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• New guidance on PSA testing for prostate cancer*new*
• Prostate Cancer Screening in Australasia *opens in new window*
• Doctors should consider legal advice over prostate cancer testing*new*
• Letter to the National Business Review
• Men have a right to prostate checks
• Men could die if they follow health minister’s advice
• Response to Tom Morris
• Ministry prostate cancer brochures don’t give full story
• Men’s health organisation proposed
• Awareness Release
• Society Helps Those with Prostate Problems
• PSA-The Facts by Peter Gilling, Hon Urologist, PCF
• Women Play a Significant Role in the Fight Against Prostate Cancer
• Women Recruited in Fight Against Prostate Cancer
• Commandos Raise Funds and Awareness
• Don’t be Prostated by your Prostate
The Ministry of Health is to develop new guidance for men and their doctors to assist their decision about having PSA testing for prostate cancer. The move follows discussions between the Ministry of Health and the Prostate Cancer Foundation of New Zealand.
The new guidance, to be developed over the next few months, will assist doctors to provide fully informed advice for men when initiating discussions about prostate cancer. The guidance is intended to encourage discussion between men and their doctors of the issues surrounding the screening, diagnosis and treatment options for prostate cancer.
Although the Ministry of Health has not changed the recommendation for a population screening programme men are encouraged to seek further advice from their doctor to make an individual decision about having a PSA test. PSA testing is available to all men who wish to be tested.
The Prostate Cancer Foundation has been concerned that the current advice, which does not recommend population screening for prostate cancer, was seen to dissuade doctors from discussing prostate cancer with men until they began to have symptoms of prostate disease.
The Ministry of Health and the Prostate Cancer Foundation agree that men should be informed about the early detection and treatment of prostate cancer. They should be advised of the pros and cons of diagnosis and treatment so they can make an informed decision whether to have a PSA test.
The new guidance will help to ensure that doctors can provide the best advice to enable men to make an informed decision suitable to their particular circumstances.
The Prostate Cancer Foundation will be working closely with the Ministry and specialist groups to produce the new guidance for men on PSA testing.
For further information please contact Barry Young, President, Prostate Cancer Foundation, 09 523 1753; or John Childs, Principal Advisor Cancer Control, Ministry of Health. Dr Childs can be contacted via Peter Abernethy, Communications Manage, 04 496 2008 or 021 366 111.
Doctors need to carefully consider their legal position if they do not discuss checking for prostate cancer with patients over 50. President of the Prostate Cancer Foundation, Barry Young, says all medical professionals should seek their own independent legal advice on where they stand on the issue of testing men for prostate cancer.
“They should make sure they discuss the matter with their medical legal indemnity provider or a medico-legal specialist lawyer. This advice comes from an Australian expert in the field, Dr Paul Nisselle, of the Medical Indemnity Protection Society, as well as a leading New Zealand urologist Robin Smart,” said Mr Young.
In an article published in the August (2004) edition of New Zealand Doctor, Robin Smart said if a request for a test for prostate cancer was dismissed by a doctor, or poor information given, complaints against the doctor are likely and indeed this has already happened in New Zealand.
“New Zealand doctors find themselves in a most difficult position. On the one hand they have advice from the Ministry of Health saying that the three recognised tests for prostate cancer are not recommended as a screening test for men who are not showing symptoms of the disease.
“On the other hand they have New Zealand’s leading urologists saying there is clear evidence that early intervention can lead to prostate cancer being cured. They are actually doing this,” said Mr Young.
Mr Young explained that in the New Zealand Doctor article Robin Smart said that if the advice not to test is followed then younger men in their 40s, 50, and 60s, with aggressive prostate cancer, will miss the chance of curative treatment made possible by PSA testing because, by the time symptoms have occurred, in 70 per cent of those men the cancer will have already spread and no longer be curable. There are perhaps 200 New Zealand men diagnosed in this group each year. Untreated, virtually all will die of prostate cancer.
The Robin Smart article continued: ‘Their doctors are being asked not to test but to instead face such men and their families later in the course of the cancer when it is incurable. An obvious difficult question for the doctor to answer is why the PSA test was not done earlier?’
