Remembering Dan Fogelberg: Understanding Prostate Cancer

What the record says

Dan Fogelberg, the singer and songwriter behind "Leader of the Band" and "Same Old Lang Syne," died on Sunday, December 16, 2007, at his home in Maine. He was 56.

The Associated Press report of his death states that he discovered he had advanced prostate cancer in 2004, and that he thanked fans for their support in a statement at the time.

That is what is on the public record. Nothing else about his diagnosis, his treatment, or his last years is described here, because nothing else was made public in that report.

He was in his early fifties when the cancer was found. That is younger than most people picture, and it is the one detail of his story with real teaching value.

What prostate cancer is

The prostate is a gland below the bladder that makes part of the fluid in semen. Cancer that starts there is prostate cancer, and our overview of prostate cancer covers the types.

Most prostate cancers grow slowly. Some do not. Both statements are true at once, and almost every argument about prostate cancer comes from trying to hold them together.

Why screening here is a decision, not a rule

For most cancers, the advice is simple: screen on schedule. Prostate cancer is the clearest exception, and NCI says so directly.

NCI's screening summary opens with a blunt line. There is no standard or routine screening test for prostate cancer.

Two tests are in use or under study. A digital rectal exam feels the prostate through the rectum for lumps or unusual firmness. A PSA test measures prostate-specific antigen in the blood, a substance made mostly by the prostate that can be raised in men with prostate cancer.

NCI then states the catch. A PSA test or a rectal exam may detect prostate cancer at an early stage, but it is not clear whether early detection and treatment reduce the risk of dying from prostate cancer.

The specific harms NCI names

This is the part usually left out, and it is the reason the decision is personal.

NCI lists the risks of prostate cancer screening plainly:

• Overdiagnosis. Some prostate cancers never cause symptoms or threaten life. If a screening test finds one, it may be treated anyway. NCI says it is not known whether treating these cancers helps a man live longer than leaving them alone.
• Treatment side effects. Radical prostatectomy and radiation therapy can have long-term effects in many men. NCI names the two most common: erectile dysfunction and urinary incontinence.
• Complications from a follow-up biopsy.
• False negatives and false positives. PSA can also be raised by infection, inflammation, or benign prostatic hyperplasia, which is an enlarged but noncancerous prostate.
• NCI also notes that some studies found men newly diagnosed with prostate cancer had a higher risk of death from cardiovascular disease or suicide, with the risk greatest in the first weeks or months after diagnosis.

Our pages on prostate cancer screening and the PSA test go through this in more detail.

When to get checked

Screening is for men without symptoms. Symptoms are a separate matter and do not wait for a schedule. NCI says to check with a doctor about:

• Trouble starting the flow of urine.
• Frequent urination, especially at night.
• Trouble emptying the bladder completely.
• A weak or interrupted, stop-and-go, flow of urine.

NCI adds that prostate cancer found at an advanced stage may cause pain in the back, hips, or pelvis that does not go away. It may also cause shortness of breath, deep fatigue, a fast heartbeat, dizziness, or pale skin, all from anemia.

An important caveat from NCI: benign prostatic hyperplasia causes symptoms very similar to prostate cancer, and it is far more common as men age. Getting checked is how the two are told apart.

Family history is the other reason to start the conversation earlier rather than later, particularly a father or brother diagnosed young.

The numbers, and the tension inside them

For 2026 the American Cancer Society projects about 333,830 new prostate cancer diagnoses in the United States and about 36,320 deaths, and SEER carries that projection. Five-year relative survival across all stages was 98.2% for people diagnosed from 2016 through 2022.

That headline figure is one of the highest in the registry, and it is why prostate cancer is often described as survivable.

The stage breakdown is where the other half sits. SEER records 69% of cases found while confined to the prostate and 14% found in nearby lymph nodes, both with five-year relative survival of 100.0%. Nine percent are found after the cancer has spread to distant sites, and there five-year relative survival is 40.1%. This breakdown rests on men diagnosed in 2016 through 2022.

Advanced disease at diagnosis, which is the category Fogelberg described, is uncommon. It is also the category where the numbers change completely.

These are averages across a whole population diagnosed over several years. They describe a group, not any person reading them.

What this does not mean

A public figure's death does not settle the screening question. Fogelberg's cancer was already advanced when it was found in 2004, and NCI notes that screening may not improve health or extend life once cancer has already spread beyond the prostate.

It also does not mean every man in his fifties should have a PSA test. NCI declines to make that a routine recommendation, and the harms above are the reason.

What his story does support is narrower and more useful: prostate cancer is not only a disease of very old men, and the decision about whether to test is worth having deliberately, with a doctor, rather than by default.

Sources

• Associated Press via The Spokesman-Review: Singer Fogelberg dies at 56
• NCI PDQ: Prostate Cancer Screening (Patient Version)
• NCI PDQ: Prostate Cancer Treatment (Patient Version)
• NCI SEER Cancer Stat Facts: Prostate Cancer

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

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