More men die of prostate cancer in Australia than women die of breast cancer each year. We chat to inspiring survivors.
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“You spend 200 or 300 dollars every six months or so to get your car serviced and what’s your car worth? A few thousand dollars, maybe? Well, why wouldn’t you go and get your body serviced too when it’s priceless?,” asks Phil Burge, 68, a retired Civil Engineer from Waitara, on Sydney’s North Shore.
We’re sitting in a café in Sydney and we’re discussing prostate cancer.
The café is full of the sounds of cups clinking, people talking and loud music, but the ambient noise drowns out our conversation – allowing us to discuss one of the most difficult male health issues in private. It’s a good thing too, because no topic is off limits; aggressive cancer, incontinence, and impotence, are all on the menu.
Prostate cancer is the most commonly diagnosed cancer in Australian men
“I lost my dad to prostate cancer when I was 50,” continues Burge. “Back then men didn’t talk about their health. They lived through the war years and the depression and they weren’t as informed or aware about their health as we are today,” he says.
Burge received the news about his father’s illness at a late stage. By then the cancer had already spread around his body. It was a shock that made a big impact on him. It’s a story that many families can relate to with their sons, husbands, fathers or grandfathers.
“I went down to see my dad one day and he was sitting in the sun in the backyard on a winter’s day. I said ‘What’s wrong with you? You look a bit crook.’ And he said he was about halfway through six weeks of radiation therapy for prostate cancer. That’s how I heard about it. Dad passed away about a year or so later. They didn’t get it early enough,” says Burge.
Angry Anderson helps spread the word for early testing
It’s this story and the story of his own brush with prostate cancer that Burge now speaks openly about, lecturing to groups on behalf of the Prostate Cancer Foundation of Australia (PCFA) and volunteering his services as a Peer Support Counsellor to men in the hope that they might become aware of this important health issue and go and seek the tests that might save their lives.
More men die of prostate cancer in Australia than women die of breast cancer each year
The stats for prostate cancer are frightening. Prostate cancer is the most commonly diagnosed cancer in Australian men. In 2015, 17,250 men were diagnosed and 3440 men died from the disease.
You wouldn’t know it by the amount of coverage it gets in the media, but the stats now show that more men die of prostate cancer in Australia than women die of breast cancer each year.
A man’s risk of getting prostate cancer increases with age. By age 75 he has a 1 in 7 chance of developing the disease. By the age of 85 this increases to a 1 in 5 chance.
In Burge’s case, knowing his own family history and the hereditary link gave him a head start on his own health screening and it was lucky he had a warning. After his father died, Burge became proactive at 50, getting tested and interpreting his own blood test results. Sure enough, it showed up years later in him.
Just like Burge, men need to be proactive and take charge of their own health care. Getting regular tests once you turn 40 is recommended for all men
“I was diagnosed six years ago when I was 62. When they did a biopsy test on me they saw that I had a high Gleason’s score – the test that determines how bad your prostate cancer is. Mine was about a 7 out of 10 which is very aggressive,” he says.
Men who are 40 to 45 are encouraged to be screened
Despite being proactive in screening, the disease nearly went undetected when one of the tests came up inconclusive at Burge’s annual check up with his GP.
“The old guidelines involved having two tests with your GP: a blood test (PSA test to detect prostate-specific antigen) and a digital rectal examination (finger test) to test for swelling. My blood test showed that I was above the normal level for my age, but when they did the digital examination they didn’t find anything. They said come back in three months time. But I could see there was a problem,” says Burge.
Inconclusive testing is a problem with prostate cancer screening since there is no absolute test that detects prostate cancer in men.
New guidelines introduced recently recommend healthy men between the ages of 50-69 have a PSA blood test biannually, unless they have an above average risk of the disease – that is, if their brother or father were found to have it before the age of 60. In that case, men are encouraged to be screened from 40-45 years of age.
Burge persisted with his doctor and was sent to a specialist for another examination. This time the digital rectal examination revealed swelling. It reinforces the need for men to be proactive and take charge of their own health care.
But the diagnosis was just the beginning of a confusing minefield of choices for Burge. Navigating through the different treatment options and deciding on the right option can be a daunting thing, especially since the different treatment options lead to different side effects and no two cases are exactly the same.
“As an engineer I didn’t know much about medical stuff. They told me I could have surgery or I could have radiation. The surgeons will tell you to go have surgery and the oncologists will tell you to have radiation. It’s a hell of a choice when you’ve got something inside you that you have to get rid of, or it will get rid of you.”
Both options have their own specific side effects. Surgery usually involves removal of the prostate, in which the surgeons cut through the urethra and remove the diseased tissue, then reattach the urethra. They also commonly cut out one of the muscles that controls the bladder, which can lead to incontinence problems after surgery.
Dr Kerryn Phelps advises how pelvic floor exercise can help with erectile disfunction after a prostate cancer diagnosis
Surgeons often have to cut dangerously close to an important nerve that controls a man’s erections. Therefore nerve damage, or a severed nerve can also lead to impotence problems after surgery.
The other common treatment option, radiation therapy, can also result in incontinence and impotence, but these side effects usually develop later and are less common than in surgery. Where radiation differs is that many men suffer bowel problems after treatment.
Burge chose the surgery option to remove his diseased prostate because he could “live with some impotency” and because you “definitely don’t want problems with your bowels,” he says.
He calls his story a “good news story” because he had only “a bit of the nerve damage” and his incontinence was “nothing more than a stress dribble every now and then.” Apart from that Burge functions as normal – but he knows of men who haven’t been so lucky. Especially with the incontinence problem that can be quite embarrassing.
But there is hope for men suffering incontinence after prostate cancer treatment. Don Morrison, 75, from Doncaster in Victoria is one such man.
The retired peach orchardist and retail gardener was diagnosed with prostate cancer in 2007 when he was 67.
Following the operation to remove his prostate, he was given the all clear but three years later he underwent radiation therapy when the cancer returned. This treated the cancer, but influenced his bladder control negatively, as did the Parkinson’s disease he was diagnosed with several years earlier.
“I tell them to go and see a physio and learn the pelvic floor exercises and they’re back playing 18 holes of golf after that”
Morrison turned to pelvic floor exercises recommended by his daughter Shan Morrison, a physiotherapist specialising in incontinence control.
Morrison is back to doing what he loves – playing golf!
His treatment involved exercises before and after surgery. This allowed him to be back playing golf and gardening just months after surgery. Now he only wears incontinence pads occasionally.
“The difference is amazing,” says Morrison. “You really feel the exercises take you to another level with your bladder control,” he says.
“When the men at my golf club talk about the prostate cancer, I tell them to go and see a physio and learn the pelvic floor exercises and they’re back playing 18 holes of golf after that. It changes people’s lives,” he says.
Back in the café the conversation turns to what men can do to help prevent prostate cancer.
“They say more than one third of cancers can be prevented by living a healthy lifestyle” says Burge. “But the main thing about prostate cancer is going and getting tested,” he cautions.
”So when are you getting tested?” he asks laughing.
After hearing his inspiring story, it will be sooner, rather than later.
For more information about prostate cancer visit the Prostate Cancer Foundation of Australia website.
For more information about how physiotherapy can help with incontinence following prostate cancer surgery, visit the Australian Physiotherapy Association website.
Have you had a personal experience with prostate cancer? Join the conversation below.
Want to help?
Australia’s Biggest Morning Tea is on Thursday 26th May, but you can hold a fund-raising morning for the Cancer Council any time in May or June. Visit www.biggestmorningtea.com.au for more information.