Prostate cancer is one of the most common cancers in men, arising from malignant growth within the prostate gland. According to national cancer registry data, it ranked as the fourth most common cancer among Korean men in 2021. In addition, the number of patients has increased by over 40% in the past five years. Family history is a significant risk factor, and age is also one of the most important contributors to disease development.
Compared to many other cancers, prostate cancer typically progresses slowly. In its early stages, it often causes no noticeable symptoms. As the disease advances, urinary symptoms may begin to appear. As cancer cells grow within the prostate, they can compress the urethra, leading to a weak urinary stream, difficulty urinating, and a sensation of incomplete bladder emptying. In more advanced stages, urinary obstruction can result in hydronephrosis or even kidney failure. Prostate cancer may also metastasize to the bones, causing pain, and when it spreads to the spine, it can lead to lower back pain or sciatica.
Because prostate cancer progresses slowly and often remains asymptomatic in its early stages, symptoms may only become noticeable after the disease has advanced or metastasized. However, when detected early, prognosis is excellent. Data from national cancer statistics show that the five-year relative survival rate for localized prostate cancer exceeds 100%, whereas it drops significantly to approximately 48.8% in metastatic cases. This highlights the critical importance of early detection through regular screening.
Unlike some other cancers, prostate cancer is not included in national cancer screening programs in certain regions, making individual screening especially important. Men with a family history are advised to begin annual screening at age 40, while those without a family history should consider screening every one to two years starting at age 50. Patients with symptoms suggestive of benign prostatic hyperplasia should also undergo annual evaluation.
Several methods are used to diagnose prostate cancer. The prostate-specific antigen (PSA) test measures levels of a protein produced by the prostate and helps assess cancer risk. A digital rectal examination (DRE) allows clinicians to detect abnormalities such as nodules, asymmetry, or firmness of the prostate. Transrectal ultrasound provides more detailed imaging of the prostate when physical examination alone is insufficient. A prostate biopsy remains the definitive diagnostic method, involving the collection of tissue samples to confirm the presence of cancer cells. In some cases, MRI is also utilized to further evaluate suspicious findings.
Treatment options for prostate cancer vary depending on the stage of the disease. In early-stage cases, surgery and radiation therapy are commonly used. Radical prostatectomy involves complete removal of the prostate gland, while radiation therapy targets the prostate and surrounding tissues. However, both treatments carry potential side effects. Radiation therapy may affect surrounding normal tissues such as the bladder and urethra, leading to complications like urinary retention or erectile dysfunction. Similarly, surgical removal of the prostate can result in nerve damage, which may cause urinary incontinence or sexual dysfunction.
Post-treatment management is essential to reduce the risk of recurrence and minimize complications. Regular PSA monitoring is a key component of follow-up care. When PSA levels remain below 0.1 ng/mL, the likelihood of recurrence is generally low. However, rising PSA levels may indicate the need for additional treatment. Therefore, consistent and periodic PSA testing is critical for long-term management.
In summary, early detection through regular screening is the most important factor in successfully managing prostate cancer. Timely diagnosis allows for treatment at the optimal stage, improving outcomes and preserving quality of life. Comprehensive care—including accurate diagnosis, appropriate treatment selection, and structured follow-up—plays a crucial role in achieving the best possible results. For men entering middle age and beyond, proactive urological screening is an essential step toward maintaining long-term health and well-being.