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Awareness Loop is a publication by Tutti Cancer Warriors, dedicated to shedding light on all types of cancer. From early signs and risk factors to research updates and warrior stories, we keep you informed and empowered. Because awareness isn’t just knowledge, it’s the first step toward action. Stay in the loop, stay aware.
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The prostate is a small gland—about the size of a walnut—in men. It sits below the bladder, in front of the rectum, and surrounds the urethra (the tube urine passes through). Its job is to help produce some of the fluid in semen and regulate urinary flow. Cancer of the prostate means certain cells in the prostate begin to grow uncontrollably, forming a tumor. Most are adenocarcinomas (i.e., cancers arising from the glandular tissue).
Often, prostate cancer starts slowly. Many small tumors grow so slowly they might never cause symptoms within a man's natural life span. In some cases, though, the cancer is more aggressive, spreads (metastasizes), and becomes life‐threatening.
Age: The biggest single risk factor is age. Very rare under 40; most diagnoses happen after age 65—median age at diagnosis globally is around 66–67 years.
Other risk factors: Family history (if a close male relative had prostate cancer), ancestry (higher in men of African descent), lifestyle factors (diet, obesity), possibly environmental risks.
How it progresses: It often begins as localized (contained within the prostate). Then it can spread locally (to nearby tissues or lymph nodes), and in more advanced disease, metastasize (bones, sometimes liver or lungs).
Because early prostate cancer tends to grow slowly, many men have no symptoms at first. When symptoms do appear, they are often vague and overlap with benign prostate enlargement (BPH). Some possible signs:
Difficulty starting urination
Weak or interrupted urinary stream
Increased frequency, especially at night (nocturia)
Feeling of incomplete emptying of the bladder
Urgent or frequent urination
In more advanced cases: pain in the back, hips, or pelvis (if cancer has spread to bone)
Rarely: blood in urine or semen, erectile dysfunction
Because such symptoms can come from many non-cancer prostate issues, they are not reliable for early detection. That’s why screening and awareness are important.
PSA is a protein made by prostate cells. The PSA test measures its level in the blood. Here are the trade-offs:
What PSA can do:
Detect elevated PSA levels that may suggest cancer even when there are no symptoms. Earlier detection may allow treatment that is more likely to succeed.
It can help monitor disease progression or response to treatment.
What PSA can’t or shouldn’t do:
Elevated PSA isn’t specific for cancer—it can be high in benign prostate enlargement, infections, prostatitis, even recent ejaculation. So PSA can give false positives.
It can lead to overdiagnosis: detecting cancers that would never have caused problems during the patient’s life. That can mean unnecessary biopsies, treatments with side effects (urinary, sexual, etc.).
There’s debate about screening frequency, age to begin, age to stop, and how to interpret results. Different guidelines and studies don’t always agree.
Important Studies:
ERSPC (European Randomized Study of Screening for Prostate Cancer): Found that PSA screening did reduce mortality but also led to many overdiagnosed cases.
PIVOT trial: comparing radical prostatectomy vs observation (“watchful waiting”) for localized prostate cancer. Showed that for low-risk cases, the benefit of immediate surgery is small, and side effects can be significant.
Globally, in 2020 there were about 1,414,249 new prostate cancer cases, and ~ 375,000 deaths annually.
In 2018, another estimate: ~1,276,106 new cases and ~ 358,989 deaths.
Projections warn that by 2040, annual new cases may double (to ~2.9 million cases) and deaths could increase by ~85%, driven by aging populations and more life expectancy.
If prostate cancer is diagnosed early, when it's localized or regional (confined to prostate or nearby), 5-year survival rates are extremely high — greater than 99 % in many high-income countries.
Once prostate cancer has metastasized (spread to distant parts of the body, like bones, liver, or lungs), 5-year survival drops markedly – somewhere around 30-40 % or lower depending on place, treatment, and how early metastasis is caught.
Survival has improved over recent decades thanks to better diagnostic tools, improved treatments, and earlier detection.
The prostate gland was first described anatomically in the 1500s (Niccolò Massa, ~1536; illustrated by Vesalius).
Prostate cancer as a disease wasn’t recognized or clearly defined until the 19th century; before modern pathology, many diseases were mysterious, life expectancy lower, diagnostic tools poor.
