Graeme Woodside: Prostate cancer - too many men diagnosed late

Too many men (11%) are being diagnosed with advanced, or metastatic disease, particularly among Maori and Pasifika men, writes Graeme Woodside. Photo / iStock

In a five-part series, the Herald investigates controversies in cancer testing and treatment and reports on the moving stories of people afflicted with cancer. In the fifth and final part of the series, Herald health reporter Martin Johnston turns his attention to prostate cancer.

Prostate Cancer is the number one cancer among New Zealand men, but sadly, too few men really take seriously the relatively high chance (1 in 10) of developing this disease.

And with no formal screening programme, it is incumbent on men, and their health professional, to have an informed discussion and decide together about having a prostate check.

This process has now been made clearer with the new Prostate Cancer Management and Referral Guidance recently issued by the Ministry of Health. These guidelines are the result of wide consultation and set out a clear pathway for testing and referral. This should result in more consistency among primary health care professionals in discussing prostate cancer issues with men, implementing checks for the disease and referring those with indications of potential disease through to the appropriate specialists.

As with many cancers, early diagnosis of prostate cancer is the key to effective treatment. Too many men (11%) are being diagnosed with advanced, or metastatic disease, particularly among Maori and Pasifika men. This inevitably limits treatment options, and survival rates.

For men, and their families and whanau who are living with prostate cancer, there are some considerable challenges. Treatments often result in at least some temporary incontinence and erectile dysfunction and lead to physical, psychological and economic concerns.

Treatments for these issues are often difficult to access and may involve pursing a claim for treatment injury with ACC, often accompanied by the uncertainties and stresses involved. Even the need to purchase an ongoing supply of incontinence pads becomes a financial hurdle for some men. Similarly it has been shown that taking a course of "little blue pills" (Viagra or the generic versions) can assist with post treatment erectile recovery, but these are not funded and therefore many men miss the potential benefits.

Earlier this year a new drug, abiraterone, was made available for men with advanced disease. This is a pleasing development, but it just the first of a new range of treatments becoming available. Others are yet to be either registered, or funded and New Zealand lags behind many of our OECD counterparts in providing funding for new therapies.

And even when funded, more use could be made of new therapies by clinicians. A case in point is recent research showing a very low use of chemotherapy for prostate cancer patients.

Men with prostate cancer deserve access to the best treatments and therapies available. And they need to talk more about this disease and consider being checked as part of their normal health programme.

Graeme Woodside is chief executive officer of the Prostate Cancer Foundation

The Series

Monday: Breast Cancer
Tuesday: Bowel Cancer
Wednesday: Lung Cancer
Yesterday: Melanoma
Today: Prostate Cancer