Prostate cancer ranks among the most common cancers worldwide. While many cases grow slowly and remain localized, others are aggressive and spread rapidly. Dr. Carlos Vargas, a radiation oncologist at Mayo Clinic, emphasizes the importance of regular screening to detect the disease early while it is still confined to the prostate and most treatable.
Screening typically involves an annual PSA (prostate-specific antigen) blood test, which measures levels of a protein that may rise due to cancer or other prostate conditions. Dr. Vargas recommends discussing with a healthcare provider whether and when to begin screening based on individual risk factors such as age, family history, and race. Men around age 50 are most commonly affected. Those with a family history of prostate cancer, BRCA gene mutations, or a strong history of breast cancer may face higher risks. In the U.S., Black men are more likely to develop prostate cancer and twice as likely to die from it.
“Early detection is critical. When found early, prostate cancer can be treated and cured,” says Dr. Vargas.
Not all prostate cancers require immediate intervention. Some low-risk cases can be managed through active surveillance, which involves regular monitoring via follow-up tests. This approach allows patients to avoid unnecessary treatment unless the cancer shows signs of becoming more aggressive. “The problem arises when screening is skipped, and an aggressive cancer is discovered only after it has spread, significantly reducing the chances of cure,” he explains.
Treatment options vary based on the cancer’s stage and risk level. Beyond active surveillance, they include radiation therapy, hormone therapy, cryosurgery, chemotherapy, and surgery such as robotic prostatectomy. Recent advances have expanded the role of radiation—even for metastatic cases. “We now know that some patients with limited spread can benefit from targeted radiation combined with systemic therapy, potentially achieving remission and extending life,” notes Dr. Vargas.
Proton beam therapy, using pencil-beam scanning, is another precise radiation technique that targets the prostate while minimizing damage to surrounding tissues. This approach helps reduce potential side effects.
Dr. Vargas encourages men to consult their healthcare providers to determine a personalized screening plan and understand the full range of management strategies, from surveillance to advanced treatments.
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