A Guide To Conquering Prostate Cancer in Belgium

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A guide to conquer prostate cancer

 Let’s Talk Men’s Health: Breaking the Silence on Prostate Cancer

Prostate cancer is the most common cancer among men in Belgium, with roughly 8,000 new cases diagnosed every year. Yet, despite how frequent it is, many men avoid talking about it until symptoms force the issue.

The good news? Overall 10-year survival rates for prostate cancer in Belgium reach an impressive 97%[1] when addressed appropriately. Because prostate cancer is often a slow-growing "silent enemy" in its early stages, awareness and timely checkups make all the difference.

Here is a straightforward, myth-busting guide to help you take charge of your prostate health.

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Myth #1: "I feel completely fine, so I don't have to worry."

Fact: In its early stages, prostate cancer rarely shows any warning signs or symptoms at all.

By the time noticeable signs appear, they may include:

  • Difficulty urinating or a weakened, interrupted urine stream
  • Pain, burning, or a sense of urgency during urination
  • Blood in the urine or semen
  • Pain during ejaculation or erectile difficulty
  • Persistent bone pain in the lower back or hips

Note: Having these symptoms does not automatically mean you have cancer; common, non-cancerous conditions like an enlarged prostate can cause similar issues. However, experiencing any of these is a clear signal to consult a urologist.

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Myth #2: "Prostate cancer is purely genetic."

Fact: Only about 8% of prostate cancer cases are caused by genetic factors.[2]

While having a father, brother, uncle, or son with prostate cancer — or a mother, aunt, or sister with breast cancer — increases statistical risk, most cases occur without any family history.

Key risk factors include:

  • Age: Risk increases after age 50, though rare cases can occur earlier if there is a strong family history.
  • Ethnicity: Men of African origin tend to be affected more frequently and experience more aggressive forms of the disease, often influenced by late diagnosis or healthcare access disparities.
  • Lifestyle & Diet: Obesity, smoking, and a Western diet rich in animal fats strongly contribute to increased risk.

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Myth #3: "Testing for prostate cancer is painful and complicated."

Fact: Initial screening is simple, quick, and non-invasive.

In Belgium, regular screening is recommended for men aged 50 to 74. An evaluation by a urologist typically involves:[3]

  1. PSA Blood Test: Measures Prostate-Specific Antigen levels (elevated levels can signal cancer or other benign conditions).
  2. Digital Rectal Exam (DRE): A quick physical exam where the urologist checks the prostate for unusual bumps or masses using a lubricated, gloved finger.
  3. Imaging: Advanced MRI or ultrasound scans to view the gland in detail if needed.

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Myth #4: "A diagnosis means immediate, drastic surgery."

Fact: Treatment is never one-size-fits-all. In Belgium, care plans are customized by a multidisciplinary oncology committee involving urologists, radiologists, pathologists, and oncologists.

  • Active Surveillance: For slow-growing, low-risk (Stage I) cancers, active treatment isn't always started right away. Instead, doctors closely monitor the condition through periodic PSA tests, imaging, and repeat biopsies. Studies show overall survival with active surveillance is very similar to immediate active treatment.
  • Curative Options: For localized cancer, surgery (radical prostatectomy) or targeted radiotherapy offer similar curative success.
  • Advanced Care: If cancer has spread outside the prostate (Stage IV), systemic treatments like hormone therapy (blocking testosterone), chemotherapy, or immunotherapy are used to control progression and protect quality of life.

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Myth #5: "Life without a prostate means the end of sexual pleasure."

Fact: It is entirely possible to lead a normal, fulfilling life after prostate surgery.

Because the prostate produces over 95% of ejaculate volume, complete removal means a man will experience "dry" orgasms without semen release, but sexual pleasure itself is preserved. While temporary erection issues or urinary incontinence can occur, urological support helps manage recovery.

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5 Daily Habits to Protect Your Prostate

While you cannot change your age or genetics, adopting healthy daily habits can help lower your risk:

  1. Ditch the cigarettes: Avoid or stop smoking.
  2. Watch your diet: Eat plenty of fresh fruits and vegetables while limiting heavy animal fats.
  3. Stay active: Maintain regular physical exercise and a healthy weight.
  4. Know your family story: Talk to relatives about any history of prostate or breast cancer.
  5. Schedule checkups: If you are between 50 and 74 (or older than 40 with a family history), book a regular checkup with your urologist.
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Frequently Asked Questions About Prostate Cancer:

1) How common is prostate cancer in Belgium, and what is the outlook?

