Prostate cancer in India: Doctor explains why men seek treatment too late

Prostate cancer grows slowly in many men, but when it is found late the treatment becomes harder and outcomes are worse. In India, several factors lead to later detection compared with other high-income countries.

Lack of awareness continues to remain the first and the most critical challenge in the fight against prostate cancer. Be it the "Prostate problems are old age problems" - a deep rooted misconception or the taboo and societal stigma of openly discussing urinary and sexual health problems, collectively these issues result in unnecessary delay seeking timely treatment. Symptoms such as weak urine flow, getting up at night to pass urine, or blood in urine often get ignored until they become severe. This delay is common among men who are busy supporting families or who fear a cancer diagnosis.

Second, screening and check-ups are not routine for middle-aged men. There is no national prostate screening programme in India, and many primary care visits focus on infections or chronic diseases like diabetes. As a result, opportunities to catch early, treatable cancers are missed. In several hospital studies from India, a large proportion of men are diagnosed when the cancer has already spread beyond the prostate.

Third, access and cost matter. In smaller towns and rural areas, there may be no nearby urology service or diagnostic tests like prostate specific antigen (PSA) blood tests and imaging. Additionally, the possible additional cost of more complex testing, like prostate biopsies or MRI scans, may deter men from seeking care early when basic screening tests are equivocal and more sophisticated procedures may be required.

Myths and cultural attitudes provide an additional dimension. Some men first consult traditional healers or try home cures. Fear of surgery, belief that “nothing can be done,” or lack of someone to accompany them to the hospital can push medical attention further into the future.

For instance, let’s consider a typical real-world scenario: a 58-year-old father notices he needs to pass urine more often and has poor stream for months. He buys over-the-counter medicine and delays visiting a doctor because of work and embarrassment. By the time he sees a hospital, the disease is advanced and needs more aggressive treatment.

What helps change this?

Simple steps, spreading clear information, encouraging men over 50 (or earlier if there is family history) to get a PSA test and a doctor’s check, improving access to urology services, and reducing stigma — can lead to earlier diagnosis and better outcomes for Indian men.

(This article is authored by Dr. Vishnu Prasad Consultant - Urologist, Uro-oncologist, and Robotic Surgeon, Manipal Hospital Yeshwanthpur)