Bryan Betty: The problem of prostate cancer

Why is prostate cancer a problem? 

- It occurs in the prostate, a gland that sits below the bladder and produces fluid for semen. 

- It’s the second highest cause of cancer death in men. 4000 are diagnosed a year, and 700 men die a year. 

- Over time the number of people being diagnosed, and death rate is dropping due to increased testing. 

- If you are diagnosed: 90% of men are alive after 5 years, and 90% alive after 10 years due to early treatment, and sometimes the cancer is slow growing.   

  

Are there symptoms that can indicate prostate cancer? 

Things to look out for: 

- A need to urinate urgently, difficulty with getting started and weak urine stream, dribbling after finish, blood in the urine. 

- However, these can be due to other ‘benign’ prostate problems: 

- BPH – Benign Prostatic Hypertrophy: the prostate getting larger with age, but it’s not cancerous 

- Prostatitis: an infection of the prostate 

If you notice any of these symptoms you need to talk to your GP. 

  

Should we be doing anything to check for prostate cancer? 

- Yes. From the age of 50 years, talk to your doctor about a two-yearly prostate check. 

- If you have a family history —father, brother— then you may need to start earlier at 40 years. 

- The check is very simple: a blood test called a PSA and quick rectal examination to feel for the size of the prostate. 

  

If a problem is detected what are the treatments? 

- If the blood test indicates a possible problem, then more tests are done: further bloods, possible MRI scan, a biopsy of the prostate to look for cancer. 

- If cancer is detected there are four main approaches: 

- Watch and wait: because the cancer is early and is considered low risk, slow growing, and may not cause a problem.   

- Radiotherapy to destroy the cancer. 

- Prostatectomy: where an operation is preformed to remove the prostate. 

- Hormone injections that shrink and control the cancer. 

Like all cancers can be treated if found early: if you are 50, a man, visit your GP and discuss a prostate check! 

 

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Episode Transcript

Speaker 1 (00:07):
You're listening to the Saturday Morning with Jack Team podcast
from Newstalks EDB.

Speaker 2 (00:12):
Twenty one to eleven on News Talks. The'd be It
is Prostate Cancer Awareness Month. There are still four thousand
New Zealand men who are diagnosed with prostate cancer every year,
and seven hundred men die from prostate cancer every year.
Doctor Brian Betty is with us this morning, Calter Brian.
Clearly those numbers indicate it's still a really significant problem.
It's the second highest cause of cancer death in New Zealand. Men.

Speaker 3 (00:35):
Yeah, you know, it is jacket. It is a real
issue for men. And you know, we've talked previously about
men sort of I suppose being bulletproof and not taking
note of their health. And yet these stats are really
really alarming that four thousand minute year are diagnosed. Now,
there's something you can do about it, which we'll talk about,
and that's what's really important that I think men need

(00:57):
to be proactive around something like prostate cancer because you
can pick it up early, you can diagnose it early,
and you can cure it, and that I think is
the big big thing. And in fact, interestingly enough, over time,
what we have seen is that the number of men
being diagnosed as going up, but the death rate is
going down because we're picking up the cancers earlier, and

(01:19):
that's really really important. So if you are diagnosed with
prostate cancer, you know, survival rate over five years is
about ninety five percent and ninety percent I think will
be alive after ten years, and that's that's often because
we are picking up the cancer earlier, it can be
treated or the other other issue that ariseses. Sometimes the

(01:41):
cancers grow very very slowly and they won't kill you.
So yeah, this early detection thing.

Speaker 2 (01:47):
Is really really important, absolutely vital. So what are the
symptoms that can indicate prostate cancer?

Speaker 3 (01:52):
Yeah, so look, it's important to look out for any
and who's listening to this need to watch out for this.
So I suppose the key things. If you suddenly find
that you need to start to urinate urgently because the
prostate sits at the base of the black and it's
increasing in size, it starts to put pressure on the bladder.
So this urinating early urgently becomes a slight issue. Maybe

(02:13):
difficulty in getting started with your urine or a weak
urine stream so you notice it's not as strong as
it normally is. Or dribbling after you're finished. So these
are very specific symptoms that can occur or blood in
the urine is something you should always always get checked. Now.
The thing to note, though, there are other reasons for
those symptoms. We need to be carefully here. There are

(02:35):
other benign, non cancerous reasons. Probably the commonest is something
called benign prostatic hypertrcy. That's where the prostate gradually gets
larger over time, and most men over the age of
fifty get that. That's what happens, and that's majority of
these symptoms is due to that. There's another one called prostatitis,
where you get an infection in the prostate and that
can cause similis or the symptoms. So it may not

(02:58):
be prostate cancer. It's causing the symptoms. However, it could be,
which is why it's so so important. If you start
to develop that and notice that these please go to
your GP and get it checked. That's probably the biggest
thing here to work out what's going on and.

