Demystifying prostate cancer

One in every 11 men will develop prostate cancer by the age of 70. What if it’s you? It can be difficult to start thinking about prostate cancer, and even harder to do something about it. Catching prostate cancer early is the best way to ensure it is ‘curable’.

One in every 11 men will develop prostate cancer by the age of 70. What if it’s you? It can be difficult to start thinking about prostate cancer, and even harder to do something about it. Catching prostate cancer early is the best way to ensure it is ‘curable’.

Should I get tested?
The Prostate Cancer Foundation of Australia suggests that all men over 50, and men over 40 with a family history of prostate or breast cancer, should have an annual PSA test.

What is a PSA test?
The initial prostate cancer test is called a Prostate Specific Antigen (PSA) test. This is just a simple blood test which your local GP can send you for. It only indicates whether or not you might have prostate cancer – it is not conclusive. If you do have a PSA reading it will also indicate to your doctor the likelihood that the cancer is contained within the prostate.

What if I do have a PSA reading?
There are a few possible follow-up tests to confirm that you do have prostate cancer, and to determine what type it is and how far it has spread. The most accurate one is a biopsy. This is most often carried out as a day procedure, where you will be put under a general anaesthetic. The doctor will insert a small probe into the rectum which will photograph your prostate through the rectum wall and a series of small spring-loaded needles will take samples of the cancer in different areas of the prostate. The results of this test will come in the form of a Gleason Score.

What is a Gleason Score?
The Gleason Score is made up of a number of different factors. The specialist will assess your age, the aggressiveness of the cancer and how far it has already spread. They will then use this to suggest the best possible range of treatments for your particular case.

What happens next?
Depending on your Gleason Score you will have a number of different treatment options available to you. Prostate cancer can often be non-aggressive, so in older men sometimes the only recommended treatment is active surveillance. Active surveillance simply means PSA tests every six months and a yearly biopsy to make sure the cancer hasn’t changed. Some other options are external beam radiotherapy, surgery and brachytherapy.

External beam radiotherapy (EBRT)
External beam radiotherapy has been a very successful method of ‘curing’ cancer confined to the prostate, and has a track-record similar to surgery or brachytherapy, the other two most successful prostate cancer ‘cures’. EBRT is sometimes coupled with hormone therapy, which can have some unpleasant side effects such as bone loss and weight gain.

Surgery
Surgery involves a radical prostatectomy, or the removal of the whole prostate. This is also a very effective method when the cancer is confined to the prostate. It involves four or five days in hospital, then about six weeks of recuperation at home.

Brachytherapy
Brachytherapy is a newer treatment where radiation is delivered from inside the prostate. Radioactive seeds are placed inside the prostate to kill the tumour. The process generally only takes a few days of recovery after the hospital stay.

How do I choose?
The above are only some of the more popular treatments available. Your doctor will advise you on the most effective options based on your Gleason score. He or she will also discuss the pros and cons, including recovery time and side effects.

Where can I get more information?
The Prostate Cancer Foundation of Australia has very detailed information about prostate cancer and treatments on its website. It also provides information about new research and offers support services for those with prostate cancer and their families.

Does prostate cancer frighten you? Do you think men should be routinely tested?

*We have chosen to put the word ‘cured’ in inverted commas as cancer survivors are generally considered to be in remission, not cured. This is because there may still be a small number of undetected cancer cells in the body, and a recurrence is possible.





