Introduction

September is Prostate Cancer Awareness Month, a time dedicated to educating the public about prostate health and dispelling myths that often surround the disease. First established by the American Foundation for Urological Disease (AFUD) in 1999 and later endorsed by a U.S. Senate resolution, this observance carries renewed urgency after President Joe Biden publicly shared his stage 4 prostate cancer diagnosis in May 2025.

Prostate cancer is the fourth most commonly diagnosed cancer worldwide, accounting for about 7.3% of all cancer cases. Despite its prevalence, many misconceptions persist. Below are the top 10 myths, followed by evidence-based facts that debunk them.

Top 10 Prostate Cancer Myths

1. Myth 1: Only older men get prostate cancer

• Reality: The median age for prostate cancer diagnosis is about 67 years, and the risk increases with age. As a result, it is a commonly held belief that prostate cancer only occurs in elderly men; it can occur in younger men as well. In a 2022 retrospective study, researchers examined 116,796 prostate cancer patients in the Surveillance, Epidemiology, and End Results (SEER) database. These patients were diagnosed between 1992 and 1997 and followed for 20 years. The study found that among men diagnosed after the age of 70, 21% died of prostate cancer. For those diagnosed before the age of 60, 14.4% died of the disease. Although rare, prostate cancer can even occur in men under the age of 40.

2. Myth 2: Prostate cancer always causes symptoms early

• Reality: In its early stages, when prostate cancer is still confined to the prostate, patients often have no symptoms. When symptoms do appear, they are usually similar to those of other non-threatening urinary tract conditions, such as an enlarged prostate. Many cases of asymptomatic prostate cancer are slow-growing and may only require a doctor’s active surveillance. However, you should talk to your doctor if you notice symptoms like dull pain in the lower pelvic area, a frequent need to urinate, or difficulty urinating, such as pain, burning, or a weak urine flow. Blood in the urine (hematuria) and painful ejaculation can also occur. Some men may also experience pain in the lower back, hips, or upper thighs. Many early cases are slow-growing and may be managed with active surveillance.

Myth 3: A high PSA level always means prostate cancer

• Reality: While the prostate-specific antigen (PSA) test is one of the early detection tools used for prostate cancer screening, elevated levels do not always indicate cancer. An enlarged prostate, a prostate infection, or even genetic factors can also cause higher PSA levels. For this reason, if your doctor suspects prostate cancer, they may recommend additional tests such as a digital rectal exam and a prostate biopsy to confirm the diagnosis.

Myth 4: Men with no family history are safe

• Reality: Although studies show that men with a family history of prostate cancer have a higher risk of developing the disease, it can also occur in men without any family history. Only about 5–10% of prostate cancer cases are considered hereditary. The vast majority are linked to random genetic changes that develop over a man’s lifetime.

Myth 5: Prostate cancer is always aggressive and fatal

• Reality: Prostate cancer can take different forms. Some patients have slow-growing cancers that may take time to progress, while others develop aggressive prostate cancer that progresses rapidly and can spread to other parts of the body. One study reported that only 20% of diagnosed patients have prostate cancers that progress to a deadly stage. Doctors use a combination of PSA levels, clinical stage, and Gleason score from biopsies to guide personalized treatment plans.

Myth 6: Screening is unnecessary and risky

• Reality: When used appropriately, PSA and digital rectal exams can save lives. Currently, the United States Preventive Services Task Force (USPSTF) recommends that men aged 55 to 69 make individual decisions about PSA-based screening in consultation with their clinician. This shared decision-making should consider factors such as family history, race or ethnicity, existing health conditions, personal values, and preferences regarding potential screening and treatment outcomes. The USPSTF advises against screening men who do not express a clear preference for it.

Myth 7: Surgery or treatment always leads to impotence or incontinence

• Reality: Side effects vary depending on treatment type, cancer risk, and individual health. Also, among men with low-risk cancer, 14% of those who had surgery had ongoing urine leakage after 10 years, compared with 4% for radiation and 10% for active surveillance. For high-risk cancer, about 25% of men who had surgery experienced urinary leakage, compared with 11% for radiation plus hormone therapy. Overall, treatment type affects urinary, sexual, and bowel side effects, but overall health and survival remain comparable regardless of the choice. Modern surgical and radiation techniques always aim to preserve function.

Myth 8: Lifestyle changes alone can prevent prostate cancer

• Reality: Healthy habits may help lower the risk of prostate cancer, but they cannot guarantee prevention. Other factors that cannot be changed, such as age, family history, race, and inherited genetic mutations, continue to be major contributors to the disease. It is important to discuss your personal risk and potential strategies to reduce it with your doctor.

Myth 9: Prostate cancer spreads quickly and is untreatable once diagnosed

• Reality: Many prostate cancers are slow-growing. About 80% of men diagnosed have cancers that are still localized to the prostate. When detected at this early stage, life expectancy can be as high as 99% over 10 years. Managing slow-growing, early-stage prostate cancer typically involves a personalized plan of active surveillance, with treatment initiated only if the doctor determines it is necessary to control the disease while it is in a curable stage. For advanced prostate cancer, several treatment options offer a chance of survival. About 37% of patients with advanced prostate cancer survive five years after treatment.

Myth 10: Supplements, herbs, or alternative therapies can cure prostate cancer

• Reality: No supplement or herbal remedy has been clinically proven to cure prostate cancer. Many studies on alternative therapies are still at the preclinical stage, conducted in lab-grown cells or mice. As a result, the reported benefits cannot be applied to humans. Relying solely on these remedies can delay effective treatment.

Conclusion

Prostate cancer remains one of the most common cancers worldwide, yet misinformation continues to cloud public understanding. By addressing these myths with evidence-based facts, Prostate Cancer Awareness Month underscores the importance of early detection, informed decision-making, and ongoing research. Open conversations and education are crucial to improving outcomes for men everywhere.

References

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