UK HealthCast: What men need to know about prostate cancer

UK HealthCast is a podcast series featuring interviews with UK HealthCare experts on a variety of health-related topics.

Prostate cancer is the most commonly diagnosed cancer in men and while it can be serious, it's also very treatable, especially when found early. 

In this edition of UK HealthCast, Dr. Stephen Strup, chair of the Department of Urology at the University of Kentucky, explains what men need to know about prostate cancer, associated risks, when to get screened and the different ways the UK Markey Cancer Center can help patients.

Listen to Dr. Strup’s conversation below. For key takeaways from that conversation, continue reading.

What is prostate cancer?

Prostate cancer starts in the prostate, a gland found only in men. It’s a common cancer, diagnosed in about 300,000 men in the U.S. each year. 

While many men can live for years with prostate cancer, about 35,000 die from it annually. That’s why early detection matters.

Who is most at risk for prostate cancer?

There are several known risk factors for prostate cancer:

• Sex: Only men can be diagnosed with prostate cancer.
• Age: Risk for prostate cancer increases as men get older.
• Family history: If a father, brother, or even a mother had cancer (especially breast cancer), your risk for prostate cancer may be higher.
• Race: Black men are at higher risk of developing and dying from prostate cancer.

Can prostate cancer be prevented?

There’s no guaranteed method to prevent prostate cancer, but healthy habits help. Dr. Strup says “If it’s good for your heart, it’s good for your prostate.” That means:

• Eating a healthy, low-fat diet
• Avoiding obesity
• Exercising regularly

These habits not only support your overall health, but they may also lower your cancer risk.

When should men get screened for prostate cancer?

Dr. Strup says most men should start screening around age 45 to 50. The standard test is the PSA blood test. If you're at higher risk, especially if you have a family history of cancer, it’s a good idea to talk with your doctor about starting even earlier.

You may not need the test every year. If your PSA levels are low, your doctor might recommend spacing it out to every two or three years. The key is establishing a baseline and tracking changes over time.

Early detection is important. Before PSA testing became common, prostate cancer was often diagnosed late and after it had already spread. Today, screening gives doctors the chance to catch it earlier, when there are more treatment options.

Early-stage prostate cancer is usually easier to treat and has better outcomes. That’s why screening that is done carefully and with advice provided by experts such as those at the UK Markey Cancer Center is so important.

What are the treatment options?

Not all prostate cancers are the same. Some are aggressive while others grow slowly and might not need treatment right away. Dr. Strup encourages a personalized approach depending on your specific case.

Here are the main treatment paths:

• Active surveillance: For low-risk cancers, doctors may simply monitor the tumor without immediate treatment. 
• Surgery: Robotic surgery has made this option more precise, with fewer side effects than older methods https://ukhealthcare.uky.edu/markey-cancer-center.
• Radiation therapy: Newer technology allows doctors to target tumors more accurately and protect healthy tissue.
• Focal therapy: Still being studied, this option uses energy (like heat or electricity) to destroy cancer in just part of the prostate.
• Some patients might also need hormonal therapy or medication, especially if the cancer is more advanced.

At UK HealthCare, patients work with a full team—including surgeons, radiation specialists, and medical oncologists. They meet with patients together, explain every option, and help them decide what’s best based on their values and goals.

“We have a multidisciplinary clinic for prostate cancer,” Dr. Strup said. “And so you'll come in and, and you'll talk with me about the surgical options, about any focal ablation, if that's something that would be reasonable for your particular disease. At the same time, we'll have you talk to our radiation therapy team about the different options, whether it's brachytherapy, which is a seed implant therapy we do here. We also have SBRT, which is a shorter course radiation or standard radiation, about the pros and cons of each of those approaches and if appropriate, active of surveillance.

"We try to talk about all of those things and we talk about it from different perspectives and help the patient come to the realization that they have a big role in this.”

Many prostate cancers grow slowly, and there’s usually time to learn, think, and plan before jumping into treatment. Every case is different, so understanding your cancer is the first step. Ask questions, talk about your options and don’t be afraid to get a second opinion.

“Cancer's a scary word and nothing I say or do, is going to take that away and I don't want to because it is a huge threat,” Dr. Strup said. “But with prostate cancer, it's far better to say, ‘let's make a good decision and understand our treatment choices.’ … I think really educating the patient in this cancer is paramount because to make a good decision, you've gotta understand where you are on that spectrum and what choices make sense for where you are. And I think patients get that and I think they can understand that and make good choices.”