September is International Prostate Cancer Awareness Month and the disease is the second-most commonly diagnosed cancer in Australian men and is the second most common cause of cancer death in Australian men.

Urologist Associate Professor Ian Vela has shared information on prostate cancer and some recent medical advances which are changing treatment options available to men.

“There is no single blood test able to diagnose prostate cancer. The first thing we would do is a prostate specific antigen (PSA) blood test, however the results do not specifically diagnose prostate cancer,” Ian said.

“PSA is produced by the prostate gland and by prostate cancer. Most men with prostate cancer will have an elevated PSA test and therefore if a patient’s PSA is above where we expect it to be, we would proceed with further investigations to determine if the patient has cancer.

“There are common causes other than cancer of an elevated PSA, including benign enlargement of the prostate or inflammation. A high PSA therefore does not equal a diagnosis of cancer but requires further investigation.”

Ian said today men are being diagnosed with prostate cancer from a younger age yet due to the rapidly improving treatment options and early detection, many will be cured with a long-life expectancy, so treatment options have adapted for the individual patient.

“Not all men diagnosed with prostate cancer require immediate treatment, are possible side effects associated with all treatments and we are now avoiding overtreatment of men with low risk prostate cancer by placing them on active surveillance,” Ian said.

“Active surveillance is a very thorough process where we closely monitor and reassess patient risk with various protocols to ensure no higher risk cancer has been missed. Improved imaging with MRI plus that of new biopsy techniques such as MRI fusion targeted and transperineal saturation biopsy means we are very confident in the safety of this approach.

“MRI technology has significantly improved, and Australia leads the way in medical imaging detecting prostate cancer. If higher risk cancer is detected, then Ian says he would proceed with curative measures. “

Ian noted unfortunately, early prostate cancer does not have any symptoms so it’s imperative you see your doctor for your scheduled check-ups. 

“Advanced symptoms can include frequent urination, pain while urinating, blood in the urine or semen, a weak stream, pain in the back or pelvis, weak legs or feet and unexplained weight loss or fatigue,” Ian said.

“For men especially, there is still a stigma around prostate cancer and being tested. I would encourage all men to be aware of the symptoms and don’t be afraid to speak to your doctor if you’re concerned.”