Annual event gets people talking about prostate cancer

It’s a top health concern among men, but one that hasn’t always been so easy to discuss. Prostate cancer now affects one in seven men, warns the 2012 Canadian Cancer Statistics report. This year alone, an estimated 26,500 men will be diagnosed with the disease, and the cancer will claim 4,000 lives.

It’s too big a risk to ignore. To help spread the word about beating the disease, walkers and runners across the country will be taking to the roads on Sunday, June 17 for Prostate Cancer Canada’s annual Father’s Day Walk/Run.

“It’s more than just a fundraiser and chance to raise awareness,” says Rebecca von Goetz, Executive Vice President at Prostate Cancer Canada, in an interview with 50PLUS. “It’s a chance for families to come together and celebrate a loved one.”

The event brings in survivors and their families, and people who are commemorating the loss of a loved one. Like Movember, the walk raises much-needed funds for research and support services. More importantly, it’s raising awareness. We’ve been talking about breast cancer for a long time now, but it’s only been in recent years that prostate cancer has been getting the same kind of attention. Prostate Cancer Canada formed three and a half years ago, and its events are raising the profile of the disease in Canada.

“Our goal is to get men talking about their health and taking charge of their health,” says von Goetz. “Men aren’t as open about discussing their health as women are — especially health issues below the belt. However, 90 per cent of prostate cancers are curable if they’re caught early enough.”

The conversation every man should have with his doctor

We know early detection is crucial when it comes to any type of cancer, but prostate cancer usually doesn’t have obvious symptoms in its earliest stages.

Enter the prostate-specific antigen test (known as PSA for short). This routine blood test has met with some controversy in recent years, but it’s still the go-to screening method for detecting early troubles involving the prostate. An abnormal result on a PSA test doesn’t automatically mean cancer — it could warn of other conditions like an enlarged prostate or infection.

Because there’s an increased risk of prostate cancer as men age, experts recommend men should talk to their doctors about their risks and need for screening as they approach age 40. (Of course, it’s never to late to have this crucial talk if you haven’t done so already.) 

Men who have known risk factors like a family history of the disease or who are of African or Caribbean descent should initiate the conversation a little sooner — even in their early 40s.

If you’re trying to research current screening guidelines, you might be understandably confused. There’s no one-size-fits-all solution.

“It depends on the individual,” explains von Goetz. “Doctors will talk to their patients about the risks and benefits of the PSA test and determine how soon testing should start and how frequently it needs to be done.”

In other words, not all men require a PSA test before age 50 — or need annual testing after a baseline has been established. Furthermore, the PSA test should be regarded with fear.

“It’s just a blood test,” says von Goetz. “It’s a red flag that lets doctors know there’s something to watch. A lot of men think an abnormal result means they’re automatically headed for surgery. That’s not the case — it doesn’t work that way.”

Simply put: the PSA test is just a starting point. When something is amiss, doctors will turn to other diagnostic tools such as a digital rectal exam (DRE) or imaging tests (like an ultrasound or CT scan) to pin point the problem.

If prostate cancer is the diagnosis, there are treatment options besides surgery including radiation therapy, hormone therapy and chemotherapy.

Sometimes immediate treatment isn’t needed at all.  In many men, prostate cancer progresses so slowly that it could be years before it poses a danger. That’s where “active surveillance” comes in. Instead of risking unnecessary and potentially harmful treatment, doctors will keep a close eye on the cancer with regular PSA tests and examinations.

How important is the PSA test? Experts note it’s one of the reasons fewer men are dying of prostate cancer than in the past. Men are more aware of it now — and more likely to talk to their doctor about it

“We have over 70 support groups across the country,” says von Goetz. “We often hear men say ‘if I hadn’t had a PSA test, I don’t know where I would be today.'”

Clearing up the confusion over new U.S. screening recommendations

What about that new report from the U.S Preventative Services Task Force that discourages regular prostate cancer screening? The task force points to studies suggesting that regular PSA tests don’t save enough lives to out weigh the risks associated with over treatment or unnecessary. It’s possible that radiation and chemotherapy do more harm than the disease itself.

Not surprisingly, the recommendation has been met with controversy south of the border. Prostate cancer survivors, doctors and health advocates aren’t happy with the new guidelines.

But what do experts in Canada think of the advice to ditch routine PSA screening in healthy men?

“Canadian doctors don’t agree,” says von Goetz. “Things are different here. In the U.S., overtreatment has certainly been an issue. In Canada, doctors have been more cautious. More doctors opt for ‘active surveillance’ or what used to be known as watchful waiting’ as a first step.”

The bottom line: studies from other countries don’t necessarily apply to Canadians, and experts here aren’t suggesting any changes to current practices. The PSA test has its benefits and pitfalls — but it all comes back to that crucial conversation between doctor and patient to decide what to do.

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What you can do

If you’re interested in supporting the Father’s Day Walk/Run, you can find out more information and make a donation via the Prostate Cancer Canada website.

Missed this event? Not to worry: in addition to Movember and Wake Up Call Breakfasts, many communities hold events throughout the year, such as golf tournaments or Ride for Dad. Participants and volunteers are always welcome.

Perhaps the most important thing we can do is to have those conversations about prostate cancer. Men, talk to your doctors and fathers, sons, brothers, friends and partners. Ladies, the latter part of that advice goes for us too — talk to the ones you love. (Remember that study about pesky partners saving lives?)

Need a little help starting that conversation? Check out our primer on prostate cancer and visit Prostate Cancer Canada and the Canadian Cancer Society for more information.