Mr Young said the PSA test was a simple blood test for prostate specific antigen, a protein that leaked into the blood in increased amounts if the prostate was experiencing some problems, one of which might be prostate cancer. The other tests were the DRE, a digital rectal examination and transrectal ultrasound.
“Dr Paul Nisselle also offers what I believe to be good advice. He says that in his view GPs should not be waiting for patients to ask about screening and early detection programmes, but should raise them themselves, including prostate cancer screening, as part of their routine preventative medicine protocols in exactly the same way as they routinely take patients’ blood pressures and discuss cholesterol tests, pap smears and mammograms. Whether or not to proceed to DRE and or PSA testing is ultimately a decision for the patient. Whilst it is not for the GP to decide whether or not the patient should proceed to testing, it is incumbent on the GP to raise the issue with male patients for discussion,” said Mr Young.
(For further information: Barry Young, 09 523-1753) 8.9.04
It is time for men to take a reality check in this matter of testing for prostate cancer. The story last week by Lynda Wharton about a new test for prostate cancer now available in the United States is most interesting and we eagerly await its arrival here in New Zealand.
In the meantime New Zealand men have the Prostate Specific Antigen (PSA) test and the Digital Rectal Examination (DRE), or how to get to know and trust your doctor in one easy lesson. The PSA test is not 100 percent accurate, but it is no less accurate than that used to diagnose breast cancer.
What men need to keep in mind is that no-one should go running off to have surgery or radiation treatment on their prostate after having just a PSA test. This is where men, and possibly even the Minister of Health, are being misled.
If a PSA test is slightly higher than normal then a doctor will usually suggest a wait and see procedure and do a further test in a few months. Depending upon the result the doctor will then suggest a further test in a few months, or, if the PSA reading has increased significantly, suggest a biopsy. The doctor will also perform concurrent DRE procedures during which he/she can feel some of the prostate for lumps, general hardening or other abnormalities.
So it is usually only after a series careful procedures that a doctor will suggest a man consider having an ultra-sound guided biopsy. It is then only after analysis of the samples of the prostate taken during this biopsy that a man will be diagnosed as having prostate cancer or not. Even this is not 100 percent accurate. The biopsy needle may have missed the part of the prostate with cancer. But again careful follow-up will suggest further monitoring and possibly a further biopsy.
If cancer is diagnosed then the man and his doctor will discuss the various treatments available. There are pros and cons to these treatments, just like in most other medical procedures, and a man must be fully informed about these before making a decision.
There is something else men need to keep in mind. In its early stages prostate cancer does not usually exhibit symptoms. If a man begins to have prostatic problems, and it is found these are caused by prostate cancer, then the cancer may well be too advanced for effective treatment. There is no cure for advanced prostate cancer.
The envelope of opportunity, therefore, is to detect prostate cancer while it is still within the prostate and more responsive to treatment. This is why the Prostate Cancer Foundation (PCF) agrees with most urologists that men should discuss with their doctor having their prostate regularly checked from the age of 50 and, if there is a history of prostate cancer in the family, start check-ups from 40 or 45.
Our web-site is: www.prostate.org.nz
Visit it and remember that many companies now make it mandatory for executives to include a PSA and DRE in their annual health check up.
Barry Young
President
Prostate Cancer Foundation
All men have an absolute right to know what is going on within their bodies. They need to know they have an organ called a prostate that can cause them problems, and they need to know that if the problems turn out to be caused by cancer then it can kill them, says the director of information and national vice president of the Prostate Cancer Foundation, Barry Young.
Mr Young was responding to a suggestion in a story in this month’s Medical Journal that GPs were testing too many men for prostate cancer.
“The decision about whether to be tested for prostate cancer or not should only be made by a man when he is in full possession of the facts. There is a great deal to be taken into account, not the least of which are the possible side effects of treatment. These need to be discussed by a man with his doctor, but so too do the various treatment options.
“The problem with the diagnosis and treatment of prostate cancer is that it is the subject is so complicated. Not even the most eminent urologists in New Zealand can agree,” said Mr Young.
“What everyone needs to keep in mind is that men are all different. We each have our own way of dealing with things. What might be right for one man might not be right for another. Some men will want to know if they have a cancer growing in their body. Others will not. This is why men must be given the option.