    COMMENTS

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    ticktock
    6th Aug 2011
    7:21am
    YOU neglect to mention that Hormone therapy can be used as the sole treatment for prostate cancer. I have recieved this treatment intermittently since being diagnosed 6 years ago and at the moment am on a hormone holliday. It has entailed a 3 monthly injection and 6 monthly check up.
    kino
    13th Jul 2013
    3:54pm
    Why are you short on hormones? Cows milk is full of female hormones and can cause an imbalance. Perhaps avoiding cows milk can alleviate the injections.
    Marlin
    19th Jul 2012
    9:02am
    My husband had Bracytherapy 11 years ago. He was 58 at the time. He has never looked back.
    kino
    19th Sep 2012
    12:38pm
    According to Dr. Neal Barnard , “It’s worth noting that milk and other dairy products are our biggest source of saturated fat, and there are very credible links between dairy consumption and both Type 1 diabetes and the most dangerous form of prostate cancer.”
    It seems prevention is better that whatever form of treatment. Avoid anything that comes out of a cow
    Maca1939
    26th Oct 2012
    9:12pm
    I am writing this as I feel that all men over the age of 40 should be tested for prostrate cancer on a regular basis. In December last year my husband was diagnosed with prostrate cancer and had the operation on 17th February at The Bays Hospital on the Mornington Peninsula he came thru this very well indeed. I suggested to my son who is 48 years old that he should have a check up himself, he went and had the check and his levels were higher than my husband's level.
    My son had the operation in May at the Freemason Hospital in Melbourne by the robot and has come thru this operation very well, but of course one needs to know that this is not covered by private medical and the cost is rather high. He has come thru this well also.
    I feel that after what we have gone thru that all men over the age of 40 should be encouraged to have the tests for this cancer on a regular basis once they turn 40 for after all if my husband did not get the cancer then my son would never of had the operation etc. until he was over 50 and then it might of been too late and this might of been a lot worse. We need more publicity on Prostrate Cancer to make men aware of going to have the blood test that is available for this disease.
    This should be a high priority and should be done so that we have less cases of this dreadful disease.
    kino
    27th Oct 2012
    8:20am
    I am a 73 year old vegan, and have never been checked! The last time I saw a doctor was about 20 or so years ago. Eating animal remains, and drinking animal fluids cause disease.
    Proven: Eating Red Meat Raises Death Risk from Cancer and Other Diseases
    A diet high in red or processed meats significantly raises a person's risk of early death, particularly from cancer and heart disease, according to a study conducted by researchers from the U.S. National Cancer Institute and published in the Archives of Internal Medicine.
    "The need is for a major reduction in total meat intake, an even larger reduction in processed meat and other highly processed and salted animal source food products, and a reduction in total saturated fat," wrote Barry Popkin of the University of North Carolina-Chapel Hill, in an accompanying article.
    The researchers reviewed dietary and mortality data for more than 500,000 people over a 10-year time period. They found that those with the highest intake of red or processed meat had a significantly higher risk of death from all causes than those who ate the lowest amount. The greatest risk increase was seen for death from heart disease or cancer.
    Dave R
    16th Jul 2016
    10:38am
    What you say is probably true at least in part. But prostate cancer seems to run in families so there must as well be some genetic cause, meaning some of us are programed to self destruct.
    I doubt diet or exercise can alter that, but may be preventative in persons not genetically predisposed to develop the disease.
    Brad
    31st Oct 2012
    8:08pm
    From information I have obtained a PSA test is very unreliable. A new test has been developed in the UK which 95% reliable as against a PSA which is 95% unreliable.
    There is also a simple blood test which can determine if you have early cancer in your body.
    I would think along those lines before undergoing surgery.
    Precious
    17th Jul 2013
    12:31am
    I also heard about this too....
    ballaratboy
    24th Dec 2014
    1:00pm
    Me too. My urologist said even the biopsy can be quite unreliable as the small samples taken are only from one side of the prostate. I think the accuracy rate is only a mere 25%. It would be good if a new and more reliable test becomes available. By the way, not all specialists put a guy under anesthetic when having a biopsy done.I imagine it would be quite uncomfortable.
    Marlin
    27th Nov 2012
    7:48pm
    A pas result that is higher than the normal is always followed by a referral to a Urologist who will do a biopsy and then go from there. When my husband'sbiopsy came back positive, all options were presented to us and ultimately the choice was ours. I urge all men over 40 or younger if there is a family history, to get annual PSA tests. It could save your life.
    Dave R
    16th Jul 2016
    10:45am
    I agree. But it is also important that men know there is a history of prostate cancer in their family. Sometimes prostate cancer deaths are put down to something else or sometimes the nature of the cancer is not discussed so sons only know their father died of cancer not specifically prostate cancer.
    Families need to be open and discuss this issue.
    Sampancho
    27th Nov 2012
    8:32pm
    I had a radical prostatectomy about 9 years ago and, while it got rid of the cancer, the side effects were horrendous and if I could turn back the clock I would go along a different road.
    Robotic surgery seems a much better alternative. I don't know enough about other treatments to comment but avoid surgeons who only carry out radical surgery the old fashioned way.
    Marlin
    28th Nov 2012
    7:00am
    The treatment options available, depend on the type of prostate cancer that is found, how advanced it is as well as one's general health and age.
    Ask a lot of questions and also seek a second opinion. As they say, 2 brains are better than one!
    Precious
    17th Jul 2013
    12:32am
    I read a long time ago that NOT all prostate cancers are deathly.......
    Anonymous
    20th Feb 2015
    1:50pm
    Yea precious you're fu..n precious.
    Aussie
    16th Jul 2016
    2:36am
    Yes that is correct I got tested several times and all I have small increase in size no cancer at all (Last check 1 1/2 years ago)

