Every Man Over 50 Needs to Read This About Prostate Cancer

Most prostate cancers are found before symptoms develop. Here's who should be screened and what every man needs to know.  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

August 03, 2026   |   Read online Who Is At Risk of Prostate Cancer? Prostate Cancer Treatments: From Active Surveillance to Targeted Therapy Helping adults over 50 stay strong, mobile, and independent Welcome to Monday's Edition of The Exercise Doc Good morning, and welcome! I hope you had a wonderful weekend and found a little time to recharge. As we begin a new week, we're turning our attention to a topic that affects millions of men and their families: prostate cancer. The good news is that prostate cancer is often highly treatable—especially when it's detected early. The challenge is knowing who is at higher risk, when screening makes sense, and what today's treatment options really look like. Unfortunately, there's a lot of confusing and sometimes conflicting information out there. In today's newsletter, we'll answer two of the most important questions men over 50 ask: Who is at risk for prostate cancer, and should you be screened? What are the current treatment options, and how have they improved over the last several years? Whether you're making decisions for yourself or helping a father, husband, brother, or friend navigate these conversations, my goal is to provide clear, evidence-based information that helps you make informed decisions—not fear-based ones. As always, thank you for allowing me to be part of your healthy aging journey. Every Monday, Wednesday, and Friday, my goal is simple: to help you live longer, stronger, and healthier with practical advice you can actually use. 📘 This Week's Resource If you're looking for a complete roadmap to staying healthy as you age, be sure to check out my Doctor's Guide to Men's Health After 50. It brings together practical, evidence-based guidance on the most important health issues facing men—including heart disease, prostate health, exercise, nutrition, sleep, preventive screenings, and much more. You can learn more and find all of my guides, newsletter resources, videos, and recommended products here: 👉 https://px60r.mssg.me/ Thank you for reading, and if you find today's articles helpful, please consider sharing them with a friend or family member. You never know whose life a simple conversation about prevention might change. Here's to a healthy week ahead! Dr. Mike The Exercise Doc Doctor's Guide to Men's Health After 50 Dr. Mike, The Exercise Doc, shares practical, evidence-based strategies to help men over 50 improve their health, stay active, prevent disease, and enjoy a longer, stronger, healthier life. $0.00 usd Who Is At Risk of Prostate Cancer? What Every Man Should Know About Screening For many men, prostate cancer isn't something they think about until a friend is diagnosed or their doctor mentions getting a PSA blood test. That may be a mistake. Prostate cancer is the second most common cancer in men, behind only skin cancer. In the United States, about 1 in 8 men will be diagnosed during their lifetime. The good news is that when prostate cancer is found early—before it has spread—the five-year survival rate is greater than 99%. The challenge is that prostate cancer often develops silently, without causing any symptoms until it is more advanced. That is why understanding your personal risk and knowing when to be screened are so important. What Is the Prostate? The prostate is a walnut-sized gland located just below the bladder. It surrounds part of the urethra, the tube that carries urine out of the body. Its primary job is to produce fluid that nourishes and transports sperm. As men age, the prostate commonly enlarges. Most enlargement is due to benign prostatic hyperplasia (BPH), which is not cancer. However, prostate cancer can also develop within the gland, making proper evaluation essential. Who Is Most at Risk? Several factors increase the likelihood of developing prostate cancer. Age Age is the single biggest risk factor. Most prostate cancers are diagnosed after age 65. Although younger men can develop prostate cancer, it is uncommon before age 50. As life expectancy increases, more men are living long enough to develop prostate cancer, making screening discussions especially important. Family History If your father, brother, or son has had prostate cancer, your own risk increases significantly. Your risk becomes even higher if: More than one close relative has had prostate cancer Family members were diagnosed before age 65 Multiple generations have been affected Family history is one of the strongest reasons to begin screening earlier. African American Men African American men have one of the highest prostate cancer risks in the world. Compared with White men, they are: More likely to develop prostate cancer More likely to develop aggressive disease More likely to die from prostate cancer For this reason, many experts recommend discussing screening earlier in African American men. Inherited Genetic Mutations Certain inherited gene mutations increase