Doctors warn against delayed diagnosis as prostate cancer cases rise

Prostate cancer is no longer confined to India’s metropolitan cities. While Delhi, Mumbai and Bengaluru continue to see a rise in cases, doctors say they are increasingly treating patients from smaller towns and neighbouring states such as Uttar Pradesh, Bihar and Haryana, indicating that the disease is becoming more widespread across the country.

Doctors say the biggest challenge is not just the rising number of cases but the delay in diagnosis. Unlike many Western countries, where prostate cancer is often detected through routine screening, many Indian patients seek medical care only after the disease has spread outside the prostate. By then, the cancer may have reached the bones and spine, increasing the risk of serious neurological complications.

Dr Ashwin Mallya, Uro-Oncologist and Robotic Surgeon, Sir Ganga Ram Hospital, said, “We are definitely seeing more prostate cancer than we did a few years ago. Earlier, most of these patients came from big cities. Today, a large number of people coming to us are from Uttar Pradesh, Bihar, Haryana and other smaller towns. That tells us awareness is improving, but many men are still reaching us too late.”

Dr Mallya added, “The PSA blood test is the first step in picking up prostate cancer early. If the PSA is abnormal or there is suspicion during examination, we then use tests like multi-parametric MRI and MRI-TRUS fusion biopsy to confirm the diagnosis. These investigations have made diagnosis much more accurate and help us identify cancers that need treatment.”

However, he said, “Inspite of increasing awareness about PSA testing, roughly 50 per cent of prostate cancer patients I see in practice are already stage 4. At that stage, we can only control the disease, not cure it.”

Doctors explain that metastatic prostate cancer commonly spreads to the vertebrae, where it can compress the spinal cord and surrounding nerves. Persistent lower back pain that does not improve, increasing weakness in the legs, difficulty walking, numbness or tingling, and loss of bladder or bowel control should never be ignored, as they may indicate spinal cord compression-a medical emergency requiring immediate treatment.

Dr Praveen Gupta, Chairman, Marengo Asia International Institute of Neuro and Spine (MAIINS), Marengo Asia Hospitals, Gurugram, said, “Sometimes patients don’t come to a neurologist because of prostate cancer. They come because they are unable to walk properly, have severe back pain or suddenly develop weakness in their legs.”

Dr Gupta added, “Once prostate cancer reaches the bones, especially the spine, it can press on the spinal cord. That’s when patients may develop severe back pain, weakness in the legs, numbness or even paralysis. Many of these complications can be avoided if the disease is diagnosed earlier.”

Dr Gupta advises, “When someone develops weakness, numbness or loses control over bladder or bowel function along with persistent back pain, it should be treated as a neurological emergency. Every hour matters. These patients need immediate evaluation by neurologists, urologists, oncologists, and spine surgeons. If treatment is delayed, the damage can become permanent.”

Dr Mallya said that prostate cancer is highly treatable when detected early. Men over the age of 50, or earlier if they have a family history, should discuss PSA screening with their doctor. He also advises men not to ignore persistent urinary symptoms, unexplained bone pain or ongoing back pain, as early diagnosis remains the best way to prevent advanced disease and its potentially disabling neurological complications.