“For medical bureaucrats, or anyone else, to suggest that men should be dissuaded from talking about their prostate and perhaps opting to have it tested for prostate cancer is paternalistic and should be recognised as such,” said Mr Young.
Issued on behalf of the Prostate Cancer Foundation.
Contact: Barry Young, PCF vice president, 09 523-1753.
A number of New Zealand men could face a miserable and painful death if they follow ministerial advice and not have their prostate checked for cancer says the president of the Prostate Cancer Foundation, Barry Young. Prostate cancer does not usually exhibit symptoms in its early stages and when symptoms do occur it is often too late for effective treatment, said Mr Young.
“It is also hard to understand why the minister to says she will not back a screening programme for prostate cancer because she questions the accuracy of the prostate specific antigen (PSA) test. This simple blood test is only one of the indicators a doctor uses to establish if a prostate is having a problem and I am advised by doctors that it is no less accurate than the tests for breast cancer. Is the minister now going to cancel the breast cancer screening programme?
“It is worth noting that no-one goes racing off to have radiation or surgical treatment for their prostate after just a PSA test. The test is usually given in conjunction with a digital rectal examination (DRE) and doctors frequently do a number of PSA tests and DREs. If they find the PSA levels continue to rise, and if they can feel some differences in the prostate with the DRE, then they will discuss with their patient whether he should have a biopsy. This involves taking tissue samples from the prostate and analysing them in the laboratory and it is this that establishes whether a man has prostate cancer or not,” Mr Young explained.
He said the report on which the minister based her comments also recommended that: ‘Men who request a PSA test and or a DRE be provided with information which clearly explains the possible harms and benefits of screening and subsequent treatment. This is to ensure that men reach a fully informed decision’.
“This is the advice that men and their doctors should take. Men should talk to their doctor about their prostate when they reach about 50 years of age. If they have a history of prostate cancer in the family then they should talk to their doctor even at 40 or 45.
“A significant number of men in New Zealand are having a PSA and a DRE on an annual basis as part of their regular health check-up. I am sure they will continue to do so,” said Mr Young.
From Barry Young
President, Prostate Cancer Foundation
To the National Business Review
The suggestion from Tom Morris that I am irresponsible for propagating the idea that men should talk to their doctors about the health of their prostate is a direct and unwarranted criticism of his urological colleagues, the Urological Society of Australasia and the Prostate Awareness and Support Society (PCF), all of whom follow the same policy.
This policy recommends that men should talk to their health professional about the health of their prostate and be fully informed about any treatments that might be required to enable them make an informed decision about whether to be treated or not. Such a policy is also enshrined in the New Zealand Code of Health and Disability Services Consumers’ Rights that says everyone has the right to be fully informed and the right to make an informed choice and give informed consent. For Tom Morris to suggest he would actively discourage men from having tests would seem to put him outside his obligations under this code.
It also is a great pity that Tom Morris did not consult with urological specialists. It might have helped in presenting a balanced picture and he would surely have been told to include hormone treatment in his list of treatments available. He is seemingly so knowledgeable about the subject of prostate cancer treatment that he ignores it completely.
He says that the only treatment without side effects is no treatment at all. What he doesn’t mention are the possible effects of untreated prostate cancer when it spreads beyond the prostate:
Bone pain and fractures.
Spinal cord compression and paralysis
Urinary retention
Renal failure
Bleeding
Some patients without symptoms may have advanced prostate cancer that has spread beyond the prostate. This can almost always be detected by the PSA test and although this advanced cancer cannot be cured it can still be treated before the above complications occur.
Tom Morris also suggests that men usually suffer incontinence and/or impotence after a radical prostatectomy. This might have been the case years ago but it is only rarely now that a man suffers incontinence and if he does then there are further measures that can be taken to rectify the situation. While impotence does remain a possible problem, nerve sparing surgery and the early use of medicines such as Viagra can decrease this risk.. Once again, if it does occur, there are increasingly effective measures that can be taken to restore function.
For Tom Morris to suggest that deaths from prostate cancer have been reduced in the United States simply because prostates are being removed at such a rate none have the chance to become malignant is bizarre. Prostates are only removed if they are malignant.