Speaker 2 (03:14):
What should we be doing as a kind of proactive
check for prostate cancer.

Speaker 3 (03:19):
Yeah, no, this is really important. So what's been sort
of recommended, certainly by the Prostate Cancer Society in New
Zealand and sort of backed by a lot of practitioners. Now,
is that from the age of fifty years on which
you should really go and have a chat to your
doctor about getting a prostate check. Okay, So now if
you've got a family history, so you've had a father,

(03:42):
a brother, or close reality who's had prostate cancer early on,
then from the age of forty you should be having
that discussion. Now, the checks are relatively simple, so if
you decide to have one, it's a blood test called
a PSA and if that's elevated, it could indicate a problem,
but it may not be, and that's again really important

(04:02):
that it could be something like this side lunch process
is not cancer, but indicate cancer. The other thing we
do is a quick what's called rectal examination where we
feel the prostate through the rectum and we can just
feel if it's getting enlarged or there's any lumps or
bumps or anything we should be worried about. Now, if
the PSA is going up, we sometimes just watch it
and see what's going on, or we need to sort

(04:25):
of intervene and sort of start to think about some
additional tests.

Speaker 2 (04:28):
Yeah, right, Okay, talk to us about treatment, then what happens.

Speaker 3 (04:32):
Yeah, so look, so you know, if we think there's
a problem, there's some things that are routinely done. Now,
so if PSA has gone up, we're thinking, well, could
this be cancer or not, and in many cases it's not.
We do some tests so that we some further blood
tests done. Often often there'll be now done what's called
an MRI scan, which is a very specialized scan called

(04:53):
a magnetic resonance imaging scan to look at the prostate
to pick up any changes in the prostate. And then
sometimes some men end up having what's called a prostate biopsy,
where there's some needles popped into the prostate through rectimor
or through the paranoun and some little samples are taken
out to test at the laboratory to look for cancer. Now,

(05:13):
if it is diagnosed that look it is cancer. Then
there's really four main approaches. The approach number one is
to watch and weight. So I made the comment that
some prostate cancers are very very slow growing, so once
you look at them under the microscope and see what
they are, sort of classify what's going to happen. So
for a lot of men, it's basically a six monthly

(05:35):
review a MRI once a year just to check it
and to make sure nothing's happening. And it's called a
watch and weight strategy. Now where you decide to treat
these three main treatments. One's radiotherapy where you sort of
burden the cancer out and that's a very very effective treatment.
This prostatectomy where the prostate is actually removed and taken

(05:57):
out by surgery. It's quite a big operation. It's removed
and the prostate has just taken away. And the third
one is what we call hormone treatment and hormone blockers
which were tired and stop the growth of the prostate cancer. Now,
that's often used before surgery to strenk shrink the cancer
or if the cancer has sort of spread beyond the prostate,

(06:20):
it's used to control the cancer and can be very
effective at doing that for a number of years.

Speaker 1 (06:26):
OK.

Speaker 3 (06:26):
So look, number of treatments, number of things you can do.
But look, I'll tell you what the big big thing is.
If you get any of those symptoms, please please go
and see your GP discuss whether the prostate check is required.
Because I tell you what, I've got a number of
patients now who are so so grateful they went into that,
and that's probably the big, big message.

Speaker 2 (06:46):
Oh that's such a good message, such a vital message, Brian,
thank you. We've got one right here. Jack.

Speaker 3 (06:51):
Hi.

Speaker 2 (06:51):
I'm fifty nine. Eighteen months ago my yearly PSA test
came back higher than previous, so I got it investigated.
I had a biopsy done. It came back with low
grade cancer, so we watched it. Six months later, I
had another biopsy done and that was graded higher. They
offered us treatment. My wife and I decided on surgery.
I have my prostate removed at the beginning of May.
My recovery has been great and I'm now a cured.

(07:13):
Life is wonderful. It's so good to hear. Thank you
for sharing that, and it is such an important thing
to keep in mind because, as Brian says, so many
key we guys like to think they're a bit bulletproof
from time to time. So we'll have more details about
Prostate Awitness month up on the News Talk's EDB website

Speaker 1 (07:31):
For more From Saturday Morning with Jack Tame, Listen live
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