Update on Prostate Cancer
National Radio Nine to Noon yesterday interviewed Prof Mark Frydenberg, an expert on prostate cancer who works at the Urology Dept, Monash Medical Centre, Melbourne. 600 men per year die of prostate cancer in New Zealand each year.
Prof Frydenberg explained that several international studies to evaluate the benefits of screening programmes had not been running long enough to come up with results, and the key argument against screening programmes was the lack of evidence that such programmes would actually achieve worthwhile reductions in death rates. However, an informal screening programme introduced by a urologist in Tyrol, Austria resulted in 50% less deaths from prostate cancer than in the rest of Austria where no screening was done.
The professor’s personal opinion was that screening programmes were likely to be helpful and that they were justified given that as many men die from prostate cancer as women die from breast cancer in Australia. He also said that the false positive rate for prostate tests was approximately the same as that for breast cancer mammograms leading to biopsies, thereby dispelling one of the favourite arguments against prostate screening. He strongly advised men to seek checks for prostate cancer from a younger age, given that earlier onset prostate cancer was more likely to become the cause of death, and by the time symptoms (typically, difficulty passing urine) are evident it is too late for effective treatment in many cases.
The professor was of the opinion that more flexibility could be exercised in treatment options. Small, slow-growing tumours could be safely watched and may not become significant prior to death from other causes, while only the more aggressive cancers might need surgery or hormonal treatment.
Although interviewer Kathryn Ryan deserves credit for airing the case for prostate cancer screening, it’s a shame the interview stuck to National Radio’s track record of never seeking comment from men’s movement representatives. Radio NZ interviews about breast or cervical cancer inevitably provide airtime to the likes of Sandra Coney or other feminist activists alleging sexism and demanding an ever-increasing slice of the health budget because women deserve it. In regard to prostate cancer, the men’s movement doesn’t necessarily demand screening programmes if these are not yet proven, but it may ask why more money is not spent to educate men about the symptoms and risks, or greater subsidies are not provided for the medical assessments, especially given that there is really no option for self-assessment as can be undertaken by women checking for lumps on their breasts. Also, Ms Ryan lost most of her brownie points at the end of the interview when she laughingly suggested that perhaps men’s wives should be targeted in a campaign to increase the rate of male testing for prostate cancer. While the professor agreed that men were slow to seek medical tests, Ms Ryan’s statement was patronizing and demeaning towards men, suggesting that men needed women to live their lives responsibly. This insinuation ignored the fact that the medical assessment for prostate cancer is especially embarrassing and uncomfortable because it involves the doctor sticking a finger up the man’s anus, this being incomparable with the relative ease of mammogram testing. It also ignored the fact that very little government funding has been allocated to encourage men to seek such tests, compared with that spent on encouraging screening for breast and cervical cancers. And of course, men must pay fully for the prostate test whereas women’s screening is provided free. Further it ignored the fact that even though breast cancer screening is easy, free and conveniently shipped into every local community, a significant proportion of women still don’t take advantage of it. There are many reasons other than the “stupid men who need their wives to manage them” theory implied by Ms Ryan for men’s low self-initiation of testing.