Priti Patel, M.D., left, a radiation oncologist specializing in CyberKnife radiosurgery at Hackensack Meridian Riverview Medical Center, explains the technology to Anthony Leanza. It is one of the many options available at the hospital to treat prostate cancer. Courtesy Hackensack Meridian Health
By Jamie Jablonowski, MPH, BSN, RN, CPH
When former President Joe Biden revealed he had been diagnosed with prostate cancer earlier this year, it reignited a national conversation about a disease that affects hundreds of thousands of men each year. While prostate cancer is often highly treatable, it starts with knowing it’s there.
According to the American Cancer Society, prostate cancer is the second-most common cancer in the United States. It’s estimated there will be approximately 313,780 new cases in 2025 and 35,770 deaths related to the disease.
What is
Prostate Cancer?
The prostate is a walnut-sized gland found in the male reproductive system, situated just below the bladder and in front of the rectum, that is responsible for producing seminal fluid. It surrounds the urethra (imagine a piece of clay molded around a straw) and tends to enlarge with age, causing the urethra to narrow. This is why problems with the prostate often lead to urinary issues in men.
Prostate cancer occurs when abnormal cells within the prostate gland grow uncontrollably. This causes the prostate gland to enlarge, though not all prostate enlargement is due to cancer. When detected and treated early, the cancer can be treated. However, if the abnormal cells multiply undetected, they can spread to other parts of the body, most commonly to the bones and lymph nodes. This appears to be what occurred in Biden’s case, where the cancerous cells moved beyond the prostate to his bones.
According to the American Cancer Society, 1 in 8 men will be diagnosed with prostate cancer in their lifetime; however, prostate cancer is more common in men who are 65 years or older. The average age of first diagnosis is 67. Most men who are diagnosed with prostate cancer will not die from it. In fact, there are over 3.35 million individuals who have been diagnosed with prostate cancer currently living in the United States.
Prostate cancer is often considered a “silent cancer” because many men do not experience symptoms, especially in early stages. Priti Patel, M.D., a radiation oncologist with Hackensack Meridian Health, explained that while frequent urination or getting up to use the bathroom more at night may be symptoms of prostate cancer and should not be ignored, most patients are asymptomatic.
Screening Tools
Screening is a process used by doctors to look for cancer before it causes symptoms. Two tests commonly used are a blood test that measures the level of prostate specific antigen (PSA) in the blood. Levels of PSA are elevated in patients with prostate cancer but can also be elevated due to other causes such as medications, an enlarged prostate, infections or medical procedures. PSA is “a protein that’s released from both normal prostate cells and cancer cells. Usually, people will have some value of PSA,” said Patel. “Sometimes exercise or sexual activity prior to blood work can elevate a PSA, so a lot of it is based on watching the trends.”
Another screening tool used is called a digital rectal examination (DRE). A health care provider inserts a finger into a man’s rectum to feel the prostate and palpate for any abnormalities.
Screening for prostate cancer has been controversial, specifically regarding PSA testing, as there is a risk for false-positive results, leading to additional tests and overtreatment. The U.S. Preventive Services Task Force recommends men aged 55 to 69 years discuss screening with their health care clinician to make an informed decision. They do not recommend testing for men 70 years or older. Patel said she believed men over that age should be assessed for both longevity and age. “If the patient has a long life expectancy greater than 10 years, they’re fit, they’re active, they don’t have multiple medical issues, then maybe it’s worth continuing getting that PSA scan.”
Risk Factors
There are several factors that can increase an individual’s risk of prostate cancer, including:
• Age The chance of having prostate cancer increases significantly over age 50. According to the American Cancer Society, about 6 in 10 men diagnosed with prostate cancer are over age 65.
• Race/Ethnicity African American and Caribbean men of African ancestry are at higher risk. These men also tend to be diagnosed at a younger age.
• Family history Having a father or brother with prostate cancer doubles an individual’s risk of developing the disease, with the risk being higher if a man has a brother with the disease than those who have a father who is diagnosed.
• Inherited gene variants or mutations Individuals with the BRCA1 or BRCA2 gene can have an increased risk of prostate cancer. The risk is also increased for men with Lynch syndrome.
Patel recommends that men with the above risk factors discuss earlier screening with their doctor. She also suggests that patients who wish to undergo genetic testing do so under the guidance of a genetic counselor. “I always feel that testing with a genetic counselor is the best because then they can really talk them through their likelihood of carrying the mutation and what are the pathways for them to go to if they are positive,” said Patel. 
Diagnosis, Prognosis and Treatment
Prostate cancer is primarily diagnosed through a biopsy of the prostate. The tissue sample is then examined under a microscope and is then graded based on the Gleason scale. A lower grade means the cancer is less likely to spread to other parts of the body.
According to the Centers for Disease Control, 97% of patients with prostate cancer do not die from the disease five years after their diagnosis. Patel elaborated that part of the reason prostate cancer has such a positive prognosis is that the cancer is slow to advance. “Prostate cancer cells tend to be slow growing if they are caught early and not in an aggressive stage, it can take years actually to grow or spread,” said Patel.
There are several treatment options available to patients diagnosed with prostate cancer and the type of treatment will be dependent on several factors, including the patient’s risk factors and the results of diagnostic tests.
Treatment options include active surveillance, where PSA blood levels and biopsies are completed regularly. Treatment is offered if the cancer grows or begins to cause symptoms. Watchful waiting is another option, where no tests are completed, but symptoms are treated if they present. This option is only recommended for older men not expected to live more than 10 years.
Surgery, radiation and other therapies, including cryotherapy, biological therapy, chemotherapy, high-intensity focused ultrasound, hormone therapy and targeted drug therapy are options.
Patel emphasized that each patient’s treatment protocol will be unique. “We talk to surgeons, radiation oncologists, urologists, medical oncologists, radiologists, pathologists, and we can really come up with the best plan that’s comfortable for that patient.”
According to Patel, following diagnosis, the patient will be sent for imaging to ensure the cancer hasn’t spread to other parts of the body. The most common treatments offered to patients are active surveillance, surgery, and radiation. “If someone has an aggressive prostate cancer or a metastatic prostate cancer, sometimes we add these hormone-blocking medications to help prevent the prostate cancer from spreading. And that’s where prostate cancer is a little bit unique than other cancers. We don’t necessarily talk about chemotherapy unless they don’t respond well to the hormone therapy.”
Patel is optimistic about the future of treatment options for prostate cancer. “One of the exciting things about prostate cancer treatment is how we can start to tailor it more based on these genomic or molecular tests that are available,” she said. Patel described new methods of identifying a patient’s risk for more aggressive prostate cancer by looking at the cancer’s specific genes. This then helps physicians decide how aggressively to then treat the patient.
Is Prevention Possible?
Many of the risk factors for prostate cancer cannot be controlled, such as age, ethnicity, family history or genetics. However, some studies have shown that maintaining a diet and exercise regimen may lower your risk.
Patel acknowledged the fear that patients can experience when being diagnosed with cancer. “I get a lot of patients, they hear a cancer diagnosis and, you know, obviously they’re very anxious or nervous about it. I think prostate cancer, for the most part, can be caught very early and is very treatable.”
The article originally appeared in the June 5 – 11, 2025 print edition of The Two River Times.
