I am 55, diagnosed with stage 1 prostate cancer. What to do?

Question

Hello doctor,

I’m a 55-year-old male. Lately, I’ve been urinating more often, especially at night, and sometimes feel discomfort in my lower back and pelvic area. My PSA levels came back high, and a biopsy confirmed stage 1 prostate cancer. My doctor said it’s localized and recommended active surveillance instead of immediate treatment.

I’m a bit unsure.
Is it safe to wait and just monitor the cancer?
What are the risks of delaying treatment?
How often will I need PSA tests, MRIs, or follow-up biopsies?
Can this cancer spread quickly even if it’s stage 1?
Are there any proven lifestyle changes, vitamins, or diet tips that might help slow the cancer’s growth?

I’m trying to stay calm and informed, but I’d really appreciate your guidance on whether active surveillance is the right step or if I should be considering treatment sooner. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Prostate cancer is usually less aggressive than most other cancers. It is a common malignancy in men that begins in the prostate gland, a small organ located just below the bladder. The treatment approach varies based on the stage, biopsy findings, and the molecular profile of the tumor.

Causes of prostate cancer:

Age: The risk of prostate cancer increases with age.
Genetics: Inherited gene mutations account for 5 % to 10 % of cases. Acquired genetic changes over time can also elevate the risk.
Family History: Having a father or brother diagnosed before age 60 significantly increases your risk.
Obesity: Research shows a strong link between obesity and an increased risk of developing aggressive prostate cancer.
Diet: Diets high in red meat and calcium are associated with a greater risk of prostate cancer. A plant-based diet may help reduce this risk.

Screening and prevention

Screening usually starts at age 50, but if you have a family history of prostate or bowel cancer, earlier screening is advisable.

To help lower your risk of prostate cancer, you can:

Limit red meat and animal fat intake.
Follow a vegetarian-rich diet including broccoli, tomatoes, soy, green tea, and vitamin E.

Treatment overview

The treatment strategy depends on the stage of cancer, histopathology, and molecular profile. In cases of early-stage and low-grade prostate cancer, a “watchful waiting” or active surveillance approach may be appropriate. This means:

No need for frequent biopsies – regular PSA (prostate-specific antigen) testing and clinical exams are usually enough.
If the cancer is low-grade, localized, and the Gleason score is low, the chances of progression are low.
For most early-stage cases, men can live over a decade without disease progression. However, if you have a high Gleason score, even at stage 1, delaying treatment can increase the risk of cancer spreading to the lymph nodes or other organs.

In such cases, treatments like:

Surgery (removal of the prostate gland).
Radiotherapy.
Hormonal therapy (in advanced cases) may be needed to stop further growth and improve outcomes.

I hope this helps.

Please revert so I can assist you further.

Thank you.