Early treatments: orchiectomy (removal of testicles) in late 1800s; radical prostatectomy (removing the prostate) first done in 1904 by Hugh Young at Johns Hopkins.
There’s work on risk stratification: identifying which cancers are likely to be aggressive vs indolent, to avoid overtreatment.
Novel diagnostic tools: AI-enhanced imaging (micro-ultrasound + AI) comparing favorably with or complementing MRI and PSA/DRE. (Example: a recent study showed AI micro-US had good sensitivity & better specificity vs traditional screening to detect clinically significant prostate cancer. Less unnecessary biopsies.)
Genetic / molecular markers, polygenic risk scores, liquid biopsies, and even spit / saliva tests being explored. These may pick up genetic predisposition or risk earlier.
Because if cancer is caught while still localized, treatment is far more likely to succeed, with fewer side effects.
Key: awareness of risk factors and symptoms, but also being proactive about screening (balanced with understanding risks of overdiagnosis).
Decisions should be personalized: age, overall health, life expectancy, risk factors, patient preferences.
This week’s puzzle is based on previous edition (childhood cancer awareness) — so if you haven’t read it yet, you might want to catch up first. The answers are hidden in plain sight.
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American Cancer Society. (2025). Key statistics for prostate cancer. https://www.cancer.org/cancer/types/prostate-cancer/about/key-statistics.html
American Cancer Society. (2025). Prostate cancer early detection. https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/tests.html
Emory University. (2025, July 24). Scientists map how prostate cancer transforms into deadlier form. https://news.emory.edu/stories/2025/07/hs_prostate_cancer_research_24-07-2025/story.html
Guardian. (2024, January 30). Getting fitter can reduce prostate cancer risk by 35%, study finds. https://www.theguardian.com/society/2024/jan/30/getting-fitter-can-reduce-prostate-cancer-risk-by-35-study-finds
Guardian. (2024, April 4). Prostate cancer cases worldwide expected to double by 2040. https://www.theguardian.com/society/2024/apr/04/prostate-cancer-cases-worldwide-diagnoses-deaths-2040-study
Guardian. (2024, June 1). Scientists develop quick and cheap spit test for prostate cancer. https://www.theguardian.com/society/article/2024/jun/01/scientists-develop-cheap-and-quick-spit-test-for-prostate-cancer
Medscape. (2025). Prostate-specific antigen (PSA): Overview. https://emedicine.medscape.com/article/1967731-overview
National Cancer Institute. (2025). Prostate cancer—patient version. https://www.cancer.gov/types/prostate
National Library of Medicine. (2018). Prostate cancer overview. In StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK470550/
Pfizer. (2025). Prostate cancer disease overview. https://www.pfizer.com/disease-and-conditions/prostate-cancer
PubMed Central. (2019). Epidemiology and risk factors of prostate cancer. https://pmc.ncbi.nlm.nih.gov/articles/PMC6497009/
Reuters. (2025, June 2). Novartis’ Pluvicto shown to slow prostate cancer earlier. https://www.reuters.com/sustainability/boards-policy-regulation/novartis-pluvicto-shown-slow-prostate-cancer-earlier-setting-2025-06-02/
Times of India. (2024). Prostate cancer in men: How obesity and diet increases the risk. https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/prostate-cancer-in-men-how-obesity-and-diet-increases-the-risk/articleshow/123873180.cms
Wikipedia contributors. (2025). Prostate cancer screening. In Wikipedia. https://en.wikipedia.org/wiki/Prostate_cancer_screening
Wikipedia contributors. (2025). Carcinoma della prostata. In Wikipedia (Italian). https://it.wikipedia.org/wiki/Carcinoma_della_prostata
Wikipedia contributors. (2025). Prostatakrebs. In Wikipedia (German). https://de.wikipedia.org/wiki/Prostatakrebs
World Cancer Research Fund International. (2025). Prostate cancer statistics. https://www.wcrf.org/preventing-cancer/cancer-statistics/prostate-cancer-statistics/
ZERO Prostate Cancer. (2025). Facts & statistics. https://zerocancer.org/about-prostate-cancer/facts-statistics
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