Ashraf Engineer
June 14, 2025
EPISODE TRANSCRIPT
Hello and welcome to All Indians Matter. I am Ashraf Engineer.
When news broke that former US President Joe Biden has been diagnosed with prostate cancer, it was a reminder of how prevalent this disease is and how susceptible men over 40 years of age are to it. In India, prostate cancer is on the rise, posing not just medical but also financial challenges. Doctors have warned that the disease, once rare in India, is now one of the fastest-growing cancers. According to the Global Cancer Observatory, prostate cancer, at 14.2% of all new cases among males, is the second most common cancer among men across the world. In India, doctors say, the prostate is the third leading cancer site among men, following the lungs and the mouth.
SIGNATURE TUNE
The prostate is a small gland, roughly the size of a walnut, below the urinary bladder. Its main function is reproductive – it contributes to the nourishment of sperm. Prostate cancer is an abnormal growth that can spread to other organs and even prove fatal. It is estimated that one in eight men will be affected by prostate cancer during their lifetime. In India, the incidence is increasing and experts predict a major rise over the next two decades.
Doctors say the risk of prostate cancer rises significantly after age 50. But, there have been several cases of even men in their 40s being diagnosed with it.
A recent study presented at the Urological Society of India revealed that the age-standardised incidence rate is projected to increase from 7.41 per 100,000 men in 2022 to 9.15 by 2031.
While the exact cause of the cancer is not fully understood, it is likely to be multi-factoral. For example, family history matters. Men with a father or brother who have had the disease face a much higher risk. Other causes include sedentary lifestyles and poor diets. Long hours at a desk, little physical activity and unending stress have become the norm. These factors affect hormone regulation, which could contribute to the risk.
On the diet front, traditional foods are giving way to fast food and processed meals. These aren’t great for health. Indian diets, once rich in fibre and plant-based foods, now have more red meat, fats and dairy. There have been several studies that suggest that high-fat, low-fibre diets could increase the risk of prostate cancer. A balanced diet rich in vegetables, fruits and whole grains is the key to prevention.
Early prostate cancer may not offer any symptoms but you could sometimes see blood in the urine, sudden weight loss, an increase in the frequency of urination or a burning sensation while passing urine. Prostate cancer often spreads to the bones, and patients may present with bone pain or fractures in advanced cases.
Prostate cancer is diagnosed using MRI and a prostate biopsy in suspicious cases.
If confined to the prostate, that is Stages I or 2, the cancer can be cured completely in most cases through active surveillance, surgery or radiation. Surgery is considered the best treatment as the entire prostate and surrounding tissue are removed, resulting in good cure rates. Today, such surgery is performed through a minimally invasive technique, allowing for better surgical outcomes and quicker recovery.
If the cancer has spread to other organs, a whole-body approach with hormonal therapy and sometimes chemotherapy is executed. Hormone therapy blocks testosterone, which is fuel for prostate cancer. There are newer therapies too like androgen signalling inhibitors, nuclear medicine and targeted therapy. While, at this stage, the cancer is not curable, the treatments allow the patient to have a good quality of life for three to five years.
Prostate cancer is the second most common cancer in men across the world, according to a study by the Global Center for Evidence Synthesis of Chandigarh. The study said prostate cancer is the fifth leading cause of cancer-related mortality among men.
The study added: “In India, the trends and burden of prostate cancer have been understudied compared to western countries. However, with the rapid socioeconomic development and adoption of western lifestyles, there has been an observed increase in the incidence of PC. This trend highlights the need for comprehensive epidemiological studies to understand the scope of the problem better and to inform public health strategies.” Awareness, say the authors, remains shockingly low. Men often don’t go for a checkup until it’s too late. Prostate health, unfortunately, is still not part of regular conversations or public health policy.
Let’s not forget the stigma around it either. Many patients experience symptoms like difficulty urinating, frequent night-time bathroom trips and a sensation of incomplete emptying. Many find this embarrassing to talk about.
But, silence costs lives. India needs a cultural shift in the approach to men’s health. Campaigns that normalise discussions around prostate health, much like those for menstrual hygiene, are the need of the hour. Awareness begins with conversation. If you are over 45 years of age, talk to your doctor about the risk, especially if you have a family history of prostate cancer.
Other than low awareness, the cost of treatment is a serious concern. Costs can range from Rs 1.5 lakh to more than Rs 14 lakh. So, having an adequate health insurance cover of Rs 20 lakh to Rs 25 lakh is essential. However, the premium for such coverage would be out of reach for most Indians. Nevertheless, what cover is possible should be sought. Most health insurance plans cover all types of cancer, including prostate. Read the policy terms carefully so that you are aware of waiting periods and exclusions.
Unlike many other cancers, prostate cancer, if detected early, has a high survival rate. Simple screening tools like Prostate-Specific Antigen, or PSA, blood tests and digital rectal exams can catch the disease early.
However, India does not have a national prostate cancer screening programme. Even many state-run hospitals have no standardised protocol for screening men above 50. This is a serious gap. Just as we screen women for breast cancer, we need regular prostate cancer screening, especially for men over 50 or those with a family history of cancer.
States like Kerala and Tamil Nadu, known for better healthcare, have non-communicable disease screening programmes — but prostate cancer is often missing from them.
Is prostate cancer curable?
Earlier, the usual recourse was radiotherapy but, with the advent of surgical robots, there is a shift to prosthetic surgery, which is precise and gives excellent results.
The main concerns after a diagnosis are generally erectile dysfunction and persistent urinary leakage. However, with robotic surgeries, these complications can be prevented to a large extent. There are also new hormonal treatments as well as high-density frequency ultrasound approaches that are being considered.
Prostate cancer is among the most common cancers in the world, and it seems like the incidence is only going to rise. This is natural as populations age and lifestyles change.
To stay healthy, make sure you are aware of the symptoms, that you get regular checkups and that you have the maximum health insurance possible.
Thank you all for listening. Please visit allindiansmatter.in for more columns and audio podcasts. You can follow me on Twitter at @AshrafEngineer and @AllIndiansCount. Search for the All Indians Matter page on Facebook. On Instagram, the handle is @AllIndiansMatter. Email me at editor@allindiansmatter.in. Catch you again soon.
