Men who have been diagnosed with prostate cancer face a confusing array of treatment choices, each with its own price tag and “idiosyncratic” side effects, we’re told in a news report this week.
The confusion is intensified by the politics surrounding prostate cancer treatment.
The medical specialists who favour radiation therapy are in one corner; in the other corner are the urologists who favour surgery.
Radiation oncologist Professor Sandra Turner told the Sydney Morning Herald that urologists are failing to provide information about the alternatives to surgery.
“It’s not all about money, but the bottom line is, there’s a massive financial incentive for surgeons to do an operation and they may not even be conscious of it,” Professor Turner said.
“If you know that the core of your business is prostatectomies and you even lose 20 to 30 per cent of those guys who never have an operation, that’s a massive chunk of your income.”
The Urological Society president, Mark Frydenberg, responded by acknowledging that surgeons’ fees are largely unregulated but urologists take seriously their obligation to look after patients.
Besides, the mortality rate for prostate cancer patients treated with radiotherapy was higher, he said, than for those who had surgery.
So where does that leave the 20,000 or so of us who are diagnosed with prostate cancer each year in Australia, and the more than 1.1 million men diagnosed each year, worldwide?
Plenty of people will tell you the best thing you can do is seek out information and get advice.
Problem is, there’s so much information floating around, and the advice you get is often contradictory.
I was able to talk to my father about his experiences with prostate cancer surgery, and I had a urologist who I instinctively trusted because he came across as a no-bullshit kind of guy. These things helped.
But making an informed decision based on all the available evidence felt like a herculean task. I had no prior experience in this area, so how could I get across the options in the short period of time available?
During the past year or so, I’ve had elevated PSA readings, had a biopsy, been diagnosed with prostate cancer, had surgery, and experienced “idiosyncratic” side effects such as incontinence and loss of sexual function.
The information needed to navigate these things rarely comes to you upfront, in one neat package. Some of it is volunteered; much of it has to be asked for; sometimes you stumble across it. The best collection of information I received was a kit a nurse gave me when I checked out of hospital, after the op. Better late than never…
The takeaway here is to seek information that’s specific to your age, your general health, and the particulars of your cancer. The kit I received from my nurse, post-op, was written for gay and bisexual men. It’s available here.
Avoid information-overload by finding a General Practitioner that you like and trust. She or he becomes your go-to person, the one who makes sense of your test results and explains things like the PSA testing guidelines, recently approved by the National Health and Medical Research Council.
Finally, be open to learning from other men’s experiences. Dan’s Journey Through Prostate Cancer is a blog worth visiting, and support groups such as those listed here are also useful.
These are the ways we can beat prostate politics.