Prostate cancer is the 6th most common cancer worldwide and the most common cancer (apart from skin cancers) in Australian men.
There are approximately 20,000 new diagnoses of prostate cancer every year in this country and it is more common as men grow older (see more statistics). The incidence is very low until the age of 50 years at which point it increase. A man’s life time risk of developing the disease is around 16%. This increases in members of affected families, increasing with the number of affected first degree relatives (eg. brother, father) within a particular family:
x1 first degree relative
x2 first degree relative
x3 first degree relative
Prostate cancer used to present at a late stage when men were bothered by urinary symptoms. However, since the introduction of PSA testing (a blood test to assess the risk of having the disease) the disease has been detected at a much earlier and more curable stage. The result of PSA testing has been to dramatically increase the numbers of patients detected with the disease We have also seen a huge shift in diagnosing less men with metastatic disease ( disease that has spread from the prostate) and a reduction in the mortality rate amongst men that have undergone a PSA test. The problem with the widespread use of this test is that there are men who are diagnosed with what are termed indolent or latent cancers. These are small tumours that are unlikely to result in local problems (difficulty with the passage of urine) or result in cancer spread and death. If these men subsequently go on to have a prostate cancer treatment they are potentially being exposed to the complications of treatment with apparently little gain in terms of increasing life expectancy.
That being said there is a growing body of evidence in the surgical literature indicating that amongst populations were PSA screening is widespread there has been a reduction in the mortality rate from the disease. In addition there is also a reduction in the number of men presenting with metastatic disease (ie disease that has already spread to other areas of the body).