itself is an important fact! Here’s one more key point: ALL treatment choices come with some risk of side effects, and NO treatment choice comes with a 100% guarantee of cure.

Therefore, patients are encouraged to ask questions of their doctors, and to do their own research. At our Center, which specializes in MRI-based early detection, diagnosis, and MRI-guided focal therapies, we make every effort to inform patients about the nature of their PCa 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 and knowledgeable increase the chances of successful treatment without interfering with 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] Raychaudhuri R, Lin DW, Montgomery RB. Prostate Cancer: A Review. JAMA. 2025;333(16):1433–1446. doi:10.1001/jama.2025.0228