September is Prostate Cancer Awareness Month in Australia, and being the 3rd most common cause of cancer related deaths in Australia, regular screening is important. The good news is this has recently become more accessible, with prostate MRIs now eligible for a $400 Medicare rebate. Read on for more information on the different screening options.
What is prostate cancer?
The prostate is a small, walnut-sized gland that produces seminal fluid. Prostate cancer, like all other forms, occurs when abnormal cells develop in the prostate. It is a slow developing form of cancer and many men can live for years without any signs or symptoms or without it spreading and becoming life threatening. However, aggressive forms of the disease spread quickly and can be fatal if not diagnosed and treated early enough. Hence, it is important that men, specifically those over the age of 50, are regularly screened to ensure they are not at risk.
What are the symptoms?
The early stages of prostate cancer may not produce any symptoms and can go completely unnoticed. As the disease develops and grows, symptoms may include;
- Frequent and/or sudden urge to urinate
- Difficulty or discomfort when urinating
- Blood in urine or semen
- Pain in the lower back, upper thighs and hips
Who is at risk?
Age and family history are said to be the two factors most strongly linked to risk of developing prostate cancer.
- Age – the chance of developing prostate cancer increases with age. It is suggested that 1 in 7 men over the age of 75 are at risk and by 85, this increases to 1 in 5.
- Family history – like most conditions, if you have a direct relative with prostate cancer, you are more likely to develop it than men who don’t. This risk also increases should you have more than one male in your family diagnosed.
How is it diagnosed?
The 2 most common ways to diagnose prostate cancer are a blood test or a physical examination.
- The Prostate Specific Antigen (PSA) blood test shows whether there is an increase in a specific protein. However, a high PSA test does not necessarily equal cancer – it can also highlight other prostate diseases.
- The prostate’s location sometimes means a physical examination is required where a doctor will insert a gloved, lubricated finger into the rectum and will assess the prostate for abnormalities in size. However, if normal, this does not necessarily rule out cancer.
- A biopsy is the only way a definitive diagnosis of prostate cancer can be made. In this biopsy, a urologist will remove small samples of prostate tissue using a very thin, hollow needle, guided by ultrasound. This is usually completed as an out-patient procedure and antibiotics are usually prescribed post-biopsy to reduce chance of infection. The extracted tissue is sent to a pathologist to identify whether cells are malignant or benign.
- Prostate cancer can also be identified via MRI imaging. This is a fairly new procedure which can be requested by your GP for men who have a raised PSA blood test result – and as of 1st July 2018, a new $400 Medicare rebate will be offered for prostate MRI scans. For the 20,000 Australian men diagnosed each year who may not have been able to afford such scans, this is estimated to cut the need for painful, costly and unnecessary investigations by 27%. With a detection sensitivity of over 85%, the prostate cancer MRI detects cancer at least twice as reliably as ultrasound or the usual biopsy. This is because it identifies the exact location of cancer cells, allowing subsequent biopsies to be performed more precisely and, if necessary, the patient to engage in treatment much sooner. A negative MRI result (i.e. one that does not show any cancer) is reliable; it is at least 90 % accurate in precluding cancer.
What can I do?
- Spread the word – if you have been diagnosed with prostate cancer or know someone who has, share your story to reduce stigma and increase awareness.
- Get screened – increased awareness is aimed to encourage more men, especially those over 50, to get regularly tested. We recommend testing every 12 months to ensure changes are tracked and if needed, treatment is accessed early.
- Pester! Partners, encourage your other halves, however reluctant they may be, to book in with their GP and discuss prostate health. Around 3,000 Australian men die each year from prostate cancer, ensure your partner is safe or diagnosed and treated early.
If you wish to discuss your prostate health, risk of prostate cancer or have any other questions, please do not hesitate to book an appointment with your usual GP. To book an appointment, head to cremornemedical.com.au, download the HotDoc app and search for “Cremorne Medical Practice’’, or contact our reception team on (02) 9908 2233.