If a man lives long enough, he’ll get prostate cancer. It might sound cold but according to leading American urologist Dr. Michael O’Leary, it’s a fact. And beyond a certain age it’s not worth treating.

Dr. O’Leary of Brigham and Women’s Hospital in Boston, Massachusetts said he typically stops screening for this type of cancer in men over 70. “At that age, the risk of treatment is usually higher than the mortality,” he said. In Bermuda to deliver a talk on prostate cancer, Dr. O’Leary addressed a men-only crowd at the Bermuda Underwater Exploration Institute on June 14. The Bermuda TB Cancer & Health Association organised the event and explained entry was restricted to men only as a means to encourage them to fully participate in the meeting.

Dr. O’Leary said prostate cancer is one of the leading concerns in men over 40. There are no warning signs, no symptoms once you have the tumours and, perhaps even worse, scientists have no idea what causes it.

“It’s not linked to any lifestyle or particular behaviour,” Dr. O’Leary said. “There’s no correlation, for example with cigarette smoking or alcohol consumption. The best indicators are genetics. Men at high risk are those with a first degree relative — a father, brother or grandfather, who has had the disease.” The incidence level is also higher in the black population. But Dr. O’Leary also said the disease will hit all men if they simply live long enough. While no one knows exactly what causes it, doctors do know what it is.

“It’s molecular,” said Dr. O’Leary, “Something happens to cells in the ageing of the gland that cause them to mutate and become tumours.”

The best time to check for prostate cancer in men at high risk is when they hit 40. “Those men should be checked annually, and all men over 50 should be checked annually,’” Dr. O’Leary said.

Since there are no symptoms, regular screening is the best way to determine if you have the disease. A PSA blood test which looks for the prostate specific antigen, and the notorious digital (as in finger) rectal exam are the most common screening methods used. And the good news is that if found early, most men can be cured.

Typical treatments include surgical removal of the prostate gland or radiation.

“The surgery is not trivial and I wouldn’t advise any man to enter into it lightly,” said Dr. O’Leary. He said there are currently two types of radiation which will combat most cases of this type of cancer.

There is the conventional external radiation treatment where the patient can be treated in an outpatient basis. But the treatment is long. The patient must get a daily dose of radiation for 40 consecutive days.

Brachytherapy is another form of radiation treatment where small radioactive seeds are implanted in the patient. Dr. O’Leary said the procedure is a simple one “the seeds are easy to put in just under the scrotum,” he said. The benefit of brachytherapy is that after one doctor’s visit the radiation continues effortlessly. The patient doesn’t have to remember or think at all about the treatment.

This helps lower the stress and worry of men who suffer with the disease. It can also lower the stress of men who don’t have the disease or don’t know that they have it. According to Dr. O’Leary prostate cancer and erectile dysfunction top the list of health concerns in ageing men. “It really bothers them,” he said.