Browse evidence-based analysis of health-related claims and assertions
After spine surgery for spinal cord compression from prostate cancer, most men who couldn't walk before can walk again, and many feel less pain.
Descriptive
Most men who need spine surgery for prostate cancer that has spread to the spine are already weak or can't walk when they get to the hospital.
Men with prostate cancer that doesn't respond to hormone therapy live much shorter lives after spine surgery than those whose cancer still responds to hormone treatment.
Quantitative
Most men who need surgery for spinal cord compression from prostate cancer have a form of the disease that no longer responds to hormone therapy.
Even when young men only have mild bladder symptoms like burning when peeing—along with blood in urine—they can still have bladder or ureter cancer.
Even when cancer was found in the bladder or ureter, the urine test for cancer cells came back negative every time—so it didn’t help catch the cancer early.
When doctors looked inside the bladder and didn’t see any tumors, taking random tissue samples from normal-looking areas never found cancer—so those biopsies don’t help.
When young men with blood in urine also have side pain, looking inside the ureter with a scope found cancer in one out of two cases—even though the CT scan showed nothing wrong.
In young men under 40 who have blood in their urine (but no infection or kidney stones seen on scan), about 1 in 5 turned out to have a bladder or ureter cancer when doctors looked inside with a scope.
TURP costs a bit more than open surgery for rural patients, but it’s less invasive, patients leave the hospital sooner, and it’s cheaper than newer laser treatments.
Doctors believe TURP is the best surgery for enlarged prostate if they have the right training and equipment — but many rural areas don’t have access to it.
Of the 47 men who had TURP surgery, about 1 in 8 had bleeding, some got a urinary infection or clots blocking their urine, and 3 needed a blood transfusion.
In 47 older men with an enlarged prostate causing urinary problems, doctors removed the excess tissue through the urethra; no one died, and no one needed open surgery.
If radiation therapy brings the PSA level back to undetectable after cancer comes back, the patient is much more likely to live longer—even if the PSA was already high when treatment started.
Correlational
After prostate cancer comes back, how high the PSA is when you start radiation therapy matters more for your survival than how aggressive the cancer looked when it was first diagnosed.
If PSA starts going up—even if it’s still super low (20–50 ng/L)—it’s a strong warning sign that the cancer is coming back and the person is much more likely to die from it than if PSA stays flat.
New, super-sensitive blood tests can spot tiny amounts of PSA that older tests miss, letting doctors find cancer coming back much sooner—sometimes years before it would have been noticed before.
Men whose prostate cancer comes back after surgery and get radiation therapy when their PSA is still very low (under 50 ng/L) live longer and are less likely to get cancer spread than those who wait until their PSA is much higher.
After prostate surgery, men whose PSA levels drop to almost nothing (below 10 ng/L) are much less likely to have the cancer come back or die from it than those whose PSA stays higher.
We need better ways to find the dangerous prostate cancers early, avoid treating harmless ones, and figure out who really needs testing based on their personal risk.
Because we now have better scans and can watch slow-growing cancers instead of treating them right away, PSA testing might be more helpful than harmful—but we still don’t have enough proof to start a national screening program.
Doctors don’t think the finger exam (DRE) is needed if the PSA test is high, and it’s not very useful at all if the PSA is normal—even for men at higher risk.
A new type of scan (mpMRI) before biopsy helps avoid unnecessary procedures and finds more dangerous cancers, but we still don’t know if it saves lives in the long run.
Doctors don’t agree on what PSA level should trigger further testing, and the usual cutoff may not work well for Black men or men with a family history of prostate cancer.