Prostate Cancer Awareness Month: How early detection and vigilance can provide the ‘key to survival’

Prostate cancer is the most commonly diagnosed cancer in Australia, having recently overtaken breast cancer as the nation’s leading cause of cancer, with over 24,000 men expected to be diagnosed with the disease this year alone.

It’s estimated that 240,245 men are currently impacted by prostate cancer with 66 men diagnosed each day and 10 losing their lives to the disease every day, as reported by Australian Institute of Health and Welfare. 

Although these sobering statistics are certainly cause for alarm there is a silver lining hidden within the numbers, with an increased number of diagnoses linked to early detection which can mean the difference between life and death.

Prostate Cancer Foundation of Australia CEO Anne Savage said that “if prostate cancer is detected early, it’s very treatable”.

“The five-year survival rate for men diagnosed at Stage 1 is nearly 100 per cent. Yet only 36 per cent of prostate cancers in Australia are diagnosed at Stage 1,” Savage said.

“Detecting prostate cancer before it spreads beyond the prostate is key to survival. This month, we are encouraging men to chat with their GP about their risks and testing options to help save more lives.”

Encouraging regular testing and early intervention comes to the fore this month as part of Prostate Cancer Awareness Month which serves as “an important opportunity to increase awareness about the disease and encourage all Australian men to understand their risks and testing options”.

Savage stressed that “men should be proactive about prostate cancer” and speak with their GP in order to prevent late diagnosis and offer the best chances of effective treatment and successful recovery.

“Prostate cancer can strike without warning, at its earliest stages, it has no symptoms,” Savage said.

As symptoms can be rare and early intervention is of paramount importance when it comes to successfully treating prostate cancer, Starts at 60 spoke further with Savage and Senior Research Fellow and Prostate Group Lead Prof. David Smith from Cancer Council New South Wales as part of Prostate Cancer Awareness Month in order to better understand some of the warning signs for prostate cancer while highlighting the importance of remaining vigilant.

What are the warning signs of prostate cancer?

Prostate cancer is often referred to as the ‘silent killer’ given that in the early stages of the disease there are rarely any obvious symptoms that may indicate the onset of cancer.

Although symptoms may not be obvious, Senior Research Fellow and Prostate Group Lead Prof. David Smith from Cancer Council New South Wales said that “if symptoms do occur they might include frequent or sudden need to urinate, blood in urine, feeling like your bladder is not empty after passing urine or unexplained weight loss”.

“These are not always symptoms of prostate cancer, but you should see a doctor if you are worried or the symptoms are ongoing,” Smith explained.

Smith further explained that “even people diagnosed with advanced prostate cancer may not exhibit symptoms”, highlighting just how important being aware of risk factors is and the need for regular testing and early intervention.

Some of the risk factors that can contribute to prostate cancer.

Although prostate cancer can develop silently with no obvious symptoms, there are a number of factors that can increase one’s risk of developing the disease which can inform the need for more regular testing or heightened vigilance.

“Prostate cancer risk increases with age but what many men don’t know is that family history can also significantly increase their risk,” Savage said.

“If someone in your immediate family has been diagnosed with prostate cancer, you are at twice the average risk of developing the disease.”

Smith claimed that although “the exact causes of prostate cancer are not known” there are “things that can increase the risk of developing” the disease.

“Over 90 per cent of people diagnosed with prostate cancer are aged 55 and over,” Smith said.

Smith also revealed that “if your father or brother has had prostate cancer before the age of 60, your risk will be at least twice that of others” and that a “strong family history of breast or ovarian cancer, particularly cancer caused by a fault in the BRCA1 and BRCA2 genes” can also increase an individual’s risk.

Despite “many other risk factors” being examined which included “different types of diets, past sexual activity, having had a vasectomy to having experienced benign prostate problems”, Smith claimed that “the evidence for clear risk factors is still lacking”.

With noticeable symptoms being rare and definitive evidence for risk remaining lacking, the need for regular testing and practicing preventative measures becomes paramount.

What treatments and preventative measures are recommended?

While the exact cause of prostate remains a mystery, there are still a number of preventative measures and treatment options available that can manage and treat the disease while supporting a better quality of life.

In spite of the fact that limited knowledge of prostate cancer’s cause results in sparse information regarding best practice measures for prevention, Smith explains that there is “some evidence emerging regarding issues such as being overweight or obese or not being physically active increase the risk of more advanced prostate cancer”.