As for there being no evidence of the effective use of treatment he should refer to a major Scandinavian prostate cancer trial on increases in disease specific survival (New England Journal of Medicine, 2002) that showed there is an advantage from treating prostate cancer.
In conclusion I ask Tom Morris and other men in New Zealand to consider the following:
The surgeon who operated on me over six years ago discovered he had prostate cancer when he broke his femur when the cancer had spread to his bones. From that painful diagnosis to death took 18 months. He died at age 56.
And one more thing for Tom Morris to chew on: Every word of this letter has been run past one of New Zealand’s foremost urologists for accuracy, so no more of this ‘ill-informed enthusiast’ thank you.
Two prostate cancer brochures launched by the Minister of Health do not present the full story about the disease and do not meet the government’s own guidelines about patients’ rights.
President of the Prostate Cancer Foundation (PCF), Barry Young, says both the brochure prepared for general practitioners and the brochure prepared for patients recommend that men who do not have symptoms of prostate cancer should not have a test for the disease.
“The insidious thing about prostate cancer is that in its early stages it does not usually have symptoms. When a man does begin to have symptoms and it is found that these are caused by prostate cancer then the cancer is less amenable to treatment. Put bluntly it is often too late,” said Mr Young.
“Without this information in the brochures men are not being told everything they need to know before making an informed choice about whether to have their prostate checked. Yet under the government’s own Code of Health and Disability Services Consumers’ Rights everyone has the right to be fully informed and the right to make an informed choice and give informed consent.
“We are of the view that from about the age of 50 men should be encouraged to discuss the health of their prostate as part of their normal health check-up. If there is a history of prostate cancer in the family the check-ups should start earlier. The brochures tend to discourage this.
“But it is the men of New Zealand who will make their own decision about having a check-up. The National Health Committee may say it does not recommend a national prostate screening programme but in fact we already have one. Men are not prepared to take the risk that they may have this disease developing in them and not know about it. It is their right to know what is happening to their bodies and they are exercising that right.
“Once they are diagnosed what they then decide to do is up to them in consultation with their doctor. Age, family circumstances, treatment options and other factors come into this decision making but the important thing is that it is their decision,” said Mr Young.
The Prostate Cancer Foundation (PCF) is to explore the development of an organisation dedicated to all health issues affecting men. Since it was formed eight years ago PCF has played a significant role informing men about prostate problems and providing counselling and support to those who are diagnosed with prostate cancer.
President of the national executive of PCF, Barry Young, said the work PCF did talking to men and their families about prostate problems frequently led to discussion about wider health issues.
“We believe the operational techniques and philosophies developed within PCF might well be useful in an holistic approach to men’s health issues. This is what we are going to explore,” said Mr Young.
He explained that PCF had created a New Zealand wide network of men who had personal experience with prostate problems and prostate cancer in particular. The network, available on 0800 62 72 77, is widely used by men and their partners seeking information and counselling. The PCF web-site, www.prostate.org.nz receives an average of 84 hits a day.
“When people contact us they know they are talking to someone who has a significant degree of empathy with what they might be feeling. We have become increasingly aware that this is important to men and their families as they deal with the sometimes traumatic experience of diagnosis, selecting treatment options and then perhaps having to live with the effects of treatment or progressing disease."
“If we decide to proceed we anticipate developing similar support networks to deal with a wide range of men’s health problems. It will also be our intention to provide promotion and advocacy on men’s health issues just as we are doing with prostate problems,” said Mr Young.
If 2002 is the same as other years then about 600 men will die of prostate cancer. It could well be more, and it might be a few less, but year after year something like 600 men in New Zealand die of a cancer which, if diagnosed early enough, can in many cases be successfully treated.
The problem for New Zealand men is that too few of them know anything about prostate cancer. Access to information is often only made available when a prostate problem becomes obvious. For many this is too late.
There is no need for this. A simple blood test and a physical examination can indicate if the prostate is abnormal and can lead doctors down the track of accurate diagnosis. Luckily, something like 90% of men who are diagnosed as having a prostate problem do not have prostate cancer.
But what is so insidious about prostate cancer is that in most cases it does not reveal itself with symptoms and in other cases its presence may be masked by other prostate problems.
