Conquering Fear and Tackling Prostate Cancer Head-On
- Former NFL player Leonard Wheeler, 57, was diagnosed with prostate cancer after noticing a steady rise in his PSA levels—despite having no symptoms or discomfort.
- Prostate cancer screening may often involve a digital rectal exam and a prostate-specific antigen test. This test measures the level of PSA in the blood, and higher levels can indicate cancer. Most cancer diagnoses are caught with screening.
- The prostate cancer treatment plan is based on whether the cancer is considered low, intermediate, or high risk. The risk level is assessed after your doctor evaluates test results.
- Prostate cancer treatment may include surgery, radiation, and/or hormonal therapy. Each treatment method comes with potential side effects such as sexual dysfunction and urinary incontinence.
- Surgery is not needed for all men diagnosed with prostate cancer. In some cases, active surveillance is a preferred treatment option for older men or those with a low risk of the disease spreading.
- SurvivorNet’s “Men Beating the Odds” is an uplifting 12-part documentary series highlighting real-life journeys of men thriving with advanced prostate cancer, created with the intention of encouraging men to open up about health concerns, especially with more sensitive topics: their prostate and sexual health.
“I felt invincible for a long time. Football gives you that mindset, but my prostate cancer diagnosis showed me that being proactive about your health can save your life,” Wheeler told WCNC News.
“When I was diagnosed with prostate cancer, when you hear those words, it transforms your soul,” Wheeler said in an Instagram post.
“The biggest barrier is fear—fear of what we might find—and ego…A lot of men don’t want to talk about health issues. Most men stay away from screening because they don’t like the proverbial finger insertion,” Wheeler added.
Wheeler highlights a heightened risk for Black men, who tend to be at a higher risk, making early screening critical.
“We break the stigma by having real conversations about screening procedure, by being visible, and by showing that taking care of yourself is strength, not weakness,” Wheeler adds.
WATCH: How Former NFL Star Russell Wilson’s Coach Alex Peavey, a Prostate Cancer Survivor, Uses Mindfulness To Reframe Cancer Pain
Some of the issues Wheeler hopes to address more widely are key parts of SurvivorNet’s Men Beating the Odds series. The uplifting 12-part documentary series highlights real-life journeys of men thriving with advanced prostate cancer, created with the intention of encouraging men to open up about health concerns, especially with more sensitive topics: their prostate and sexual health.
Expert Resources on Prostate Cancer Treatment
- ‘A Profound Effect’: Treating Advanced Prostate Cancer With Hormone Therapy
- ‘A Relationship Disease’ — SurvivorNetTV Presents: The Power of Emotional Support For Men Handling Prostate Cancer
- ‘Early Detection Can Be the Key’: National Guard Vet & Prostate Cancer Survivor Urges Others to Get Screened
- A True Game-Changer in Prostate Cancer: A Simple Genomic Test Can Tell Us Who Needs Hormone Therapy And Who Doesn’t
- Hormone Therapy for Advanced Prostate Cancer: Blocking Testosterone To Fight Cancer
When Caught Early, Prostate Cancer Is Very Treatable
Prostate cancer is very treatable when caught early — and thanks to incredible advances in treatment options, even prostate cancer that is caught in advanced stages can often be managed. A long-standing prostate screening tool is the protein-specific antigen (PSA) test. This test screens for prostate cancer by looking for larger amounts of prostate-specific antigen in the blood. An elevated PSA test does not always mean prostate cancer, but it could indicate a man’s cancer risk is higher or lower.
WATCH: Hormone Therapy for Advanced Prostate Cancer: Blocking Testosterone To Fight Cancer
“Population-based prostate cancer screening has historically relied on PSA levels, which have led to the diagnosis of many prostate cancers that are not a threat to the patient’s life,” a study published in The New England Journal of Medicine said.
In recent years, other test methods, including prostate-specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET-CT) scans and MRI imaging, have gained increasing support from cancer experts. PSMA PET-CT scans are a relatively new imaging technique that allows physicians to visualize prostate cancer cell clusters anywhere within the body. PSMA PET-CT is helpful for people with prostate cancer where there’s a high risk of the disease spreading outside the prostate gland or those who have recurrent cancers.
Magnetic resonance imaging (MRI) uses a magnetic field, radiofrequency pulses, and computer technology to generate highly accurate body images.
What Factors Go Into Treatment Choices?
For many patients, the differences between treatment options — such as surgery, radiation, or hormone therapy — can be subtle. But those nuances matter, especially when side effects impact daily life.
Dr. James Ryan Mark, a urologic oncologist at Fox Chase, urges patients to weigh the benefits and trade-offs of each treatment option carefully.
“In certain cases, the differences in treatment options can be relatively minor,” Dr. Mark explains.
WATCH: Balancing Treatment and Quality of Life: What Men Should Know About Prostate Cancer Care
One common combination for aggressive prostate cancer is radiation therapy paired with androgen deprivation therapy (ADT), also called hormone therapy, which suppresses testosterone to slow cancer growth. While this approach can significantly improve recurrence rates and survival, it’s not without cost — especially for older patients.
“Adding those treatments to radiation has a big improvement on the recurrence rate of survival,” Dr. Mark says. “But not all men sustain that big of an improvement, and particularly if you’re older, taking out your testosterone can really affect your muscle strength and vitality.”
