Early Detection Is Key
- “Goodfellas” Actor Robert De Niro was praised during 81st Annual Golden Globe Awards as “amazing decade after decade” about 20 years after beating prostate cancer.
- The 80-year-old actor appears to be thriving just two decades after battling prostate cancer. His health battle reminds us that there’s is hope amid disease, thanks to advancements in treatment and cancer screenings.
- Early detection of prostate is important as it can help reduce the risk of cancer spreading to other organs.
- Screening for prostate cancer generally involves a PSA (prostate-specific antigen) test and a digital rectal exam to feel the prostate gland. The prostate-specific antigen is a protein secreted by the prostate gland, large amounts of which can indicate prostate cancer.
- “It’s slightly uncomfortable but painless, and takes less than 30 seconds,” Dr. Edwin Posadas tells SurvivorNet of these methods. “The amount of information that is gained from that is tremendous, and it can be a life-and-death type decision that is made.”
- Though the PSA test is not always accurate and an elevated PSA test does not always mean you have prostate cancer, our experts maintain that these tests are helpful. Make sure to discuss your options with your doctors and decide what screening should look like for you.
The 80-year-old actor appears to be thriving just two decades after battling prostate cancer, something he never allowed to negatively affect his career and has inspired others diagnosed with the same disease.
Read MoreFollowing laughter from the crowd, including from De Niro himself, and the mother of his seventh child, Koy jokingly asked, “CGI?”CGI is a type of specific technology which stands for computer-generated imagery.
Koy then proceeded to ask the crowded if De Niro was looking at him. The comedian continued, “Is he looking? Are you talking to me?” before pointing out how the cast of the 2024 Western crime drama film “Killers of the Flower Moon” was sitting at the table with De Niro.
Seeing De Niro doing so well in his career and in his personal life, having his seventh child at 79, offers hope to anyone who has been diagnosed with prostate cancer, like Defense Secretary Lloyd Austin, who was diagnosed with the disease last month and is now recovering from complications following a minimally invasive procedure to treat and cure the cancer.
News of Austin’s cancer diagnosis was revealed this week in a statement from Walter Reed National Military Medical Center Officials.
The statement read, “As part of Secretary Austin’s routinely recommended health screening, he has undergone regular prostate specific antigen (PSA) surveillance. Changes in his laboratory evaluation in early December 2023 identified prostate cancer which required treatment.
“On December 22, 2023, after consultation with his medical team, he was admitted to Walter Reed National Military Medical Center and underwent a minimally invasive surgical procedure called a prostatectomy to treat and cure prostate cancer.”
“He was under general anesthesia during this procedure. Secretary Austin recovered uneventfully from his surgery and returned home the next morning. His prostate cancer was detected early, and his prognosis is excellent,” the statement continued.
Officials also pointed out that Austin dealt with some complications from his Dec. 22 procedure and was admitted to Walter Reed National Military Medical Center with various health issues, “including nausea with severe abdominal, hip, and leg pain.” It was also revealed in his initial evaluation that he had a urinary tract infection. Further evaluation led doctors to learn there were “abdominal fluid collections impairing the function of his small intestines.”
Thankfully, after being transferred to the ICU, Austin’s infection has cleared and a “full recovery” is anticipated.
Robert De Niro’s Cancer Journey
De Niro was diagnosed with prostate cancer at 60-years-old. According to the actor’s publicist, the cancer was caught during a routine PSA screening test (blood test for prostate cancer). He immediately went through treatment at Memorial Sloan Kettering Cancer Center in New York City.
Due to the disease being caught during a routine check-up, it was in the earlier stages and De Niro was able to make a full recovery. Additionally, the actor’s publicist claims De Niro’s healthy lifestyle contributed to his speedy recover.
RELATED: Prostate Cancer: Overview
Initially the actor kept his battle with cancer out of the public eye, but after being in remission for a few years, he decided to go public as a way to urge men to start screening. The PSA screening test, also known as the PSA blood test, can be a valuable resource in catching prostate early.
