By Dr. Rich Bevan-Thomas, Prostate Cancer Surgeon and Urologist
Introduction
Prostate cancer affects one in eight men during their lifetime, yet misconceptions about the disease remain surprisingly common. These myths can lead to delayed diagnosis, missed screening opportunities, and unnecessary anxiety about treatment.
At Urology Partners of North Texas, our physicians see the impact of misinformation every week. Many men assume that prostate cancer only affects older patients or that no symptoms mean they’re in the clear. The truth is that early detection saves lives — and understanding the facts can make all the difference.
Below are five of the most common myths about prostate cancer, along with what every man should know to protect his health and peace of mind.
Myth #1: “Prostate Cancer Only Affects Older Men”
It’s true that prostate cancer becomes more common with age, but it’s far from a disease that only affects “old men.” While most diagnoses occur after age 60, it’s not rare for prostate cancer to appear earlier in life. Recent national data show that about one in twenty new prostate cancer cases are found in men in their 40s and early 50s, and that number rises sharply with each decade that follows. By the time men reach their mid-50s and 60s, prostate cancer becomes one of the most common cancers they’ll face.
“We still see too many men in their forties or early fifties who were told they were ‘too young to worry,’” says Dr. Justin Lee, a urologic surgeon and partner at Urology Partners of North Texas. “By the time their cancer is detected, it’s sometimes already advanced — and that’s something we can often prevent through early screening.”
Younger age lowers your odds, but it doesn’t grant immunity. For men with any family history or risk factors, having a conversation with a doctor early on can make all the difference.
Myth #2: “No Symptoms Means No Cancer”
Prostate cancer can be one of the most deceptive diseases in men’s health because it often develops silently. Many men assume that if they’re not having urinary problems, pelvic pain, or changes in sexual function, everything is fine. Unfortunately, that false sense of reassurance is exactly what allows some cancers to progress unnoticed.
“Most early-stage prostate cancers cause little to no symptoms,” says Dr. Adam Hollander, a urologist and partner at Urology Partners of North Texas. “That’s why we encourage regular screening — because by the time symptoms show up, the cancer may already be more advanced.”
Symptoms such as slow urine flow, increased nighttime urination, or difficulty starting or stopping the stream are much more often caused by benign prostatic hyperplasia (BPH) — a non-cancerous enlargement of the prostate. But that overlap in symptoms can make it difficult for men to know what’s normal and what’s not.
The key takeaway: no symptoms doesn’t mean no cancer. Prostate cancer in its earliest stages is highly treatable, and regular screening — even when you feel perfectly healthy — remains the best way to catch it early.
Myth #3: “A High PSA Always Means You Have Cancer”
Few test results cause more anxiety for men than hearing they have a “high PSA.” PSA — short for prostate-specific antigen — is a protein produced by cells within the prostate. Normally, only a small amount leaks into the bloodstream. When PSA levels rise, it’s a sign that something is irritating or disrupting the prostate’s structure — but that “something” isn’t always cancer.
“A high PSA is not a diagnosis — it’s a signal that we need to look closer,” says Dr. Keith Waguespack, a urologic surgeon and partner at Urology Partners of North Texas. “Infection or inflammation are two of the most common non-cancerous causes of PSA elevation. That’s why context and follow-up testing are so important.”
Modern diagnostics have made interpreting PSA results far more precise. Advanced imaging, such as prostate MRI, and targeted fusion biopsy allow physicians to determine whether the elevation stems from cancer or a benign process — often sparing men from unnecessary biopsies or anxiety.
An elevated PSA doesn’t automatically mean cancer. It’s an early warning that deserves careful evaluation and, when appropriate, additional testing to understand what’s really happening inside the prostate.
So What Counts as an “Abnormal” PSA?
There isn’t a single PSA number that automatically signals danger. What matters most is the trend over time and how the value relates to each man’s age, prostate size, and risk factors. That said, many urologists start to look more closely when PSA levels climb above 2.5 to 3.0 ng/mL or show a steady rise from a previous baseline.
In our practice, this often prompts a discussion about additional testing — such as a prostate MRI — to determine whether the elevation is related to cancer, inflammation, or another benign condition.
Myth #4: “Everyone with an Elevated PSA Needs a Biopsy”
Hearing that your PSA is elevated can be unsettling, and many men assume it means an immediate biopsy is the only next step. In reality, that’s no longer the standard of care.
“Years ago, most men with a high PSA went straight to biopsy,” explains Dr. Rich Bevan-Thomas, a urologic surgeon and partner at Urology Partners of North Texas. “Today, we have far better tools to determine who truly needs one — and who doesn’t.”
Current guidelines emphasize prostate MRI as the first step when PSA levels are elevated. This scan helps identify any suspicious areas within the gland. If the MRI shows an abnormality, doctors can perform a targeted fusion biopsy — precisely sampling the area of concern — instead of taking random tissue cores from multiple locations.
This approach offers several advantages:
- It reduces unnecessary biopsies for men whose MRI appears normal.
- It increases accuracy by focusing only on concerning regions.
- And it helps doctors distinguish aggressive cancers from slow-growing ones that may not require immediate treatment.
The result is a far more personalized process — one that spares many men from needless procedures while ensuring that those who need treatment receive it promptly.
Myth #5: “Treatment Always Causes Incontinence or Impotence”
One of the most common fears men have after a prostate cancer diagnosis is that treatment will permanently affect their bladder control or sexual function. While this concern was justified years ago, advances in technology and technique have dramatically changed outcomes.
Today, prostate cancer can often be treated with approaches that preserve both quality of life and long-term cancer control.
- Robotic prostatectomy allows surgeons to perform highly precise, nerve-sparing procedures that minimize trauma to the surrounding structures responsible for urinary and sexual function.
- Modern radiation therapy uses image-guided targeting to deliver focused treatment to the prostate while sparing nearby tissues.
- Focal therapy — including technologies such as NanoKnife and high-intensity focused ultrasound (HIFU) — can destroy only the cancerous portion of the gland, leaving the rest of the prostate and surrounding nerves intact.
“The goal today is not just to cure the cancer, but to protect a man’s quality of life,” says Dr. Scott Thurman, a urologic surgeon and partner at Urology Partners of North Texas. “With robotic, radiation, and focal therapies, we can often achieve both — treating the disease effectively while preserving continence and sexual function for most patients.”
While every case is different, most men who undergo modern prostate cancer treatment regain normal bladder control and maintain or recover sexual function over time. The key is early detection and individualized treatment planning with a specialist who can match the therapy to the patient’s needs.
The Bottom Line
Prostate cancer is common — but it’s also highly treatable when caught early. Understanding the facts, knowing your risk, and asking the right questions can make all the difference.
For men in the Dallas–Fort Worth area seeking expert evaluation and care, the physicians at Urology Partners of North Texas provide comprehensive prostate cancer screening, MRI diagnostics, and advanced treatment options tailored to each patient.
Early action saves lives — and knowledge is where it starts.
