Scare Tactics about the “Symptoms” of Prostate Cancer

MARK SCHOLZ, MD

In this week’s blog I was supposed to finish out the “Helpful Medications” theme started at my last blog. Specifically I need to make a case for using statin drugs and metformin, a generic diabetes drug, to help suppress prostate cancer.  However, that blog has been temporarily postponed in place of the following:

When Ralph and I wrote Invasion of the Prostate Snatchers we knew our highest priority was to calm people down so they could begin to think rationally.  Obviously the word “cancer” freaks everyone out. People get so scared that all rational thought ceases.  They immediately jump into the arms of the nearest doctor who is willing to offer a quick fix.  With prostate cancer that just happens to be a surgeon.

Scare tactics are effective from a business point of view since in business “time is money.” Frightened people act quickly and decisively, thus saving everyone time.  The psychology of fear is also quite commonly used in advertising.  You have heard these mottos and mantras many times before: “Time is Running Out,” or, “Space is Limited.”  No one wants to miss a one-time opportunity.

The threat of losing a one-time chance for cure naturally drives newly-diagnosed prostate cancer patients to act quickly. And there is after all a certain type of logic to people unfamiliar with prostate cancer.  With almost any other type of cancer a delay in treatment will reduce cure rates. Surprisingly with prostate cancer this is only rarely the case. However, the idea of a “harmless cancer” is certainly foreign to us all. It will take some time for newly-diagnosed patients to absorb this unexpected fact.

That’s why it is critically important to encourage men to take time to gather their senses and calm down.  Given some space to reflect they will learn that with prostate cancer they need to weigh the potential for treatment-related side effects against the tiny amount of increased survival surgery or radiation offers in men with low-risk disease.

As noted above, the fears and confusion incurred by a recent prostate cancer diagnosis have a certain type of logic. But what is totally illogical is the proliferation of articles I keep coming across on the internet that purportedly describe the “Symptoms of Prostate Cancer.”  Invariably these articles present a long list of symptoms such as urinary frequency, nighttime urination, slow urination, and blood in the urine as possible indications of prostate cancer.

These articles are completely false! EARLY PROSTATE CANCER ALMOST NEVER HAS SYMPTOMS.  This is why the PSA blood test has been so revolutionary.  PSA can detect prostate cancer before symptoms of advanced disease occur. The most common symptom of prostate cancer—bone pain—only occurs after the disease has spread to the bones. Prostate-related symptoms, when they are present, signal another diagnosis such as prostatitis or prostate enlargement. These prostate problems have nothing to do with prostate cancer. Symptoms such as these may need evaluation and treatment but there is no reason to scare people with the suggestion of cancer.

Competition on the internet has become so fierce that just about any scare tactic is considered acceptable, up to and including bald-faced lying.  But let’s put this falsehood to rest.  The myth that early-stage prostate cancer causes urinary or sexually related symptoms is an exploitative tactic that can lead to all kinds of harm, creating anxiety and fear that results in unnecessary diagnostic testing such as random needle biopsies that lead to the over-diagnosis of low-risk prostate cancer.