This is why a check with a simple blood test, the PSA test and the DRE (digital rectal examination) is so important. The New Zealand Prostate Awareness and Support Society recommends that all men from the age of 50 onwards should consider asking for annual PSA and DRE check. If there is a family history of prostate cancer then regular checks should be carried out from the age of 40.
PSA stands for prostate specific antigen. It is produced normally by the prostate but also by prostate cancer and it leaks into the blood. The readings need to be carefully interpreted by doctors as the results are, in part, related to age and even a higher than normal reading may not mean a man has prostate cancer. What the test does is indicate to a doctor that there is a problem that needs further investigation.
If prostate cancer is detected there are a number of treatment options which, like the initial investigations, should be discussed in depth with doctors.
PCF strongly recommends that all men discuss the question of checking for prostate cancer with their doctor when they have their next annual check-up. This is important whether they are exhibiting symptoms or not.
For those needing information about prostate cancer, or other prostate problems, PCF has established a Helpline 0800-627-277 and a web site www.prostate.org.nz
For any further information please contact Barry Young, Phone 9-523 1753, Fax 9-524 4536
By Barry Young, National Vice President, Prostate Cancer Foundation
The moments after being told one has cancer are probably some of the most traumatic anyone has to face. It is over four years now since I was diagnosed with prostate cancer, and almost four years to the day (as I write this) since I had an operation to remove both my prostate and hopefully all the cancer with it. But I still remember vividly the moment I was told, the sudden drying of the mouth, a feeling of unreality; the world had changed and would never be the same again.
Until a blood test revealed something was happening with my prostate, and a subsequent biopsy proved I had cancer, I didn’t even know I had a prostate let alone what it did.
Yet here I was with cancer in this organ and if I didn’t do something about it then it was highly likely I would die of the disease. And so started some of the most intense research I have ever done. Off to the Cancer Society to get books about prostate cancer. What are the treatments? What are the chances of cure? What do I do? Who do I talk to?
It was this last question that led me to call a friend of mine, another journalist who had written a book about his experience after having been diagnosed with prostate cancer. There was the relief of being able to talk to someone who had been through all this. Someone who knew what I was going through and who could talk almost matter-of- factly about his own experience.
It was the comfort I found I could take from knowing I wasn’t the only person around with the disease, knowing I wasn’t the only one facing the treatment options of radiation or operation, that led me to become a member of the Prostate Cancer Foundation (PCF).
The members of PCF are mostly men who have been treated for prostate cancer or are continuing to be treated for it. They have ‘been there, done that’ and can talk with you about their experience.
If you have a prostate problem, or have been diagnosed with prostate cancer, then call the PCF help-line 0800 62 72 77.
But all men should keep in mind that one of the insidious things about prostate cancer is that in its early stages it usually doesn’t exhibit any symptoms so men can be walking around with it and not know. Also keep in mind that like many other cancers, prostate cancer can be more successfully treated if it is diagnosed in its early stages. For this reason PCF recommends that all men from 50 onwards should discuss with their doctor the advisability of having a simple blood test and brief physical examination to help establish the health or otherwise of their prostate. If there is a history of prostate cancer in a family then this testing should start from the age of 40.
by Peter Gilling, Hon Urologist, PCF
Prostate Specific Antigen (PSA) is a protein produced by the cells that line the glands in the prostate. PSA is concentrated in prostate tissue and serum PSA levels are normally very low. Disruption of the normal prostatic architecture, for example, with prostate disease enables greater amounts of PSA to enter the circulation.
Many different prostate problems cause elevated serum levels but prostatic intra-epithelelial neoplasia (PIN), a pre-cancerous state, does not appear to raise the serum levels of PSA.
PSA testing detects more tumours than does digital rectal examination (DRE) and it detects them earlier. However, the most sensitive measure for the detection of prostate cancer uses both DRE and PSA. Both tests should be employed in a programme of early prostate cancer detection. Of prostate cancers currently detected about 75% have an abnormal PSA. Approximately 20% of prostate cancers with aggressive features are found in men whose PSA is less than 4.0mcg/L Many of these can be detected with DRE.
A variety of factors can effect the serum levels of PSA and should be considered when interpreting the results. The three most common prostatic disease - prostatisis, benign prostatic hyperplasia (BPH) and prostate cancer - can all be associated with elevations of serum PSA levels.