prostate cancer risk. These include mutations in: BRCA1 BRCA2 HOXB13 Lynch syndrome-associated genes Men who have a strong family history of breast, ovarian, pancreatic, or prostate cancer should discuss whether genetic counseling or testing may be appropriate. Lifestyle Unlike some cancers, lifestyle is not the primary driver of prostate cancer, but it still matters. Research suggests possible associations with: Obesity Physical inactivity Diets high in processed meat Diets high in saturated fat Conversely, maintaining a healthy weight, exercising regularly, and eating a Mediterranean-style diet are associated with better overall health and may help reduce the risk of aggressive disease. Does Prostate Cancer Cause Symptoms? Often, no. Many men with early prostate cancer feel completely healthy. When symptoms occur, they may include: Difficulty urinating Weak urine stream Frequent nighttime urination Blood in the urine Blood in the semen Erectile dysfunction Bone pain (with advanced disease) Unfortunately, these symptoms are much more commonly caused by benign prostate enlargement, not cancer. That is why screening—not waiting for symptoms—is so important. What Is a PSA Test? PSA stands for prostate-specific antigen, a protein made by prostate cells. A PSA blood test measures how much PSA is circulating in your bloodstream. Higher PSA levels can occur because of: Prostate cancer Enlarged prostate (BPH) Prostate infection Recent ejaculation Certain medical procedures involving the prostate An elevated PSA does not automatically mean cancer, but it does signal that further evaluation may be needed. One of the biggest advances over the past decade has been moving away from relying on a single PSA number. Today, physicians often consider: Your age PSA trend over time PSA density (PSA relative to prostate size) PSA velocity (how quickly it changes) Additional blood or urine biomarkers MRI findings before deciding on a biopsy This approach has helped reduce unnecessary biopsies while improving detection of clinically significant cancers. What About the Digital Rectal Exam? The digital rectal exam (DRE) allows a physician to feel the back surface of the prostate for abnormalities. Although it may be briefly uncomfortable, it usually takes less than a minute. The DRE can sometimes detect cancers that produce little PSA, making it a useful part of the evaluation in selected men. When Should Screening Begin? Current recommendations emphasize shared decision-making between a man and his healthcare provider. General guidance includes: Average risk: Begin discussing screening around age 50. Higher risk (African American men or men with a first-degree relative diagnosed early): Consider discussions beginning around 45. Very high risk (multiple affected relatives or known genetic mutations): Discussions may begin around 40. Screening decisions should also take overall health and life expectancy into account. Men with a life expectancy of less than about 10 years are generally less likely to benefit from routine screening because many prostate cancers grow very slowly. Are There Any Downsides to Screening? Yes. Screening saves lives, but it is not perfect. Possible downsides include: False-positive PSA results Anxiety Additional testing Unnecessary biopsies Detection of slow-growing cancers that may never become life-threatening Fortunately, modern prostate cancer care has changed dramatically. Instead of treating every cancer immediately, many men with low-risk disease are safely managed with active surveillance, avoiding unnecessary surgery or radiation while closely monitoring for changes. We'll discuss this approach in detail in our next article. Can You Lower Your Risk? No one can completely prevent prostate cancer, but healthy habits may lower the risk of developing aggressive disease while improving your overall health. Focus on: Maintaining a healthy weight Exercising most days of the week Eating plenty of fruits and vegetables Limiting processed meats Not smoking Keeping chronic conditions such as diabetes and high blood pressure under control These habits also reduce your risk of heart disease, stroke, and many other chronic illnesses. Research Snapshot Large randomized trials have shown that PSA-based screening can reduce deaths from prostate cancer when men are appropriately selected and followed. More recent advances—including prostate MRI, improved biomarkers, and active surveillance—have reduced unnecessary biopsies and overtreatment while maintaining the benefits of early detection. Dr. Mike's Prescription If you're over 50—or over 45 with higher risk—don't wait until you develop urinary symptoms to think about prostate cancer. Have a conversation with your healthcare provider about your individual risk and whether screening makes sense for you. Early detection doesn't mean every man needs treatment, but it does provide more options and, when needed, a much better chance of cure. Did You Know? A healthy PSA level does not guarantee you don't have prostate cancer, and a high PSA level does not necessarily mean you do. That's why PSA results should always be interpreted