What He Wouldn’t Talk About: A Woman’s Look Into Prostate Health
He paused. Just for a moment. But I noticed. “You should book a prostate check,” I said, gently.prostate cancer symptoms“You should book a prostate check,” I said, gently. He gave
He paused. Just for a moment. But I noticed.
“You should book a prostate check,” I said, gently.prostate cancer symptoms
“You should book a prostate check,” I said, gently.
He gave me a half-smile, the kind that covers discomfort. “Why? I feel fine.”
And there it was. The reflex so many men have when it comes to their health—especially this particular part of it.
But as someone who has spent years caring for the men in my life—and watching some suffer silently—I’ve come to learn that “feeling fine” isn’t the same as being safe. And when it comes to prostate cancer, waiting for symptoms can mean waiting too long.
Prostate Cancer: The Quiet Risk
Prostate cancer is the second most common cancer in men worldwide. In the U.S. alone, the American Cancer Society estimates that about 299,000 new cases will be diagnosed in 2025, and nearly 35,000 men will die from it.
The numbers are worse for Black men, who are 1.7 times more likely to be diagnosed and over twice as likely to diefrom the disease compared to white men.
Yet despite these sobering stats, far too many men avoid regular screening—often until symptoms emerge or until someone pushes them to act.
When Should Men Start Getting Tested?
Medical guidelines vary slightly, but here’s a general framework:
- Age 50: Most men with average risk should begin screening.
- Age 45: Men at higher risk (African American men or those with a father or brother who had prostate cancer before 65).
- Age 40: Men with multiple first-degree relatives diagnosed with prostate cancer at an early age.
These early screenings often include:
- PSA blood test (Prostate-Specific Antigen)
- Digital Rectal Exam (DRE)
Screening intervals depend on your results and risk level—your doctor might recommend annual checks or testing every two to three years if your PSA is low.
Why Aren’t Men Getting Tested?
This is the part that frustrates—and fascinates—me. When I started asking men in my life about it, their responses fell into one of a few common buckets:
1. Fear of Discomfort
Many men dread the digital rectal exam, assuming it’s painful or humiliating. It’s neither. It lasts less than a minute and can save your life.
2. Misinformation
Some believe that if they have no symptoms, they don’t need testing. In reality, prostate cancer often shows no signs in its early—and most treatable—stages.
3. Cultural and Generational Silence
Older generations didn’t talk about it. Many still don’t. Some men associate any health issue involving their genitals or rectum with shame or weakness.
4. Lack of Access or Time
Busy schedules, lack of insurance, or distrust in the healthcare system all play a role, especially in underserved communities.
But here’s the truth: Early detection saves lives. And now, it’s easier than ever.
Home Testing: A New Option
One way to break the silence? At-home PSA test kits. They’re discreet, convenient, and a solid first step for men hesitant to go to a clinic.
How It Works:
- You order a kit online from a reputable provider (like LetsGetChecked, Everlywell, or imaware).
- Collect a small blood sample via a finger prick.
- Mail it back to the lab in a prepaid envelope.
- Get your results in a few days via a secure online portal.
Pros:
- Privacy
- No appointments or waiting rooms
- Accessible for men in remote or underserved areas
Cons:
- No physical exam (DRE)
- PSA alone isn’t conclusive—some elevated results are benign, and some cancers don’t raise PSA levels
Important: A home test isn’t a replacement for a full screening, but it can be a gateway to action. If the PSA comes back elevated, a follow-up with a doctor is essential.
What Happens If It’s Caught Early?
This is where the story can have a hopeful ending.
When caught before the cancer spreads, prostate cancer has a 5-year survival rate of nearly 100%.
Let me say that again: nearly 100%.
Even if the cancer is more advanced but still confined to the prostate area, the survival rate is around 98%. The key is catching it early.
Contrast that with metastatic prostate cancer—where the cancer has spread to other parts of the body. The 5-year survival rate drops to just 32%.
Treatment Options: What Comes Next?
If screening reveals a concern, the next steps might include a prostate biopsy, MRI, or ultrasound. If cancer is confirmed, treatment depends on the stage and aggressiveness of the tumor.
Common Treatment Paths:
- Active Surveillance: For slow-growing cancers. Regular monitoring without immediate treatment.
- Surgery (Prostatectomy): Removing the prostate, often done with robotic assistance.
- Radiation Therapy: External or internal radiation to target cancer cells.
- Hormone Therapy: Reduces testosterone to slow cancer growth.
- Chemotherapy: For more advanced cases.
- Immunotherapy / Targeted Therapy: Newer, personalized treatments showing promise.
Every path comes with pros, cons, and possible side effects (such as erectile dysfunction or urinary incontinence), but outcomes have dramatically improved over the past two decades.
What Kind of Doctors Should Men See?
Knowing where to go is half the battle. Here’s a breakdown:
1. Primary Care Physician (PCP)
Your first stop. They’ll order initial PSA tests and refer you if necessary.
2. Urologist
A specialist in the urinary tract and male reproductive system. They perform prostate exams, biopsies, and manage both benign and cancerous conditions.
3. Oncologist
If cancer is detected, especially if it’s advanced, a medical oncologist becomes key. They handle chemotherapy, immunotherapy, and advanced treatment plans.
4. Radiation Oncologist
For those considering radiation therapy, this specialist leads that process.
Your care team might involve multiple specialists working together to create a tailored plan.
Why I’m Still Talking About This
Because the stakes are high. Because the silence is louder than it should be. Because every man deserves the chance to face this with knowledge, not fear.
Whether it’s your partner, brother, father, or best friend—ask the uncomfortable question:
“Have you had your prostate checked?”
If the answer is no, help him take that first step.
By Izzy Malcolm for Ravoke.com
