Face the facts on prostate cancer

It’s something Australian men don’t like talking about, or even thinking about. 

But with 26,368 men expected to be diagnosed with prostate cancer in Australia this year, it’s something we should all be aware of. 

The Urological Society of Australia and New Zealand (USANZ) is warning that two widespread misconceptions could be costing men their lives. 

Those myths are: 

• That men must have symptoms before they need to be tested 

• Diagnosis of prostate cancer always requires a rectal examination. 

“Many men believe that they need to have urinary symptoms to be concerned about prostate cancer,” said Associate Professor Weranja Ranasinghe, Deputy Leader of USANZ’s GU-Oncology Special Advisory Group. 

“The reality is that most prostate cancers develop without any symptoms at all. Urinary symptoms are not reliable – most of these symptoms are caused by non-cancerous enlargement of the prostate but advanced cancer can also give you urinary symptoms. So, it is important to get checked.” 

Assoc Prof Ranasinghe said the outdated belief that prostate cancer testing requires an invasive rectal examination is also a barrier.  

“This is a common fear among men, but it's no longer necessary for initial prostate cancer screening,” he said.  

“A simple PSA (prostate-specific antigen) blood test, combined with advanced imaging like MRI, is now the standard approach. 

“Many men are avoiding tests due to this outdated fear, but in the GP setting, a rectal exam is currently not required for detecting prostate cancer." 

Data shows men with a family history of prostate cancer are at higher risk and need to be especially vigilant. If a close blood relative has had cancer, their risk significantly increases – up to five times higher in some cases. 

“What’s less well-known is the connection between breast cancer genes (BRCA1 and BRCA2) and prostate cancer,” said Assoc Prof Ranasinghe. 

“Men with female relatives who have had breast or ovarian cancer are also at an increased risk of prostate cancer due to the same genetic mutations. 

“We recommend that men with a strong family history get a PSA test at the age of 40.” This is earlier than the usual recommendation of tests every two years between the ages of 50 and 69. 

Another alarming trend is that many men only seek testing after hearing about prostate cancer within their social networks.  

“We often see men wait until a friend or relative is diagnosed before thinking about getting a prostate cancer test done,” Assoc Prof Ranasinghe said. 

“This reactive approach is dangerous. Men need to be proactive and take ownership of their prostate health and talk to their GPs about this, just like they would with cholesterol or other routine health checks.” 

USANZ is urging men to overcome the myths and fears and get tested.  

“Early detection saves lives. A quick blood test could make all the difference between catching prostate cancer early, when it’s most treatable, and facing more difficult outcomes later on,” Assoc Prof Ranasinghe said.