in the context of your age, risk factors, physical examination, and, when appropriate, additional testing such as MRI or specialized biomarkers. Bottom Line Prostate cancer is common, but it is also one of the most treatable cancers when detected early. Knowing your personal risk factors and having an informed discussion about screening can help you make the decision that is right for you. For many men, a simple blood test may be the first step toward protecting their long-term health. Click here for full The Full Men’s Health After 50 video Prostate Cancer Therapy: From Active Surveillance to Targeted Therapy Hearing the words "You have prostate cancer" can stop anyone in their tracks. For decades, many men believed that a diagnosis meant immediate surgery, radiation, or chemotherapy. Today, that's no longer true. One of the biggest advances in prostate cancer care is recognizing that not every prostate cancer behaves the same way. Some grow so slowly they may never cause problems. Others are aggressive and require prompt treatment. The goal is no longer simply treating cancer. The goal is treating the right cancer in the right patient at the right time. Not All Prostate Cancers Are Dangerous Most prostate cancers grow slowly. In fact, many older men die with prostate cancer rather than from it. Doctors now classify prostate cancers into different risk categories based on: PSA level Gleason Grade Group (how abnormal the cancer cells look) MRI findings Biopsy results Size of the tumor Whether cancer has spread beyond the prostate These factors help determine whether immediate treatment is needed—or whether careful observation is the safer choice. Active Surveillance: Sometimes the Best Treatment Is No Treatment Many men are surprised to learn that the first recommendation after a prostate cancer diagnosis may be... Nothing. Or more accurately: Watch it carefully. This approach is called active surveillance. Rather than treating immediately, physicians monitor the cancer with: Regular PSA blood tests Periodic prostate MRIs Repeat biopsies when appropriate Physical examinations Treatment begins only if there is evidence that the cancer is becoming more aggressive. For men with low-risk prostate cancer, this approach has been shown to be very safe while avoiding unnecessary side effects. Thousands of men have remained on active surveillance for many years without ever requiring surgery or radiation. When Is Surgery Recommended? For cancers that are more aggressive—or in younger, healthier men expected to live many more years—surgery may offer the best chance of cure. The most common operation is a radical prostatectomy, which removes: The prostate gland Seminal vesicles Occasionally nearby lymph nodes Today, most prostatectomies are performed using robotic-assisted minimally invasive surgery. Although the surgeon controls every movement, robotic technology provides: Smaller incisions Less blood loss Less postoperative pain Faster recovery Shorter hospital stays Experience matters. Outcomes for cancer control, urinary continence, and preservation of erectile function are generally better when surgery is performed by high-volume surgeons. Radiation Therapy Has Also Improved Radiation therapy has become much more precise than it was years ago. Modern techniques can deliver high doses directly to the prostate while limiting exposure to nearby healthy tissues. Common options include: External Beam Radiation Therapy (EBRT) High-energy beams are directed at the prostate over several treatment sessions. Newer techniques allow treatment to be highly targeted. Stereotactic Body Radiation Therapy (SBRT) SBRT delivers larger doses of radiation in only a few treatments. For selected men, outcomes are comparable to longer treatment courses while offering greater convenience. Brachytherapy Small radioactive seeds are implanted directly into the prostate. The seeds deliver radiation over time while minimizing exposure to surrounding tissues. This option is often used alone for low-risk disease or combined with external radiation for higher-risk cancers. Hormone Therapy Prostate cancer cells often depend on testosterone to grow. Hormone therapy—also called androgen deprivation therapy (ADT)—reduces testosterone levels or blocks its effects. Hormone therapy may be recommended: Before radiation Along with radiation After recurrence For metastatic prostate cancer Common side effects include: Hot flashes Fatigue Loss of muscle mass Weight gain Reduced sexual desire Bone loss Regular exercise—especially resistance training—and adequate protein intake can help reduce some of these treatment-related effects. What About Chemotherapy? Chemotherapy is not commonly used for early-stage prostate cancer. Instead, it is usually reserved for: Advanced disease Cancer that has spread Cancer no longer responding to hormone therapy Newer chemotherapy regimens have improved survival for many men with advanced disease. Newer Treatments Continue to Improve Outcomes Prostate cancer treatment has advanced rapidly over the past decade. Depending on the type of cancer and its genetic features, physicians may