It’s time for the chat about prostate cancer

There’s no better time than Spring to gather for a Big Aussie Barbie. The weather’s warm, it’s footy finals time and Father’s Day. September is also international month for prostate cancer. So, grab the barbecue tongs, throw on the snags and gather around for a chat about the most common cancer diagnosed in men throughout Australia.

Unfortunately, most of us have a close family member or friend who has heard the dreaded words – ‘you have prostate cancer’. As the most common cancer diagnosed in Australia, according to the Australian Institute of Health and Welfare, it is also the second greatest cause of cancer deaths in men.

While these facts are frightening, it’s encouraging to learn, there are organisations, associations, and individuals who are working hard on the cause, diagnosis, prevention and treatment of prostate cancer.

The Prostate Cancer Foundation of Australia is dedicated to reducing the impact of prostate cancer on Australian men, their partners, families and the wider community. CEO Dr Anthony Lowe says the number of diagnoses has increased rather dramatically over the last 10 years, almost doubling from approximately 11,000 to 20,000. And, while mortalities rates have reduced slightly, the most exciting change has been the improvement in the length of time people are living with prostate cancer.

“We don’t talk about cure rates,” Dr Lowe says. “We talk about survival rates because in a sense you really never know if someone is cured or not. “Our chairman, David Sandoe, is a 16-year survivor.”

Prostate cancer is a disease of older men and really only starts to be a health issue when men reach their 40s, and increases rapidly over 50 years. “If you’ve got a first degree male relative, such as your father or brother, and they have been diagnosed under the age of 60, then you are three times more at risk than the average person,” Dr Lowe explains. “We really ask that people pay closer attention to the issue of prostate cancer if they have a family history.”

Symptoms are also not obvious, though can include frequent urination, particularly at night; pain on urination; and blood in the urine. These symptoms are not always signs of prostate cancer, but if men notice changes such as these, PCFA recommends visiting a doctor to determine the cause and best treatment.

There is no population screening tests for prostate cancer proven to lower the death rate. There are two simple tests a doctor can perform, including physical examinations and blood tests to measure Prostate Specific Antigen (PSA), to help determine its presence.

According to Dr Lowe, however, the best prevention is awareness.

“You talk to men in their 50s and almost everybody knows a colleague or a relative who has been touched by prostate cancer. “It’s similar in a way to breast cancer and the statistics are really similar in terms of diagnosis and death. “We have done a community attitude survey every year for the last 10 years and what the research actually shows is that awareness grows steeply as you approach age 50.”

The PCFA has had great success in raising awareness of prostate cancer through two major campaigns. The Big Aussie Barbie has grown in strength since starting four years ago. Held in September, which is international awareness month for prostate cancer, it’s a great excuse for people to get together for a barbecue and talk to each other. “It’s also when the footy finals are on, Father’s Day and great spring weather, so it’s the ideal time to stand around the barbecue and talk about prostate cancer,” Dr Lowe says.

This year, great Aussie cricketer Matthew Hayden will be patron.

“I’m delighted to be involved in the 2013 Big Aussie barbie Campaign which brings both awareness and much needed funds to support Prostate Cancer which affects over 20,000 men every year in Australia.” Matthew says. “Unfortunately one of those men has been my father, so I give my full support to the incredible work that Prostate Cancer Foundation of Australia does.”

And, when September is over, start thinking about growing a moustache for Movember. The fundraising campaign, which has provided PCFA with nearly $30 million for research, is now a world phenomenon.

“I’m delighted to be involved in the 2013 Big Aussie barbie Campaign which brings both awareness and much needed funds to support Prostate Cancer which affects over 20,000 men every year in Australia.”
Matthew Hayden
BIG AUSSIE BARBIE Ambassador

“It started in Richmond, Victoria,” Dr Lowe explains “with a couple of young blokes who were down the pub on Friday afternoon and talked about how hilarious it would be to grow moustaches and look like Tom Selleck. “Eventually they came to the idea of Movember and now it’s gone global. “They don’t just support us; they have men’s health partners around the world, and in Australia they support PCFA and Beyond Blue. “Last year, globally, they raised about $130 million. “It’s a fabulous effort.”

Money raised from these two events, and corporate support, is heavily invested in research , which spans the full spectrum from basic science all the way through to translation and applied research.

“If we see an issue we make it our mission to do the research.” Dr Lowe

“Because we are a community organisation, things that are practical and can be applied quickly are very important to us,” Dr Lowe explains. “If we see an issue we make it our mission to do the research. “A particular project I am working on at the moment is the costs associated with prostate cancer. “It can be expensive and if you are with the wrong health insurer you can find things aren’t covered. “We are trying to quantify all of that to help people understand what those costs are and where to go for help. “We also want to lobby government and health insurers to make changes to the system to be more helpful. “What we want to do in the first instance is talk to the ones that are less accessible to point out they can do better. “It’s quite variable between states and across health insurers and that’s really because of lack of focus on the issue than anything else.”

Dr Anthony LoweResearch funded by the PCFA is gaining international recognition and one project Dr Lowe is particularly proud of is led by Professor Daniel Galvão, Director of Edith Cowan University’s Health and Wellness Institute in Western Australia.“The interesting thing about exercise and cancer generally is, only a few years ago doctors would tell people who had cancer not to do it,” Dr Lowe says. “What Daniel’s managed to show is that exercise is actually good for you – it improves your physical wellbeing and your mental wellbeing.”

Prostate cancer can be treated with androgen deprivation therapy (ADT) which Professor Galvão explains is generally known as hormone therapy. He says recent trials show that ADT, when used with radiation, improves survival rates. It does, however, have a number of adverse effects which lead to a decline in physical capacity and make it more difficult to carry out daily activities. It leads to muscle loss, issues of fatigue, poor balance, and bone loss. There is also the risk of developing cardiovascular disease and diabetes.

“The potential role of exercise, different types, intensities and frequencies can help to minimise, offset and counteract the adverse effects of ADT,” Professor Galvão explains.

Professor Galvão cites a number of published studies, some still in progress, which show that men undergoing ADT lose around 1.5kg of muscle, and gain at the same time 2.3kg of fat. “This makes a huge difference in the way they are able to do things,” Professor Galvão says. “What’s worse, when they stop therapy, it doesn’t mean they will gain the muscle back, lose the fat or improve their physical function.”

A PCFA funded study involving Australian and New Zealand hospitals and carried out over 12 months, involved men who were five-year survivors of prostate cancer. In simple terms, the outcomes reveal the group who carried out six months of supervised exercise, followed up by a six-month home-based exercise program, reported a much higher cardiorespiratory fitness, improved lower body physical function, self-reported physical and mental health improvements, greater muscle strength, better levels of good cholesterol and skeletal strength than the standard group of unsupervised men who were directed to carry out a general exercise program typically recommended by a doctor.

The outcome from the studies is that weight based training, as well as cardio training has huge benefits for men going through treatment for prostate cancer. In another trial, impact loading, such as jumping and skipping, is also proving to arrest loss of bone. “Importantly,” Dr Galvão explains “the exercise did not change levels of PSA or testosterone. “The group that took part in the supervised exercise program reported that they were able to maintain sexual activity as opposed to the group that didn’t. The group who didn’t do exercise lost all interest in sex “This is a big issue for men with prostate cancer.”

Dr Galvão recommends people with prostate cancer should get a referral to an exercise physiologist to obtain an exercise program best suited to their needs. “The Medicare system allows for five supervised sessions,” Professor Galvão says.

For more information on the The Prostate Cancer Foundation of Australia visit www.prostate.org.au.

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Alana Lowes
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