Prostate cancer is the most common cancer among men in Belgium, with approximately 8,000 new cases diagnosed each year[1]. Despite its high frequency, the overall 10-year survival rate in Belgium is high, reaching around 98%[1].

2) Who should get screened, and when should it start?

Regular screening is recommended for men in Belgium between the ages of 50 and 74[3]. According to the European Association of Urology (EAU), men with a family history of prostate cancer should consider selective screening starting at age 40, while the general population should begin at age 50[3]. Screening typically includes a Prostate-Specific Antigen (PSA) blood test, a digital rectal exam (DRE), and imaging if necessary[3].

3) Does an elevated PSA level always mean cancer?

No. PSA is specific to the prostate, but it is not specific to cancer[3]. Higher PSA levels can be caused by non-cancerous conditions, such as Benign Prostatic Hyperplasia (BPH/enlarged prostate) or prostatitis (an infection of the prostate). If PSA levels are high, a urologist will conduct further tests; a prostate biopsy is the only way to confirm a cancer diagnosis[3].

4) What are the warning signs and symptoms?

In its early stages, prostate cancer usually presents no symptoms at all. When symptoms do occur, they can include:

  • Difficulty urinating or a weakened, interrupted urine stream
  • Pain, burning, or urgency during urination
  • Blood in the urine or semen
  • Pain during ejaculation or difficulty achieving an erection
  • Persistent bone pain, especially in the hips or lower back

Note: Having these symptoms does not automatically mean you have cancer, as benign prostate conditions cause similar issues.

5) Is prostate cancer purely hereditary?

No. Only about 8% of prostate cancer cases are caused by genetic factors[2]. While having a close family member (father, brother, uncle, mother, aunt, or sister) with prostate or breast cancer increases statistical risk, most cases occur without any family history[2]. Other key risk factors include age over 50, African ethnicity, obesity, smoking, and a Western diet high in animal fats[2].

6) What is Active Surveillance, and is it safe to delay treatment?

Active Surveillance is a monitoring approach for low-risk, slow-growing (Stage I) cancers with PSA levels below 10[3]. Instead of immediate surgery or radiation, the condition is closely monitored through periodic PSA blood tests, rectal exams, MRI scans, and repeat biopsies[3]. Studies show that overall survival rates with active surveillance are very similar to immediate active treatment[3].

7) What happens if the prostate needs to be surgically removed?

Complete removal of the prostate (radical prostatectomy) is a common curative option for localized cancer[3]. It is entirely possible to lead a normal life after surgery[3]. Because the prostate produces over 95% of ejaculate volume, orgasms will be "dry" (without semen output), though sexual pleasure itself is preserved[3]. Temporary erection difficulties or urinary incontinence can also occur following surgery[3].

8) How is advanced or metastatic prostate cancer treated?

If cancer has spread beyond the prostate (Stage IV / metastases), systemic treatments are used to control the progression of the disease, manage symptoms, and protect the patient's quality of life[3]. These treatments include hormone therapy to block testosterone (which fuels cancer growth), chemotherapy, immunotherapy, or combinations of these therapies[3].

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References:

  1. https://kankerregister.org/sites/default/files/2026/2026_BE_CFS2024_PROSTATE_2.pdf
  2. https://cancerconsult.care/en/articles/conditions/prostate-cancer/prostate-causes-and-risk-factors
  3. https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-EANM-ESTRO-ESUR-ISUP-SIOG-Guidelines-on-Prostate-Cancer-2026_2026-06-26-075609_mnhn.pdf

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Important note

Healthcare coverage and reimbursement rules can vary according to the insurer, institutional scheme, practitioner, treatment, and individual circumstances. The information in this guide is general and should not be considered a guarantee of reimbursement. For planned investigations or procedures, confirm the applicable conditions directly with your healthcare provider and insurer or institutional healthcare office.

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About the author

Dr. Fadi Dalati is the deputy head of urology service at CHU Saint-Pierre in Brussels and founder of UroBrussels. His practice focuses on minimally invasive treatments for benign prostatic hyperplasia, prostate cancer diagnostics, robotic surgery and urological oncology.

Location: Brussels, Belgium

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