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.

Tom McGrath is deeply grateful that, "purely by chance", his prostate cancer was diagnosed.

Despite being fit, active and seemingly healthy, he was diagnosed in 2007, at 54, with a slow-growing tumour that had not spread outside the prostate gland.

He had changed to a new doctor, closer to home, who recommended some blood tests, including the prostate-specific-antigen (PSA) test which can indicate an increased risk of prostate cancer. His result was slightly elevated.

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"The scariest thing is that had I not done that I might not even know now that I had prostate cancer," says Mr McGrath, who has penned a book, Blasted by Seeds, recording his experience of diagnosis and treatment.

After the diagnosis was established from tissue samples - biopsies taken with fine needles - from his prostate, he opted to be treated by having 126 tiny, radioactive seeds implanted in the gland, rather than external beam radiotherapy or surgery to remove the entire prostate. Active surveillance, with another biopsy after six months, was another option.

His chosen treatment, "low-dose brachytherapy", is provided only at private hospitals, although health insurance covered most of the $25,000 cost. He was told its cure rate is similar to the other treatments, at around 85 per cent, and he chose it partly because it was likely to minimise inconvenience.

Prostate cancer survivor Tom McGrath at his Wellington home with an x-ray image of his showing the 126 radioactive seeds planted in the gland. Photo / Mark Mitchell
Prostate cancer survivor Tom McGrath at his Wellington home with an x-ray image of his showing the 126 radioactive seeds planted in the gland. Photo / Mark Mitchell

"I was back at work the following week," recalls the 62-year-old married Wellingtonian and part-time tutor.

He has experienced a degree of ongoing impotence, which is treated with erectile medication, and urinary symptoms - going to the toilet more often, a sense of not being able to hold on and, at times, lack of flow. The urinary symptoms have largely resolved but for some months they had to be controlled with medication.

"I became very conscious of where all the toilets were in Wellington."

In 2012 and 2013, his specialists told him he was most likely cured.

Asked if the side effects were a small price to pay for being cured, Mr McGrath says while not treating a cancer such as his in an 80-year-old, the man might eventually die of something else; "doing nothing at the age of 55 or 60 the disease could well catch up with you. In cases of advanced prostate cancer they don't have cheery outcomes".

He urges the Government to give fresh thought to setting up an organised prostate screening programme, to help take the luck out of being diagnosed.

The Series

Tuesday:

Bowel Cancer

Yesterday:

Melanoma

Today: Prostate Cancer