Cancer Society’s prostate cancer screening stance labelled ‘fraught with danger’

Conor English, a director at Silvereye Communications and former farming industry heavyweight, was diagnosed with prostate cancer in April 2019.

ROBERT KITCHIN/Stuff

Conor English, a director at Silvereye Communications and former farming industry heavyweight, was diagnosed with prostate cancer in April 2019.

When Conor English turned 50, he, like many men do, turned up to his doc for a warrant of fitness. He discussed getting a PSA test – a routine blood test which helps detect prostate cancer.

But there was no family history – or so he thought – and he had no symptoms, so the test didn’t happen for another four years. By that point, the cancer had spread to his lymph nodes.

English is calling on the Cancer Society to change its stance on PSA testing, which encourages asymptomatic men to “weigh the potential advantages and disadvantages of PSA testing and treatment before deciding whether to proceed”, citing a risk of unneccessary treatment.

English’s plea is backed by the Prostate Cancer Foundation, which says the stance is “fraught with danger” and outdated. More than 650 men in New Zealand die from this type of cancer each year.

READ MORE:
* Facing up to a deadly diagnosis: The men navigating prostate cancer
* Call for prostate cancer screening to save lives and boost equality for Māori men
* Cancer testing appears to be struggling to make up ground lost during Covid-19 lockdown
* Dying man says he should’ve been tested for prostate cancer earlier

STUFF

Prostate cancer is the most commonly diagnosed cancer in men.

“The attitude GPs shouldn’t check men for men for prostate cancer unless they’re symptomatic is one we feel is fraught with danger and carries with it the strong possibilty men will be diagnosed late, their options will be reduced, and their outcomes will be poorer,” foundation chief executive Peter Dickens said.

English stressed he had no animosity towards his GP, but wondered if the invasive surgeries, radiotheraphy and chemotherapy could have been avoided if his prostate had been checked earlier.

Dickens and the foundation are backing a petition for a centrally funded, risk-based, equitable prostate cancer testing regime, which would see men who have a higher level of Prostate-Specific Antigen more closely monitored.

Peter Dickens, chief executive of the Prostate Cancer Foundation NZ, is backing calls for a prostate cancer screening programme in New Zealand.

Supplied

Peter Dickens, chief executive of the Prostate Cancer Foundation NZ, is backing calls for a prostate cancer screening programme in New Zealand.

New Zealand has three routine cancer screening programmes for breast, bowel and cervical cancers.

The Cancer Society cited the risk of false positives, which can cause anxiety, as well as overtreatment as a “harm of PSA testing”.

“For a screening test to be effective, it needs to be able to identify disease at an early enough stage and impact on deaths from that cancer,” the society’s medical director, oncologist Dr Kate Gregory, said.

It remained unclear whether men who were screened lived longer and for that reason no country in the world had a PSA screening programme, she said.

Cancer Society Medical Director Kate Gregory says it would take a compelling change in science for the society to change its position on PSA testing. (file photo)

BRADEN FASTIER/Stuff

Cancer Society Medical Director Kate Gregory says it would take a compelling change in science for the society to change its position on PSA testing. (file photo)

Since PSA testing arrived in the early 90s, diagnosis of prostate cancer has about tripled, but the death rate has remained stagnant, according to population health Professor Ross Lawrenson, from the University of Waikato.

In a recent webinar organised by the Cancer Society, Lawrenson said half a million PSA tests are done every year – 80 per cent of which were in asymptomatic men, “so can be considered opportunistic screening, or … disorganised screening”.

He did not recommend an organised prostate cancer screening programme in Aotearoa.

Conor English wants the Cancer Society to change its stance on PSA testing - a blood test used to help detect prostate cancer.

ROBERT KITCHIN/Stuff

Conor English wants the Cancer Society to change its stance on PSA testing – a blood test used to help detect prostate cancer.

Gregory said it would take a compelling change in evidence for the society to change its position, such as an international randomised controlled trial or a test that has been shown to be more effective than PSA testing.

English said it was well understood the PSA test was not perfect, but should provide a baseline for further testing – and the Prostate Cancer Foundation agreed.

“We could be sending people to die early needlessly, just because we are not doing a simple blood test,” English said.

“Everyone agrees that the earlier the detection and treatment of cancer, the better the clinical outcome.”

English later found out two relatives had had prostate cancer and said others would be in the same boat, unaware of family history.

“If we can get people talking about PSA testing for prostate cancer round the BBQ and it results in one bloke getting a PSA test and living longer, that’s something we can all be very happy about.”

English remains on hormone treatment and surveillance for his prostate cancer.

Leave a Reply

Your email address will not be published. Required fields are marked *