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BUILDING CONNECTION
SUMMER 2016
UP YA DATE, MATE!
W
hoops! Sorry about the title of this article. It
was meant to just read Up Date. But on second
thought, I reckon it might be appropriate in that
I want to update you all on the latest recommendations
on prostate and bowel cancer screening – both with anal
connections!
There has finally been a consensus among the medical
fraternity about what to do when it comes to screening for
prostate cancer as well as an expansion of the successful
bowel cancer screening program.
Firstly, I’d like to say a few words about screening in
general. Screening refers to doing a test
on a large number of individuals in
order to pick up a disease at an
early stage so that treatment
can be instituted early, thus
avoiding a premature
death.
The cost of
screening will
be offset by the
savings in monetary
terms from the
reduced medical
treatment costs of
an advanced disease
as well as the savings
from preventing lost
productivity from a
preventable, premature
death.
There also needs to be
evidence to prove that
finding the disease early
will in fact prevent a premature death,
balanced against a false positive rate where investigations
and the stress of a possible serious disease such as cancer,
eventually proving negative in some individuals, will cause
unnecessary treatment, stress and anxiety.
This has been the problem with prostate cancer screening
in the past.
There is still no government backed screening program
for prostate cancer recommended for all men but at least
there are now useful guidelines to direct GPs toward
who and when PSA testing should be done. Bowel cancer
screening with the Faecal Occult Blood Test (FOBT) or
affectionately known as the ‘poo test’ has always been a
well-respected test among medicos and there is no doubt
that when it comes to bowel cancer, early detection saves
lives.
Let us look at what is new with respect to prostate cancer.
Over 20,000 Australian men are diagnosed with the disease
every year. About 3400 men passed away because of it last
year. It is the second most common cancer behind skin
cancer and it is estimated that by 2020 there will be some
200,000 men living with it.
Fortunately, the survival rate has improved over the years
and it is now about a 95% five year survival rate. It is unclear
whether this is due to better treatments or
because it is being found earlier.
There has always been
controversy over screening
for prostate cancer with
some recommending universal
screening with the PSA test
and digital rectal examination
(DRE) versus those who
have been totally against
widespread screening,
stating that the cure may
be worse than the disease
due to the side effects of
treatment and a lot will die
with the disease, but not
because of it.
As with most controversial
issues in life, the answer
generally lies somewhere in
between. GPs are at the
forefront of this and up until
now we have had to each
develop our own protocol when dealing
with this important male disease as no formal guidelines
existed. As many men die of prostate cancer as women do
of breast cancer; however breast cancer has well delineated
investigation and treatment guidelines.
In January this year, a multidisciplinary team brought
together by the Prostate Cancer Foundation of Australia, in
partnership with the Cancer Council of Australia, presented
a set of guidelines to assist healthcare professionals and
their patients make a considered decision about testing and
managing prostate cancer.
I have had to develop my own protocol over the years
and I was pleased that the new guidelines fairly closely
DR BERNIE CRIMMINS SHARES THE LATEST UPDATES ON PROSTATE AND BOWEL CANCER SCREENING.
MEN’S HEALTH
DR BERNIE CRIMMINS
ILLUSTRATIONS: PAUL HARVEY WWW.HARV.COM.AU