For some, preserving strength and energy may outweigh a modest increase in cancer control.
“As patients are getting elderly, to some, that is more important than maybe a 10% [increase] in their case of prostate cancer control,” he adds.
Dr. Mark also cautions against rigid treatment protocols that don’t account for individual needs. He encourages patients to ask their care team questions and explore different types of treatments, specifically inquiring about possible treatment outcomes and the side effects they bring.
“Sometimes, it almost seems dogmatic in the way the treatments are delivered,” he says. “It’s always good to ask what the benefit of each aspect of the treatment is and what can be given in a different way.”
Dr. Vivek Narayan, a medical oncologist at the University of Pennsylvania, is part of a growing movement in oncology that embraces combination therapy as the backbone of metastatic prostate cancer treatment. This approach pairs traditional hormone therapy (also called androgen deprivation therapy or ADT) with FDA-approved oral agents like abiraterone, enzalutamide, apalutamide, and darolutamide — each designed to disrupt the testosterone-driven growth of cancer cells further.
WATCH: A Message Of Hope For Men Fighting Advanced Prostate Cancer
These therapies not only slow disease progression but also offer patients a chance at living longer, fuller lives — even with an advanced diagnosis.
Dr. Narayan highlights the progress in advanced prostate cancer care, noting that the disease is increasingly manageable and patients now have greater potential for improved quality of life. Still, patients must be carefully monitored.
“Even with metastatic prostate cancer, it’s not always the cancer that causes the biggest problems. We’ve got to keep an eye on overall health, because that matters just as much.” Dr. Narayan notes.
This shift in perspective is critical — not just for patients, but for caregivers and clinicians alike. It reframes the diagnosis from a terminal sentence to a chronic condition that can be managed with precision and care.
The outlook for prostate cancer care is promising, driven by breakthroughs in treatment and the rise of personalized medicine. Dr. Narayan’s work at Penn Medicine, among other cancer research centers across the country, continues to push the boundaries of what’s possible, offering patients not just treatment but a renewed sense of continued hope.
Prostate Cancer Screening and Warning Signs
When you do get screened for prostate cancer, your doctor will run a few tests.
One of the tests is the PSA test, a simple blood test that screens for prostate cancer. It looks for higher levels of prostate-specific antigen (PSA) in the blood. An elevated PSA test does not always mean you have prostate cancer. It could also reflect that your prostate is enlarged, which is common, or it could signal an infection or inflammation.
Your doctor may also conduct a digital rectal exam (DRE) to check your prostate for lumps.
Depending on the results of these tests, imaging scans and a biopsy may be ordered.
WATCH: How Gleason Grade Determines Treatment
Prostate cancer does not always behave the same in every man it impacts. The cancer can be considered “low-risk” and can be slow-growing, and treatment might not be necessary. In other men, the cancer may grow faster or more aggressively, requiring more immediate treatment. Because of this, there is some debate about screening.
The United States Preventive Services Task Force recommends that men at average risk between the ages of 55 and 69 years talk with their doctor about the pros and cons of prostate cancer screening.
The American Cancer Society recommends that men at age 50 who are at average risk should begin screening. Men who are at high risk of prostate cancer should begin screening at age 40. Men with a close relative diagnosed with prostate cancer should consider annual screenings in their 30s.
SurvivorNet experts suggested that men consider factors like their family history, genes, and age when deciding whether and when to screen.
Symptoms of prostate cancer may include:
- Urinating more often
- Waking up in the middle of the night to pee
- Blood in your urine
- Trouble getting an erection
- Pain or burning when you urinate
- Pain in your back, hips, thighs, or other bones
- Unexplained weight loss
- Fatigue
Prostate Health Among Black Men
The Prostate Cancer Foundation (PCF) has cancer screening guidelines with Black men in mind.
Since Black men tend to be diagnosed with prostate cancer at younger ages compared to other racial groups, the new guidelines state Black men should consider screening at 40 years old since this demographic group is regarded as a “high-risk population.”
WATCH: How to Address Racial Disparities in Cancer Care
“Few guidelines have outlined specific recommendations for prostate-specific antigen (PSA)-based prostate cancer screening among Black men,” researchers for PCF said in its report published in the Journal of Clinical Oncology.
“Discussions with health care providers about baseline PSA testing should begin by the time Black men are in their early 40s, and modeling data suggest prostate cancer develops 3-9 years earlier in Black men compared to their peers. Lowering the age for baseline PSA testing from 50-55 years to 40-45, followed by regular screening intervals until the age of 70, would reduce prostate cancer mortality in Black men,” the PCF said in its report.
RELATED: Black Men May Be More Susceptible To Advanced Cancer Due to Biomarkers in the DNA, Study Says
SurvivorNet holds an annual Close the Gap conference to educate, spread awareness, and ultimately work to eliminate racial disparities in cancer care. Our efforts aim to ensure everyone has access to education about cancer, screening recommendations, treatment options, clinical trials, and more.
Questions for Your Doctor
If you have experienced symptoms associated with prostate cancer or have a screening coming up, here are some questions you may ask your doctor:
- If I had elevated PSA levels, what could be causing that besides cancer?
- How long will it take to learn if my PSA levels warrant further testing?
- What are the treatment options that are best suited for me based on my risk level?
- What financial resources exist to help me with the costs associated with treatment?
- How long will my potential treatment prevent me from working or continuing normal activities?
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