Other factors that are known to cause secondary elevations in PSA levels include physical activity, infection and medications. Medications containing hormones can often lead to quite dramatic falls in PSA, as will Proscar (Finasteride), an agent used for the treatment of BPH and male pattern baldness. Various herbal medicines may effect PSA levels as well as these often have an hormonal component.
Ejaculation and rectal examination are not thought to influence the levels significantly although any instrumentation of the urethra or biopsies of the prostate can effect the levels of PSA. Testing should be postponed for at least one month due to this effect.
A prostate biopsy is indicated when the PSA is 4.0mcg/L or more, the digital rectal examination is abnormal or there is a significant rise in the PSA tests.
Serum PSA levels are proportional to the risk and extent of prostate cancer. The average man older than 50 has about a 20-30% likelihood of having prostate cancer if his serum PSA is above 4.0mcg/L. Interestingly, if a similar patient with a PSA between 2.5mcg/L and 4.0mcg/L undergoes a prostate biopsy, the likelihood of detection of prostate cancer is approximately 27%. For levels above 10.0mcg/L the likelihood increases to between 42%-64%.
Half of all prostate cancers with pre-operative PSA levels of between 4.0mcg/L and 10.0mcg/L have been found to have invaded through the wall of the prostate into the surrounding tissue already. When the PSA level rises above 10.0mcg/L this risk is substantially greater.
The PSA test can be used to aid in determining appropriate investigations before treatment of prostate cancer is performed. For example: a bone scan is generally not necessary in patients who have a PSA less than 2.0mcg/L unless there is some history suggesting bony pain, particularly if the grade of the tumour is only moderate, such as having a Gleason score of 6 or less.
Another example of this is the need for sampling of the lymph nodes in the pelvis, which is also unnecessary in this same group of patients---those with a PSA of the less than 20.0mcg/L and a Gleason score of 6 or less. Less than 5% or patients with these features would turn out to have cancer in the lymph nodes.
After treatment PSA tests should come down to 0.1mc/L or less and should stay there. This applies to surgery and radiotherapy equally. The best results with radiotherapy are achieved if the PSA drops to very low levels (less than 0.5mcg/L). The rate at which the PSA rises after treatment can help determine whether or not treatment is necessary and what sort of treatment would be appropriate.
When hormone treatment is given it can take between 3 and 6 months to achieve the lowest levels that are going to be seen with this form of treatment. The lower the PSA test result goes the better.
PSA testing is one of the most useful blood tests available in cancer treatment. It can help with early detection, treatment planning and treatment monitoring in cancer of the prostate.
Although prostate cancer is a disease that only strikes men it is women who appear to be playing an increasingly significant role in the fight against it. The Prostate Cancer Foundation (PCF) say that more women are using the organisation's 0800 number to seek advise on behalf of their husbands, partners, fathers, brothers and even grandfathers.
PCF vice president, Barry Young, says he has been one of the people providing counselling on the 0800 number for almost a year and with over 200 calls logged has estimated that almost 20% are from women.
"Not only are women calling on behalf of their men but many of them insist that we send our brochures addressed to them so they can make sure their men read the material.
"We find that many men are particularly prudish when it comes to discussing a disease which might affect their sexuality which is what can happen if prostate cancer develops too far before it is diagnosed," said Mr Young.
"The first few calls I took from women were wives of men whom they said possibly had prostate problems. I made the assumption that the motivation may have been shared concern about future sexual performance but when I began to find that the calls were also from other concerned female members of a family I rapidly changed my view.
"It became clear the women in a family were determined their men should not die from this disease. It was they who had seen the publicity that if prostate cancer is diagnosed in its early stages then in many cases it can be successfully treated. And it was they who were doing something about it.
"It makes me wonder if we should be directing more of our publicity effort to women to encourage their men to get checked out for prostate cancer. The awful thing about the disease is that in its early stages it does not exhibit any symptoms so you don't know you have it.
"If you then wait until you are having prostate problems, and the eventual diagnosis is that you do indeed have cancer, then the cancer is less responsive to treatment. It is much better if men from the age of 50 have an annual check. This involves a simple blood test known as a PSA (prostate specific antigen) test and a DRE (digital rectal examination). Together these can show if the prostate is having a problem and can lead a GP to recommend involving a urologist and possibly proceeding to have a biopsy through which an accurate diagnosis can be made," said Mr Young.