Understanding Prostate Cancer
If you or a loved one has been diagnosed with prostate cancer, it’s important to remember that most types of prostate cancers are treatable. According to the National Cancer Institute, the five-year survival rate of prostate cancer in the U.S. is 97.1%. There is, however, a small number of men whose type of prostate cancer may become unresponsive to treatment, for example, when cancer cells develop a resistance hormone therapy, the treatment may no longer work.
Prostate cancer begins in the prostate the walnut-shaped gland located between the rectum and bladder that produces the fluid that nourishes sperm. Outside of skin cancers, prostate cancer is the most common cancer in American men with about one in eight men being diagnosed with this disease during his lifetime.
It’s important to remember a prostate cancer diagnosis is not always preceded by symptoms. And even when symptoms do occur, they can be inconsistent and hard to pinpoint.
“Prostate cancer is a very odd disease in that it doesn’t have a particular symptom,” Dr. Edwin Posadas, director of translational oncology and the medical director of the Urologic Oncology Program at Cedars-Sinai, told SurvivorNet.
After the Diagnosis: “What Did I Do Wrong?”
Still, it’s important to note changes in urinary function, like urinating more or less often or waking up at night to go more than usual, could be a sign of prostate cancer. So, even if you think there’s nothing to worry about, always talk to your doctor about changes to your health when they occur.
There are many different treatment options for both early and later-stage prostate cancer including active surveillance, watchful waiting, surgery, radiation, cryotherapy, hormone therapy, chemotherapy, immunotherapy and targeted therapy. The disease is one where doctors may have differing opinions on the best treatment path to take, so don’t hesitate to ask lots of questions and seek out multiple opinions.
Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
“I think it behooves the patient to have multiple discussions or second opinions, not only by the urologist who did the biopsy and diagnosed that man, but also with other surgeons and other radiation oncologist just to get a very circumspect view of what the treatment options are,” Dr. Jim Hu, a urologic oncologist at Weill Cornell Medicine, told SurvivorNet. “Oftentimes, I think patients need to understand that our health system is based a lot on fee-for-service medicine.
“And so therefore, a lot of physicians, I think, who are very well intentioned, will believe that their treatment is best for that particular man,” Dr. Hu added.
Prostate Cancer Screening Guidelines
It’s unclear if the benefits of prostate cancer screening outweigh the risks for most men. Nevertheless, screening can be life-saving, and it’s important to discuss the pros and cons of screening and your risk factors for the disease with your doctor.
The American Cancer Society (ACS) recommends “men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer” after “getting information about the uncertainties, risks, and potential benefits of prostate cancer screening.”
The ACS says the discussion about prostate cancer screening should take place at:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).
- Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).
When Should I Get Tested for Prostate Cancer?
Prostate cancer screening methods look for possible signs of the disease, but they can’t determine for sure if you have cancer. A prostate biopsy is the only way to confirm if the patient has prostate cancer.
Screening generally involves a PSA (prostate-specific antigen) test and a digital rectal exam to feel the prostate gland. The prostate-specific antigen is a protein secreted by the prostate gland, large amounts of which can indicate prostate cancer.
It’s slightly uncomfortable but painless, and takes less than 30 seconds,” Dr. Posadas said of these methods. “The amount of information that is gained from that is tremendous, and it can be a life-and-death type decision that is made.”
Though the PSA test is not always accurate and an elevated PSA test does not always mean you have prostate cancer, our experts maintain that these tests are helpful. Make sure to discuss your options with your doctors and decide what screening should look like for you.
The Importance of Early Detection
Men with a family history of prostate cancer are at a higher risk of developing prostate cancer, so a doctor may opt to begin testing in the mid-40s.
Men of certain ethnicities who are at a higher risk of getting the disease may also want to consider screening early. For example, the incidence of prostate cancer in African American men is 60% higher, and they are two to three times more likely to die from the disease.
