Can a person die from prostate cancer

Prostate Cancer - Early Detection

The illness

Prostate cancer is the most common cancer in men. It usually occurs at an advanced age and often grows slowly: 4 out of 5 sufferers die from another cause, not from cancer. Prostate cancer is almost non-existent in those under 40. The average age of onset is 70 years. If first-degree relatives (father or brother) have had prostate cancer, your own risk of developing it one day also increases.

The investigations

For men over 45 years of age, the statutory health insurance pays a palpation examination of the prostate once a year. The doctor palpates the prostate from the rectum. Some men find the examination uncomfortable. It is also not very precise. Experts therefore do not recommend it as the sole examination for early detection.

The test for that prostatasspecific A.required (PSATest) is not a cash benefit. It costs around 25 euros, and discussing the result with the doctor again costs around 20 euros.

PPE is a protein that only makes up the prostate. An increased PSA value indicates a change in the prostate. The cause can be cancer, but most of the time it is inflammation or an enlarged prostate: only about 1 in 4 men with abnormal test results actually have cancer. The result is available a few days after the blood sample has been taken.

Early detection: benefits and risks

The PSA test has been examined in several studies. These have conflicting results. The largest study suggests the test may prevent some deaths from prostate cancer. At the same time, one often discovers cancer that would never have been noticed without a test and would never have become dangerous. This can lead to unnecessary treatments. And some men die of prostate cancer despite having a PSA test and thus find out earlier about an incurable disease. There are a number of other tests that your health insurance does not pay for. This will include more blood tests and ultrasounds. Their usefulness is uncertain, so they are not suitable for early diagnosis.

Advantage of early detection
  • The PSA test is likely to prevent some premature deaths: out of 10,000 men examined, around 12 will be saved from death from prostate cancer.
Disadvantages of early detection
  • Cancer will also be detected and possibly treated that is not dangerous and causes no symptoms: this affects about 340 out of 10,000 men examined. Consequences of this unnecessary treatment can impotence (Erectile dysfunction) and Incontinence (Bladder weakness).
  • Despite being tested, one can die of prostate cancer: this affects about 49 out of 10,000 people examined.
  • The test result may initially indicate cancer even though it is not present, in around 3 out of 4 people. That can be unsettling.
  • Cancer is rarely overlooked despite the test.

What professionals recommend

  • The experts speak out neither for nor against early detection. There is evidence that the PSA test prevents deaths from prostate cancer. At the same time, there is a higher risk of over-treatment.
  • The doctor should provide men aged 45 and over with detailed information about the advantages and disadvantages of early detection.
  • Men who opt for early detection after being informed should be offered a PSA test. A palpation examination can also be considered, but it is not sufficient as a sole examination.
  • The experts do not recommend any other tests for the early detection of prostate cancer.
  • A one-time increase in PSA value says little. It is therefore important to check it again for correctness using the same laboratory method.

Only you can judge whether a PSA test is an option for you. Take into account your state of health and other illnesses. You should only get tested if you have an elevated PSA level biopsy (Tissue removal through the rectum) are ready.

Think about what speaks for and against the test for you personally. Everyone has a different focus. Discuss uncertainties and doubts with people who are close to you and with your doctor.

What you can do yourself

Early detection of cancer is often referred to as "cancer screening". This term is misleading: if you take screening tests, you won't prevent prostate cancer. With these tests, pre-existing cancer can be detected earlier and sometimes treated early enough to prevent it from progressing.

  • Make your decision in peace. It's not urgent. Reconsider the information at home and sleep on it again. Do not be rushed and ask until you understand all the consequences of the investigation.
  • There are no miracle diets for cancer. Dietary supplements such as vitamin E or selenium do not protect against prostate cancer. This is proven by good studies.

Anyone who basically wants to do something for their health and "take precautions" can check their lifestyle:

  • A balanced diet supports health. A lot of fresh vegetables and fruit and few animal fats contribute to this.
  • Those who are physically active are less likely to develop permanent illnesses.

  • Smoking is an established risk factor for many diseases, including cancer, but also cardiovascular and respiratory diseases. You can find support for quitting smoking, for example, at www.rauchfrei-info.de.

June 2019, published by the German Medical Association and the National Association of Statutory Health Insurance Physicians