"Most of the men in PCF have heard those dreaded words 'yes, you have cancer' and have had treatment. We have been there and know what men go through. This is why we are dedicated to promoting these regular check-ups. We say they should start at 50 for most men but if there is a history of prostate cancer in the family the checks should start at 40.
"In the week leading up to Fathers' Day we feel it is appropriate for families to think about all their men and persuade them to have what are essentially some very simple checks done. Our slogan is ‘The kindest Gift for Father’s Day, is DRE and a PSA’.
"Why not buy Dad a prostate check-up for Fathers' Day," said Mr Young.
The PCF national helpline number is 0800 62 72 77.
For any further information please call Barry Young, PCF, 09 523 1753.
Issued on behalf of the Prostate Cancer Foundation.
Women have been members of the national executive of the Prostate Cancer Foundation virtually since it started and they continue to play an important role in the fight against prostate cancer.
Although only men have a prostate, it is women who actively encourage their male partner to go to a doctor for regular check-up; including discussing the possibility of asking the doctor for a check on the prostate.
National vice president for PCF, Barry Young, said up to 20 per cent of the calls received on the national PCF helpline (0800 627277) are from women concerned about the man in their life.
“When I began doing telephone counselling for PCF I was surprised at how prudish men were in discussing anything to do with an organ that is part of their sexual system. Women have far fewer inhibitions. For most of their lives they have to go for regular medical checks for breast or cervical cancer and they see no reason why men should not have regular examinations as well,” said Barry.
“At our recent annual conference we decided we would make sure women continued to play their important role. Next year, whenever a man joins PCF his membership will include his partner as well. I suppose it will work the same way in reverse, if a woman joins PCF then her partner will become a member. Either way we get them both involved and that is important in the fight against prostate cancer,” said Barry.
The Auckland region is to be the target for a series of commando attacks. The sea borne commandos are expected to make landings at various parts of the Hauraki Gulf and the Waitemata, Manukau Harbour and Paihia sometime in March next year.
The commandos, or more correctly former Australian commandos, will be taking part in a major project to raise money to help in the fight against prostate cancer. Chairman of the Auckland branch of the Prostate Cancer Foundation (PCF), Mr Jack Irwin, said the commandos were circumnavigating New Zealand in a rigid hulled inflatable outboard-powered boat following the track of Captain Cook’s ‘Endeavour’.
“Wherever they come ashore they will be holding public meetings in co-operation with organizations such as Lions, Rotary or the RSA. They will talk about their adventure, and believe me it is truly an adventure, and will seek donations to help PCF establish and operate branches throughout the country,” said Mr Irwin.
“Their adventure will start at Cooktown in Northern Queensland. They will then head south to Sydney before setting out for Lord Howe Island. After Lord Howe Island they will head for Norfolk Island and then to New Zealand, probably landing at Paihia in the Bay of Islands. They will head further south to Auckland before setting off on their circumnavigation of New Zealand.
“A rigid hulled inflatable has never been used to cross the Tasman Sea before and they will be setting a number of records during the whole project,” said Mr Irwin.
The project is called ‘Operation Pilgrimage’ and was developed by a group of former Australian commandos who had retired but wanted to use their training to do some good. They have already circumnavigated Australia following in the track of explorer Matthew Flinders, raising money to help in the fight against prostate cancer in Australia.
A member of the team has already completed an eight-week reconnaissance around New Zealand looking at harbours, and having discussions with Coastguard, police and other organizations.
Part of this reconnaissance involved looking at what type of boat to use for the total adventure. Rather than using a French built boat Operation Pilgrimage will now use a New Zealand vessel built to New Zealand offshore survey standard.
For any further information please contact Barry Young, PCF Director of Communications, 09-523-1753.
by Barry Young
The threat of prostate cancer is not something New Zealand men should take lying down. But the problem is that many men don't even know they have a prostate. They tend to confuse it with being prostrate, which the dictionary defines as 'lying flat on the ground; overthrown, overcome', which might well happen if men don't become more aware of the threat of prostate cancer.