RELATED: Staggeringly Higher Prostate Cancer Rates for Black & Latino Men
There’s No One Definitive Symptom for Prostate Cancer, But There Are Clues
Screening is typically done with the PSA test. If a man has an elevated PSA level, he has somewhere between a 20% to 40% chance of having cancer.
The PSA test is not a perfect test, says Dr. Posadas, director of the Translational Oncology Program at Cedars-Sinai Medical Center in Los Angeles.
The PSA test is more controversial when it comes to using it to detect prostate cancer in older men. This is because most men will develop prostate cancer at some point in their lives if they live long enough, Dr. Geoffrey Sonn, assistant professor of urology at Stanford Medicine, previously told SurvivorNet.
But most men will not die from prostate cancer.
In addition, because prostate cancer is such a slow-growing type of cancer, it is much more likely that older men will die of something other than prostate cancer.
Getting Tested If You Have A Family History of Prostate Cancer
Family history can matter a lot when it comes to prostate cancer.
“It’s estimated that five to ten percent of prostate cancer can run in families,” Dr. James Brooks, Chief of Urologic Oncology at Stanford Medicine, told Survivornet.
If you have a close relative who has had prostate cancer, such as a brother or father, the risk you will develop prostate cancer in your lifetime is almost double.
If You Have a Family History of Prostate Cancer, Get Screened Early
Men with a family history tend to get prostate cancer at a younger age, so Dr. Brooks recommends getting screened, in some cases as early as age 45, by having a PSA test.
Early detection can help reduce the risk of cancer spreading to other organs. The National Comprehensive Cancer Network also recommends germline genetic testing for men with high-risk prostate cancer.
But, screening can also open up a whole can of worms, finding cancers that are slow growing and may not need aggressive treatment. Still, when most men are told they have prostate cancer, they want it out. And that’s understandable.
What Are Your Treatment Options?
After your care team has all of the information (PSA, prostate exam, and the results of any imaging scans), your doctor will use it to categorize your cancer into one of several groups, called risk groups.
These include:
- Low risk
- Intermediate risk
- High risk
There are several subgroups within these categories that your doctor may mention. Which risk group your cancer falls into will determine what treatment options may be best for you. Men with low-risk and very low-risk disease may be candidates for active surveillance, an approach that closely monitors the cancer for changes and helps men avoid potential complications from more aggressive treatment.
On the other hand, men with high-risk disease may be treated with radiation therapy and androgen deprivation therapy (hormonal therapy).
In addition to your risk group, your doctor will also consider other factors, including:
- Your age
- Your overall health
- Your life expectancy
- Your goals for treatment
A combination of all of this information will allow your treating team to discuss all of the options that are available for treating your specific cancer.
Common treatment options for men with prostate cancer include:
- Surgery
- Radiation therapy
- Active surveillance
- Combination radiation therapy with hormonal therapy
- Surgery followed by radiation therapy
The reality is that most treatments are effective at curing the cancer. However, they each have different side effects that your doctors should discuss with you.
We encourage and recommend that if you are diagnosed with prostate cancer, you get an opinion from a urologist (surgeon) and a radiation oncologist to hear all of your options before choosing a treatment. We also recommend you get a second opinion from another institution.
Given the many treatment choices, doctors at some centers may do things quite differently than others.
We believe it is important to understand all of your options and hearing from other doctors at different institutions is helpful. The good news is that we have a lot of great options to treat men with this cancer. It can sometimes be overwhelming to pick what is best for you.
Questions to Ask Your Doctor
Here are some questions you may consider asking your doctor about your risk of developing prostate cancer:
- How does my family history affect my risk of developing prostate cancer?
- Are their tests available to determine my genetic risk of developing prostate cancer?
- Based on my history, genetic test results and other factors, when do you recommend I begin screening for prostate cancer?
- How can I prepare for prostate cancer screening?
The Challenge of Deciding When to Treat Prostate Cancer
Contributing: SurvivorNet Staff
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