The Prostate Issues 1 – Testing for the cancer

Every year 600 women die from breast cancer, while the figure for prostate cancer deaths is 650.

The poor relation?

By Roger Childs

The country recently had a week to increase awareness of breast cancer and this is to be applauded. There was also a Pink Ribbon Appeal Day. During the awareness week he Dominion Post in an excellent gesture, replaced the usual blue backing near the top of its front page with pink. Furthermore, the Taranaki men’s rugby team has recently been wearing bright pink socks in National Provincial Championship matches.

Increasing awareness of this killer is very sensible and emphasizing early detection is highly appropriate. However, shouldn’t prostate cancer get the same attention? 

September was the prostate cancer awareness month and there was a push for fund raising at that time, but there was no particular collection day. There is a Prostate Cancer Foundation and you can make donations. This year the media did publish a number of articles on prostate cancer in September, including one emphasizing the delays many sufferers face who do not have access to the private health system.

The PSA testing, diagnostic process and subsequent options

The PSA test measures the level of prostate-specific antigen in the blood and high levels may indicate cancer. Urologists will often recommend having a biopsy to take samples from the organ to see if cancer is present. A full body scan may also be suggested if cancer is detected in the prostate to check if it has spread to other parts of the body.

If he answer is “No”, the urologist or oncologist will usually recommend continuing PSA blood tests, say every three months. If a man is diagnosed with prostate cancer there are various options.

  • Watchful waiting – on-going monitoring of PSA levels to see if there are significant changes. If the PSA level stays much the same, this approach continues.
  • Removing the prostate – this may be suggested and will often result in the PSA dropping to virtually nil. However, there is the risk of side effects such as  – incontinence, erectile dysfunction and impotence.
  • Hormone treatment (Androgen Depressive Therapy. ADT) – this involves regular injections of Zoladex which will temporarily halt the progression of the cancer, but it will not cure it. The side effects are many, including uncontrolled weight gain, loss of muscle and bone mass, erectile dysfunction, loss of energy and drive, among others,
  • Brachytherapy – radioactive implants are put into the prostate tissue to neutralize the cancer. This will cure the cancer as long as it has been detected early enough.
  • Radiotherapy – this will often kill the cancer, but the side effects listed above often occur.

A big issue for men

Prostate cancer is the most common form among Kiwi men. It is no respecter of social status, wealth or ethnicity. Close on 3000 males are diagnosed with the cancer every year in New Zealand. And with the continuing ageing of the population, these figures will increase.

Health Ministry figures showed that the number of prostate cancer diagnoses increased 24% from 2015 to 2017.

(In the next article we’ll look at whether men can survive prostate cancer. My thanks to Graham Clouston for his assistance in writing the article above.)

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