Prostate Cancer Can Stay Silent: Why Men Over 50 Should Know Their Risk
Dr. Ajay Chanakya Vallabhaneni & Dr. P. Vamsi Krishna
Prostate cancer can develop without noticeable symptoms in its early stages. This makes awareness of age, family history and individual risk particularly important for men over 50.
The International Agency for Research on Cancer (IARC), the cancer agency of the World Health Organization, reports that more than 1.5 million cases of prostate cancer were diagnosed worldwide in 2024, accounting for almost eight per cent of the global cancer burden. Prostate cancer was the second most commonly occurring cancer among men worldwide.
Rising Cases Raise Concerns
India, too, is seeing a growing prostate cancer burden. According to projections from the Indian Council of Medical Research–National Cancer Registry Programme (ICMR-NCRP), prostate cancer cases in the country were projected to increase from 41,532 in 2020 to 47,068 in 2025 — a rise of more than 13 per cent in five years. With prostate cancer risk increasing with age, doctors say greater awareness is becoming increasingly important as India’s population ages.
One of the challenges with prostate cancer is that early-stage disease may not produce obvious warning signs. A man can feel healthy and continue his normal routine while the disease remains undetected. Age is among the most important risk factors, with the likelihood of developing prostate cancer increasing as men grow older. Family history is also significant, particularly for men whose father, brother or another close relative has been diagnosed with the disease.
One of the biggest misconceptions is that prostate cancer will always cause urinary symptoms. Early prostate cancer may cause no symptoms at all. The risk increases with age, particularly after 50, and family history can further increase an individual’s risk. Men should not wait for symptoms to become troublesome before discussing prostate health with their doctor. Based on age, family history, symptoms and individual risk, the doctor can advise whether further evaluation is appropriate.
While early prostate cancer can remain silent, persistent changes in urinary habits should not be ignored. Difficulty starting urination, a weak or interrupted urine stream, increased frequency of urination, particularly at night, difficulty emptying the bladder completely, pain or burning during urination, or blood in the urine or semen should be medically evaluated. Persistent pain in the lower back, hips or pelvis may also require assessment, particularly when accompanied by other concerning symptoms.
Not All Urinary Issues Signal Prostate Concer
Doctors emphasise, however, that urinary problems do not automatically mean prostate cancer. Benign enlargement of the prostate becomes increasingly common with age and can produce similar symptoms. Infections and other prostate conditions can also affect urination. The concern is that some men may dismiss persistent changes as a normal consequence of ageing and delay seeking medical advice.
A Prostate-Specific Antigen (PSA) blood test is one of the tools doctors may consider while assessing prostate health. An elevated PSA level does not, by itself, confirm prostate cancer. PSA levels can also rise due to benign prostate enlargement, inflammation and other conditions. The result therefore needs to be interpreted in the context of the man’s age, clinical findings, family history and overall risk, with further investigations recommended when clinically appropriate.
Prostate cancer does not behave the same way in every patient. Some cancers grow slowly and selected patients may be managed through active surveillance, while clinically significant or aggressive cancers may require surgery, radiation therapy, hormone therapy or other systemic treatments. When clinically significant prostate cancer is identified before it has spread, we generally have a broader range of treatment options. The objective is timely and accurate diagnosis followed by treatment tailored to the patient and the biology of the cancer.
Common Misconception About Prostrate Cancer
Doctors also caution against some common misconceptions surrounding this disease. The absence of urinary symptoms does not rule out early disease, while a high PSA result does not automatically mean cancer. Similarly, a diagnosis of prostate cancer does not mean every patient requires immediate surgery. Treatment decisions depend on the stage and grade of the cancer, PSA levels, age, overall health, patient preferences and the likely behaviour of the tumour.
Prostate health needs to become a more routine part of men’s health conversations. Persistent urinary changes should be medically evaluated rather than automatically attributed to ageing, while men over 50 should understand their risk even when they feel completely healthy.
Dr P Vamsi Krishna is Clinical Director, Sr. Consultant & Head – Urology, Robotic, Laparoscopy & Endourology Surgeon, CARE Hospitals, Banjara Hills, Hyderabad.
Dr Ajay Chanakya Vallabhaneni, Senior Surgical Oncologist and Robotic Surgeon, CARE Cancer Institute, CARE Hospitals.