recommend: Targeted Therapy Certain medications work especially well in men whose cancers carry specific inherited or acquired genetic mutations, such as BRCA1 or BRCA2. These therapies attack cancer cells while limiting damage to healthy tissue. Immunotherapy Some advanced prostate cancers can be treated by stimulating the body's immune system to recognize and attack cancer cells. Although not appropriate for every patient, immunotherapy has become an important option in selected cases. Radiopharmaceutical Therapy One of the newest advances involves radioactive medications that travel directly to prostate cancer cells throughout the body. These treatments can improve survival and reduce pain in men with metastatic prostate cancer. What Are the Chances of Survival? This is the question every patient asks. The encouraging news is that outcomes are excellent when prostate cancer is detected early. For cancer that remains confined to the prostate, the five-year relative survival rate is greater than 99%. Even for men with more advanced disease, treatment options continue to improve, allowing many to live active, meaningful lives for years after diagnosis. Choosing the Right Treatment There is no single "best" treatment for every man. Instead, decisions depend on: Your age Overall health Life expectancy Cancer stage Gleason Grade Group PSA level MRI findings Personal preferences Potential side effects Your goals and priorities For many men, obtaining a second opinion from a urologist, radiation oncologist, or multidisciplinary prostate cancer center can provide valuable perspective before making a final decision. Research Snapshot Long-term studies have shown that active surveillance is a safe option for carefully selected men with low-risk prostate cancer, with very low rates of prostate cancer-related death over 10 to 15 years of follow-up. At the same time, advances in robotic surgery, image-guided radiation therapy, genetic testing, targeted therapies, and radiopharmaceuticals have significantly expanded treatment options and improved outcomes for men with higher-risk or advanced disease. Dr. Mike's Prescription A diagnosis of prostate cancer should never be viewed as an emergency requiring an immediate decision. Take the time to understand your cancer, ask questions, review all of your treatment options, and consider a second opinion—especially if major surgery or radiation is being recommended. The best treatment is the one that matches both your cancer and your personal goals. Did You Know? The majority of men diagnosed with low-risk prostate cancer today do not go directly to surgery. Many safely choose active surveillance, allowing them to avoid or delay treatment-related side effects while remaining under close medical supervision. Bottom Line Prostate cancer treatment has changed dramatically over the past two decades. Today, physicians can tailor treatment to the biology of the cancer and the health of the individual patient. Many men never need immediate treatment, while those who do benefit from more precise surgery, improved radiation therapy, and innovative new medications. The most important step is not rushing into treatment—it is understanding your options and making an informed decision with your healthcare team. ⚡ Quick Health Wins 🩺 Know Your Family History If your father, brother, or son had prostate cancer—especially before age 65—your own risk is significantly higher. Make sure your healthcare provider knows your family history. 🥗 Fill Half Your Plate with Plants A diet rich in vegetables, fruits, legumes, and whole grains is associated with better overall health and may help reduce the risk of several cancers. It's one of the simplest healthy aging habits you can adopt. 🚶 Move for 30 Minutes Today Regular physical activity won't prevent prostate cancer by itself, but it can help you maintain a healthy weight, improve heart health, lower inflammation, and better tolerate treatment if cancer is ever diagnosed. 📅 Stay Up to Date on Screenings Don't wait until something feels wrong. Preventive health visits are your opportunity to discuss PSA screening, colon cancer screening, blood pressure, cholesterol, diabetes, and other important health checks. 💪 Try This This Week Take 10 minutes to schedule or prepare for your next annual wellness visit if you don't already have one on the calendar. Before your appointment, write down: Your family's history of prostate, colon, breast, or ovarian cancer. Any urinary symptoms you've noticed, even if they seem minor. Three health questions you've been putting off asking your doctor. The date of your last PSA test and colon cancer screening (if you know them). Walking into your appointment prepared helps you get more value from your visit and ensures the issues that matter most to you don't get overlooked. Small step. Big payoff. Preventive care works best when you're proactive—not reactive. How did you like today's newsletter? Love It It's Okay Not Great   Update your email preferences or unsubscribe here © 2026 The Exercise Doc 228 Park Ave S, #29976, New York, New York 10003, United States Powered by beehiiv