When Norman Beck started experiencing mild incontinence, he did what plenty of us would do before booking a doctor’s appointment: he searched the internet.

Coffee came up as a possible explanation, and for a man who kept himself fit through walking, cycling and trips to the gym, that seemed reasonable enough. At 73, he had no chronic conditions and little reason to think something more serious might be going on.

Fortunately, he took the question to his GP rather than leaving it with the search results.

His doctor recommended a visit to a urologist, taking into account his age and the fact he had not had a check-up in more than five years. That referral began a series of investigations that would lead to a prostate cancer diagnosis and, eventually, surgery.

“This was very fortuitous; otherwise, my prostate cancer could have gone on being undetected,” Norman says.

The Melbourne grandfather’s PSA blood test had risen from previous readings, but he was not particularly worried at that stage. It was during his appointment with urologist Sarah Azar that the situation became clearer.

A digital rectal examination revealed an unusual lump, prompting an MRI and then a biopsy. Over about two months, Norman went from wondering whether he drank too much coffee to considering how to treat his cancer.

He remembers his specialist explaining each step and giving him information about what might come next, although having a plan did not take away all the anxiety.
There were questions about whether the cancer had spread, what treatment would involve and what life might look like afterwards, along with the difficult business of taking in information while worrying about your health.

Norman spoke with a prostate cancer nurse and friends who had faced similar decisions. He also met a radiation specialist to discuss radiotherapy, its potential benefits and its side effects.

Surgery was another option. Although his age was part of the discussion, his specialist considered his fitness made it a possibility.

For Norman, removing the prostate felt like the right choice.

“Basically, I wanted it removed so I could get on with my life as best as possible without worry,” he says.

He weighed the possible effects on continence and sexual function against his own priorities, but is careful not to suggest another man should necessarily make the same decision.

“I’ve got to stress that other men may reach different conclusions, and age can be a factor.”

His robotic keyhole surgery took more than five hours, and recovery involved a catheter, restrictions on lifting and exercise, and around four months of incontinence. Sexual function also changed, something he says required adjustments.

He is pleased with his decision, while acknowledging that understanding the possible side effects beforehand is different from knowing how you will feel when you experience them.

Eighteen months after surgery, his PSA has remained negligible, and he says there is now no impact on his day-to-day life.

“Outlook-wise, I’m happy with the choices and am just getting on with life normally.”

Norman’s experience comes as Australia introduces updated prostate cancer early detection guidelines, with a greater emphasis on individual risk and identifying cancers that need attention without putting everyone through unnecessary investigations or treatment.

Associate Professor Weranja Ranasinghe, a leadership team member of the Urological Society of Australia and New Zealand, says the guidelines give GPs, specialists and patients a shared framework for PSA testing.

A PSA test is a blood test that measures prostate-specific antigen. It helps guide whether further investigation is needed, rather than diagnosing cancer on its own.

Assoc Prof Ranasinghe says most men should consider testing from 50, with earlier discussions from 45 for those at higher risk, including men with a family history, certain genetic mutations or sub-Saharan African ancestry. Men without those risk factors can also discuss an initial test from 45.

For older men, the conversation should take account of their health, individual risk and preferences, rather than assuming everyone needs the same approach.
Importantly, men should not wait for urinary trouble before asking about testing, because early prostate cancer often causes no symptoms. Equally, changes in urination do not automatically mean cancer, but are worth discussing with a GP.

Further investigation has changed, too. Assoc Prof Ranasinghe says MRI has helped specialists decide who needs a biopsy and target suspicious areas more accurately.
“So if an MRI is negative, it is largely reassuring and most people don’t need biopsies,” he says.

A reassuring MRI is not an absolute guarantee, however, and the next step depends on the wider clinical assessment.

Nor does every diagnosis mean immediate surgery or radiotherapy. Many low-risk cancers can be managed through active surveillance, with regular checks to monitor for changes and treatment considered if needed.

For Norman, the message is about giving yourself the chance to understand what is happening and discuss your options.

He is back to enjoying life with his family, with ambitions to keep doing so until he is 100, and is glad he mentioned those early changes.

“Don’t be embarrassed to talk about these things with a GP.”