“Being active and a healthy weight are likely to benefit overall health and wellbeing, not just prostate health,” he said.

When it comes to treatment, prostate cancer can vary in how aggressive it is and it’s not uncommon for patients with low-grade or low-risk cancers to be told they don’t need to undergo treatment. Then there are those that, if left untreated, can cause major health problems or even death.

“There are different options for managing and treating prostate cancer, and more than one treatment may be suitable for you. Your specialists will let you know your options. The treatment recommended by your doctors will depend on the stage and grade of the prostate cancer as well as your general health, age and preferences,” Smith said.

“Men with low-risk prostate cancer are generally recommended to monitor their disease with what is called Active Surveillance. This involves regular testing, scans, and biopsy to ensure the cancer is still contained and not progressing. Men also commonly have surgery, termed radical prostatectomy, to remove the prostate or can have radiation therapy to treat the site of the cancer.

“For men with more advanced prostate cancer either androgen deprivation therapy and/or chemotherapy might be used.”

In addition to the treatment options, there are a number of considerations and challenges patients may face, including navigating their sex life post-treatment.

“It often takes some time to recover from the physical and emotional changes caused by treatment for prostate cancer. Treatment side effects can vary – some people experience many side effects, while others have few,” Smith said.

“Some side effects may include urinary problems, erection problems, loss of libido, dry orgasm, infertility, fatigue, bowel problems. Some of these can be treated and others managed.”

Isiah McKimmie is a leading Australian, Sexologist, Sex Therapist and Couples Therapist and spoke further with Starts at 60 regarding the impact of prostate cancer treatment, revealing that “there can be various impacts on someone’s sex life as a result of prostate cancer and treatment”.

“These can include lowered libido, erectile dysfunction and penis shrinkage. Surgery can damage nerves that assist with erections. Radiation and hormone treatments can impact erectile function over time. Low libido can be due to both hormonal changes, but also due to anxiety about changed sexual function,” she said.

“Taking steps for sexual rehabilitation as soon as you can after treatment gives you the best chance of regaining sexual function. Research shows the earlier you take action, the higher chance you have of regaining sexual function. Essentially, you need to increase blood flow to the penis and attempt to get erections in a ‘use it or lose it’ approach. Speak to your doctor or surgeon for advice on the best option for you. You may benefit from meditation or other supports.

However, McKimmie highlighted that the effects of prostate cancer and its treatment are not reserved solely for the patient.

“Prostate cancer and treatment can have impacts on a partner also. Keeping communication open and working as a team to address the impacts can lesson the impacts on both the patient and their partner,” she said.

The importance of regular testing.

Undertaking preventative measures and managing risk factors aside, the greatest weapon against the development of prostate cancer is regular testing.

The “two commonly used tests are the Prostate Specific Antigen (PSA) blood test and the digital rectal examination(DRE), according to Smith.

According to the Cancer Council, the Prostate Specific Antigen (PSA) is a protein made by both normal prostate cells and cancerous prostate cells and can be measured with a blood test.

The test measures the level of PSA in your blood as nanograms of PSA per millilitre (ng/mL) of blood and if your PSA level is above 3 ng/mL, this could indicate that prostate cancer has developed.

It’s important to remember that younger people or those with a family history of prostate cancer may have a lower threshold and PSA levels can vary from day to day.

If a patient’s PSA is higher than the threshold, a GP will usually repeat the test in order to determine the risk of prostate cancer.

Although it is no longer recommended as a routine method of testing, the Digital Rectal Examination (DRE) will be used in some instances to assess the prostate and decide if further testing is required.

The examination involves a urologist placing a finger into the patient’s rectum to feel the back of the prostate. If an unusual shape or hardened area is felt further tests may be required.

“These tests used separately or together, only show changes in the prostate. They do not diagnose prostate cancer. If either test shows an abnormality, you will usually have more tests, biopsies or scans,” Smith said.

“Health professionals use Australian clinical practice guidelines to help decide when to use PSA testing and other early tests for prostate cancer, the tests men have depend on individual choice and specific situations.

“Under the current Australian guidelines men at average risk of prostate cancer who decide to be tested are recommended to have a PSA blood test beginning at age 50 and continuing every two years to age 69.

“Men with a higher risk, for example because of a family history of prostate cancer, who make a decision to be tested are encouraged to begin testing in their 40s.”

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.