For the first time, more than 10 Australian men are dying from prostate cancer every day. And 70 men are diagnosed with the disease daily.

This is revealed in new data from the Australian Institute of Health and Welfare (AIHW) that shows there has been a 25 per cent increase in the number of deaths from prostate cancer since 2007.

The AIHW says 3507 men died from prostate cancer in 2022 – and that 3743 will die in 2023.

The AIHW estimates 25,487 Australian men will be diagnosed this year, an increase of about five per cent in just 12 months.

Most-diagnosed cancer, third most deadly

The data reveals that prostate cancer is the most diagnosed cancer in 2023 – ahead of breast cancer and melanoma.

It’s predicted to be the third most common cause of cancer-related death in 2023 –  behind lung cancer and colorectal cancer.

But the overall snapshot for prostate cancer in Australia is a mixed one.

On the upside, more men are surviving prostate cancer.

Between 1989 and 1993 and 2014 and 2018, five-year relative survival for prostate cancer improved from 63 per cent to 96 per cent.

Which is great, but …

But that survival rate could be further improved – and there’s possibly an argument that we’re lucky to have such a high survival rate.

Why? Because little more than a third of these cancers are picked up at an early stage when a virtual cure is all but guaranteed.

Only about 36 per cent of prostate cancers in Australia are detected at Stage 1, when the disease can be more effectively treated,” says Dr Steve Callister, Prostate Cancer Foundation of Australia chairman and Adjunct Professor.

He says the need for an effective awareness campaign is high.

“Early detection is key to survival, but to achieve higher rates of earlier detection we must have government and community support for awareness activity to improve understanding of the disease,” Dr Callister said in a statement.

That might be true.

Need for a screening program

But what would the messaging look like? There is no clear agreement among doctors that all men with symptoms should be tested.

As the Cancer Council explains: “There is concern that testing healthy men will cause unnecessary harm and lead to treatments that may not offer long-term benefits.

“Treatment for prostate cancer can leave men with side effects such as erectile dysfunction and continence issues, which can affect their quality of life.”

However, testing may “identify fast-growing or aggressive cancers that have the potential to spread to other parts of the body and would benefit from treatment”.

It may also detect “very slow-growing cancers that are unlikely to be harmful”.

We could do with a screening program, as we have with breast and bowel cancer.

But the problem is, our standard test simply isn’t reliable enough to deliver a diagnosis or at least a very strong suggestion that the cancer has taken hold.

The PSA test

‘The most common way a patient learns that he might have prostate cancer is when he undergoes a ‘prostate specific antigen’ (PSA) test.

Your doctor might include the PSA test when you’re getting all your bloods done at a check-up. (Cholesterol, liver function and so on.)

The test measures the level of a protein, PSA. The higher the PSA level, the more likely you might have a problem.

To know for sure, you need a biopsy. And the biopsy can damage healthy men.

The UK has the same problem

As an article from Dr Matthew Hobbs, Prostate Cancer UK’s director of research, explains: “If we were to use the PSA tests in a national screening program, lots of cancer would be caught earlier, and some lives would be saved. But far more men will have multiple tests, and potential side effects from a biopsy, only to be told they don’t have cancer or that the cancer they have will never cause them harm.

“Some of these men may also go through unnecessary treatments for a cancer that would never have impacted their life. This is why, even though PSA-based screening has been tested and shown to save lives, it hasn’t been approved by the UK’s National Screening Committee.”

An MRI test would be reliable, but expensive

UK scientists have found that using Magnetic Resonance Imaging (MRI) detects prostate cancers missed by blood tests.

This came from a recent study from University College London researchers, published in BMJ Oncology.

The study caught the attention of Jeff Dunn, Professor Social and Behavioural Science from the University of Southern Queensland. He’s also head of research at the Prostate Cancer Foundation of Australia.

He said that half of participants in the new study who had “serious prostate cancer” recorded a “low” PSA reading.

Their findings also suggest MRI could be more reliable than the PSA test in detecting serious cancers early.

Professor Dunn is co-chair of a steering committee overseeing a review of Australia’s clinical guidelines for PSA testing.

He said that MRI “could also mitigate over-diagnosis and other risks”.

“Perhaps most importantly, there is emerging evidence that MRIs can play a key part in reducing mortality from the disease, which could help to save more than 3500 Australian men every year,” he said.

There’s a good medical argument that MRI be used as the primary screening tool for men with symptoms. The one hurdle is cost. The federal government would need to initiate a Medicare subsidy. Not likely in this economic climate.

For more information, go to www.pcfa.org.au.