So what is the prostate? It is a gland roughly the size of a walnut, it is located below the bladder and it surrounds the tube (urethra) which drains the bladder.
But what does the prostate actually do? It produces most of the fluid of a man's semen so is therefore an important part of the male reproductive system.
This is where educating men about their prostate can become difficult. Because it involves their reproductive system a great many men just don't want to know about such things. Not only do they seem excessively prudish when it comes to talking about their reproductive organs but they interpret any slight malfunction as a threat to their masculinity.
What they all need to know is that very often the prostate tends to become larger as a man ages. It grows to its normal size as a man reaches puberty and then, for some reason, begins to enlarge as a man grows older.
This tendency varies from individual to individual but as the enlargement progresses the effects become the same. Being a tricky little devil the prostate not only grows larger in diameter but it also expands inwards which puts pressure on that tube draining the bladder.
For most men the first indication they have a prostate problem is a decrease in the flow of urine. This can happen so slowly over a number of years that it is almost unnoticeable. Or it can happen quite quickly. Whatever the case this generally caused by an enlargement of the prostate, is called 'benign prostatic hyperplasia' or BPH. This should it be confused with prostate cancer.
What is alarming about prostate cancer, however, is that it usually does not present any symptoms at all in the early stages.
Until recently this provided doctors with the classical medical conundrum: 'Is it or isn't it? One of the methods they used examine the prostate was, and still is, the DRE. Simply think of this as getting to know and trust your doctor. Your relationship may well never be the same again as the DRE involves your doctor thrusting his or her finger up your bottom. By doing this they can detect if there are any abnormalities to the part of the prostate they can feel.
The other test is a simple blood test which, if it is abnormal, may indicate the presence of cancer or other non-cancerous prostate conditions. This can lead to a biopsy to establish whether or not a man has prostate cancer.
This blood test, known as the PSA test, detects prostate specific antigen, which is a protein manufactured normally by the prostate, and prostate cancer, and which leaks into the blood.
At this time international studies of the effectiveness of widespread screening for prostate cancer using DRE and PSA are still being done and with no definite proof that a screening programme would improve survival or quality of life there is no national screening programme here in New Zealand.
What is significant, however, is that since 1992 death rates from prostate cancer have steadily decreased throughout the United States due to widespread screening and treatment. The American Cancer Society and the American Urological Association also recommend annual checking with DRE and PSA on an individual basis, particularly for men with a family history of prostate cancer who are two to three times more at risk than other men.
The levels of PSA are, in part, age related with older men sometimes having higher levels. The interpretation of these levels should be left to the medicos but what every man needs to know is that he should discuss with his GP the option of having an annual check from the age of 50, or from the age of 40 if there is a family history of prostate cancer.
These discussions with a GP should also explore the possible down-sides to the check-ups. For example where the PSA test might be elevated from causes other than cancer or, in a small number of cases, complications from having a biopsy.
The New Zealand Prostate Awareness Support Society (PCF) suggests men must make up their own minds about whether to have themselves checked for prostate cancer, but in making that decision they should remember that prostate cancer is not just a disease affecting older men, it also strikes those in their 40s and 50s.
Men should keep in mind that if prostate cancer can be detected in its early stages it can very often be treated successfully.
Anyone thinking about have a prostate cancer check-up should also ask his doctor for a prostate score sheet.
This will ask questions like:
Over the past month
• How often have you had a sensation of not emptying your bladder completely after you finish urinating?
• How often have you had to urinate again less than two hours after you finished urinating
• How often have you found yourself stopping and starting several times as you urinate?
• How often have you found it difficult to postpone urinating?
• How often have you had a weak urinary stream?
• How often have you had to push or strain to begin urinating?
• How many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning?
You can see why men might be turned off by all this, but if you are showing some of these symptoms then don't mess about. Get your doctor to check you out more intensively. Keep in mind that 90 per cent of men with prostate problems do not have cancer and if this is the case the symptoms outlined can be treated by medicines or a simple operation.
If you do have prostate cancer then the earlier you know about it the better. Otherwise you might truly get prostrated by your prostate.
For any further information please contact Barry Young, Phone 9-523 1753, Fax 9-524 4536
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