International Prostate Cancer Awareness Month
September is International Prostate Cancer Awareness Month. The Prostate Cancer Foundation of Australia (PCFA) is hosting a number of events and activities in our communities in order to raise public awareness and funds for research. Prostate cancer is the most common cancer in Australia with 20,000 men diagnosed and close to 3,300 deaths each year.
The recent media coverage of the early results from two randomised trials on Prostate Specific Antigen (PSA) testing for prostate cancer has once again brought to the public’s attention the controversy about prostate cancer testing around the world.
The current situation is that population-wide testing and monitoring of men is not advised, even though our first impulse is to think it should be done widely, regularly, and urgently. But this watchful waiting is recommended because a small tumour in the prostate can potentially cause no problems at all, through out a man’s normal life span. However, if through testing he became aware of it and chose to have surgery on the small tumour, he would have the expense, pain, possible loss of sexual and urinary function, loss of work and social productivity, etc. that would have best been avoided by not ever knowing in the first place.
Another way of explaining it is that most prostate cancers are found during autopsies, on men who never knew they had prostate cancer, and who were never affected with any symptoms of prostate cancer. That said, different countries have different policies about recommending PSA testing or not. For instance, the American Cancer Society has been recommending for many years that men of average risk should decide whether or not to be screened based on their own concerns and situation, and after discussing the benefits and limitations of screening with their doctors.
While in Australia a man seeking PSA testing will most likely be discouraged, which means that some men who are growing aggressive tumours will not be diagnosed while the tumour is small and easily treated but will only discover it when it causes medical problems and may have spread to other organs or tissues. Some young men (50 and younger) who have gone through that feel very strongly that they should have been tested earlier, as it would have spared them serious surgery and complications. They would advise all young men to have a baseline PSA test done.
It is well known in the medical research community that most men who do seek PSA testing from their GP’s have been encouraged to do so by their wives, who generally have more knowledge about medical issues than do the men. Women are also more screening oriented, as they regularly report for their breast screens (mammograms), and cervical cancer screens (pap smears). But PSA testing for men is not equivalent to these population based, harmless screenings.
Men owe it to themselves to become as educated as possible about the whole range of cancers that affect them because they are twice as likely to die from cancer as are women. Every other cancer, excluding prostate cancer, is preferably detected, diagnosed and treated early for the best medical outcome. To learn more about prostate cancer, go to http://www.prostate.org.au/ and then discuss any issues that concern you with your GP who will help you decide whether to have your PSA tested.