Prostate cancer has overtaken lung cancer to become the most commonly diagnosed cancer among men in South Korea. Experts advise that because early-stage prostate cancer is often asymptomatic and difficult to diagnose based solely on urinary symptoms, early screening that takes age and family history into account is crucial.
According to the latest data released by the National Cancer Information Center on the 8th, there were 23,640 new prostate cancer cases in South Korea in 2023, surpassing lung cancer (21,846 cases). This accounts for 7.8% of all cancer cases and 15.0% of cancer cases among men. In other words, approximately one in seven men diagnosed with cancer each year has prostate cancer.
Prostate cancer is often asymptomatic in its early stages, but as it progresses, symptoms such as a weak urine stream or frequent urination may appear. However, these symptoms are also common in benign prostatic hyperplasia (BPH), making it difficult to distinguish between the two conditions based solely on urinary status.
Lee Jang-hee, head of the Department of Urology at Incheon Himchan General Hospital, explained, "Most early-stage prostate cancer is asymptomatic, but as it progresses, urinary symptoms similar to those of BPH appear." He added, "The severity of urinary symptoms does not directly reflect the presence or progression of prostate cancer."
BPH and prostate cancer both originate in the same organ, but they primarily begin in different areas. BPH involves the enlargement of tissue surrounding the urethra, which compresses the urinary tract and causes frequent urination, nocturia, and a sensation of incomplete bladder emptying. In contrast, prostate cancer mainly develops on the outer side of the prostate, away from the urethra, so it may not significantly affect urinary function in its early stages.
If the cancer progresses to affect the urethra or bladder, symptoms such as difficulty urinating, hematuria, and pelvic pain may occur. If it metastasizes to the bones, pain may develop in the lower back or pelvis, and in severe cases, spinal cord compression can lead to muscle weakness or sensory abnormalities.
Survival rates for prostate cancer vary significantly depending on the stage at diagnosis. According to the 5th-year relative survival rates by stage for major cancers from 2019 to 2023 published by the National Cancer Information Center, the rate was 103.6% for localized stages where the cancer remained confined to the prostate, and 101.1% for regional stages where it had spread to adjacent tissues or lymph nodes. In contrast, the rate dropped to 51.2% for distant stages where the cancer had metastasized to other parts of the body. Relative survival rates are indicators compared against the expected survival rates of the general population and can exceed 100%.
The most widely used test for early detection of prostate cancer is the Prostate-Specific Antigen (PSA) blood test. PSA is a protein produced by the prostate, and its concentration in the blood may increase if abnormalities such as cancer occur. A digital rectal examination, in which a doctor checks for nodules or asymmetry in the prostate through the anus, is also utilized. However, neither of these tests confirms a diagnosis of cancer.
The 2026 European Association of Urology (EAU) guidelines for the management of prostate cancer recommend that men without specific risk factors begin PSA testing at age 50. If a father or brother was diagnosed with prostate cancer before age 60, testing should be considered from age 45, and if there is a BRCA2 gene mutation, from age 40.
The frequency of testing varies depending on risk factors such as initial PSA levels and family history. If levels are low and risk factors are minimal, the interval between tests can be extended, but if levels are high or there is a family history, more intensive follow-up monitoring is required.
A high PSA level does not necessarily indicate prostate cancer. Levels can also rise due to BPH, prostatitis, or urinary tract infections. Conversely, even if PSA levels are within the normal range, cancer cannot be completely ruled out, so a comprehensive evaluation considering repeated test results, age, family history, and prostate volume is necessary.
Dr. Lee stated, "We do not apply the PSA threshold of 4.0 ng/mL as an absolute boundary for determining the presence of cancer. Instead, we carefully assess the need for a biopsy by comprehensively considering PSA density, repeated tests, and prostate MRI findings." He added, "The most basic method for early detection of prostate cancer is to understand one's own PSA level according to age while asymptomatic and to regularly track changes in the levels over time."
in THEBIO