    My specialist agreed with Precious not all are cancerous and all depends on your health system and how good you control yourself after 25 or 30 Now I am 73 and all good.
    Rese
    24th Mar 2014
    11:24am
    From time of diognosis to my husband passing was 22 months. He did not make his 62nd birthday.
    Testing for men over 40 should be part of their annual checkup. My husband may still be alive if this had have been the case. He died ten years ago from this nasty cancer.
    newvogue
    15th May 2014
    11:56am
    I had Prostate cancer some years ago. Went for the Davinchi Robot. In one day operated on, out the next. No problems, everything works. Happy to talk to any one and give details. A friend had EBRT and it still went into his bones.
    Get rid of it the earlier you can.
    Lori
    7th Aug 2014
    4:35pm
    Not all prostate cancers secrete psa. My late husband had.prostate cancer that.never secreted anything that showed up in blood tests......hence advanced and terminal prostate and bladder cancer.....he lived another three years in relatively good health the first two....with hormone treatment. Do not mystify the fact that hormone treatment kills your sex life. It surely does. Radical prostatectomy causes massive problems with erectile function. It is my understanding that robotic surgery and brachy therapy do not........that's a very big bonus if you can manage the cost.

    Oh yes I meant to say.....please consider the old digital test.....better to suffer the test and have a chance than have the Cancer missed and die. Cheers
    41Alpha
    13th Oct 2014
    2:20pm
    I was diagnosed with prostrate cancer about 8 years ago, I had the radical prostasectomy , which I was confident had cured me. But after several follow up PSA tests, my doctor strongly suggested I have radiation treatment. I had the treatment ( five days a week for 6 weeks) the side effects were horrendous, I wish I never had it.
    It took me about 12 months to 'recover' from the radiation treatment, but I still have some side effects that are " manageable' .
    My PSA's have been very low for the past 7 years, was was told by my doctor that I only need PSA tests done every 12 months now ( instead of the 6 monthly test previously).

    However, my recent PSA test showed the my PSA levels are increasing again and my doctor has no idea as to what may be causing this.
    I'm wondering if the medication I take ( eye drops) for glaucoma may cause erroneous PSA reading, as I have started using them about the same time my PSA levels started to increase.
    newvogue
    15th Oct 2014
    11:07am
    My PSA went from 2.4 to 5.8 in six months. Good job my Doc spotted it. It saved my life. I lost an Uncle to PC and another had an op for PC. A radical prostatectomy can be carried out using the Divinchi robot. In one, day out the next. I recommend it. Been there done that. everything works. contact me if you want me to share the experience. Get your PSA checked today! Paul
    Argonaut
    26th Oct 2014
    7:50am
    Using either the robot or traditional open surgery can be successful. The experience of the surgeon is what counts. My husband had nerve sparing open surgery with a recommended doctor with excellent results six years ago. At 69 he has about 90% of previous function. The cancer had spread to the seminal vesicles so was caught just in time. To say that some prostate cancers don't spread is taking too big a risk and is simply burying one's head in the sand.

    20th Feb 2015
    11:01am
    Every dollar raised for breast cancer needs to be equalled for prostate cancer
    Dave R
    15th Jun 2016
    12:29pm
    I currently have prostate cancer with a Gleason score of six or seven. PSA 17. It took two biopsies a year apart to find it as the first one was clear. Have also had various other scans including two bone scans and the tumours appear to be confined to one half of my prostate. As an other wise healthy 66 yo the Urologist recommended treatment by either surgery or radiotherapy. He said both would be effective so it was up to me to decide. With surgery I was going to lose the nerves on one side which left me a 30% chance of remaining potent. After much discussion with the radiation oncologist I opted for EBRT using the most modern equipment and method. I have currently almost completed a six month course of hormone therapy and my PSA is 2.4 so the tumours have shrunk. Three gold seeds have been permanently implanted in my prostate and I have my initial radiation appointment next week. All going well after eight weeks of high tech EBRT I should be cancer free and have very little unwanted side effects short or long term. The radiation oncologist estimated a 95% chance of no serious side effects at all. My cancer was detected by routine PSA screening as I had no symptoms.


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