PROSTATE CANCER UP­DATE: THE FU­TURE LOOKS BRIGHT

Med­i­cal ex­perts aren’t afraid of the most com­monly di­ag­nosed cancer fac­ing Aus­tralian men – and you shouldn’t be ei­ther, writes Jaymie Hooper

The Sunday Telegraph (Sydney) - Body and Soul - - FRONT PAGE -

By the time they reach 85 years old, one in five Aus­tralian men will be di­ag­nosed with prostate cancer. It’s a scary statis­tic, but what if we told you the odds aren’t as omi­nous as they sound?

De­spite the fact that prostate cancer cur­rently claims more than 3000 lives in Aus­tralia each year, the mood among med­i­cal pro­fes­sion­als isn’t one of de­spair; it’s one of hope.

“I’ve never seen more progress [ in prostate cancer re­search] than in the past five years,” Dr Phillip Stricker, chair­man of the Depart­ment of Urol­ogy at St Vin­cent’s Pri­vate Hos­pi­tal and Clinic in Syd­ney, says.

“Imag­ing is be­com­ing much bet­ter, we’re see­ing great ad­vance­ments in the ge­netic un­der­stand­ing of cancer, and we’re go­ing to see im­prove­ments in ro­botic surgery in every di­rec­tion.”

THE RIGHT TEST

Typ­i­cally a slow-de­vel­op­ing dis­ease, prostate cancer oc­curs when ab­nor­mal cells in a man’s prostate gland start to mul­ti­ply un­con­trol­lably.

In most cases, the cancer re­mains lo­calised and isn’t life-threat­en­ing, and its symp­toms ( such as fre­quent or dif­fi­cult uri­na­tion or blood in the urine or se­men) never ma­te­ri­alise.

Since cur­rent screen­ing meth­ods such as the prostate-spe­cific anti­gen ( PSA) test aren’t able to de­tect cancer specif­i­cally, and some­times give false pos­i­tive re­sults (which may lead to un­nec­es­sary biop­sies and in­fec­tions), one of the most con­fus­ing as­pects of prostate cancer is when – and if – it should be treated.

Thanks to re­cent in­no­va­tions, though, it’s get­ting eas­ier to know when to act and when to wait. “We now use more so­phis­ti­cated blood tests, such as the 4Ks­core test, which is more ac­cu­rate than a PSA and only picks up the worst kind of can­cers,” Stricker says.

As well as this, sci­en­tists from the Queen Mary Univer­sity of Lon­don are work­ing on a sim­i­lar blood test that could re­veal whether a pa­tient’s cancer is likely to spread. Since sec­ondary can­cers are one of the main rea­sons men die from prostate cancer, this test could mean doc­tors would be able to ad­min­is­ter life-sav­ing treat­ment far sooner.

PER­SONAL OP­TIONS

While ad­vances in prostate cancer re­search are good news, a di­ag­no­sis is a di­ag­no­sis none­the­less. Cancer is a fright­en­ing time for pa­tients and their loved ones, but while it may feel over­whelm­ing, the ex­perts are there to guide the way.

“It’s not as sim­ple as, ‘If you’ve got this, chop it out,’” Stricker ex­plains. “Th­ese days, once we have a di­ag­no­sis of prostate cancer, we’ll have a long dis­cus­sion with pa­tients and their fam­i­lies about the dif­fer­ent op­tions.”

Given that treat­ment with surgery can lead to im­po­tence or in­con­ti­nence, a va­ri­ety of fac­tors such as the type of cancer a pa­tient has, their per­sonal pri­or­i­ties and their over­all well­ness are taken into con­sid­er­a­tion.

“If a pa­tient is par­tic­u­larly scared about de­vel­op­ing bowel prob­lems, for ex­am­ple, then ra­di­a­tion might not be the best op­tion for them,” Stricker ex­plains.

STAY VIG­I­LANT

Early de­tec­tion re­mains the top pri­or­ity for prostate cancer, but 40 per cent of men fail to book in for an an­nual check-up – and that’s where loved ones can help.

“Many men come in be­cause they’re en­cour­aged to by their part­ner,” Stricker says. So feel free to stick a not-so-sub­tle note on the fridge if your other half needs a nudge in the right di­rec­tion.

Stay­ing vig­i­lant is key when it comes to tack­ling prostate cancer and, com­bined with the right re­search, it’s a dis­ease that ex­perts such as Stricker be­lieve will soon no longer be some­thing that men die from, but some­thing they live through.

September is Prostate Cancer Aware­ness Month. For in­for­ma­tion or to do­nate, visit prostate.org.au

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