It’s fair to say receiving a prostate cancer diagnosis, particularly the advanced incurable variety, throws your world into a spin...

Any diagnosis of cancer can trigger a range of emotions and put one into an anxious state. These feelings may wax and wane through the various stages of the cancer journey and may persist. Wondering whether you have cancer; waiting for the results of diagnostic tests; going for treatment; dealing with the after effects of treatment and the fear of recurrence are just some of the potential triggers...

Hi, I’m Tim.

Diagnosed with stage 4, metastatic prostate cancer on July 7, 2015. PSA 120. Gleason score 9. Lesions in right femur (thigh bone) and left seventh rib. Those of you with a maths brain might have already calculated that was nearly seven years ago. In that time, I’ve had early chemotherapy with concurrent hormone therapy, targeted radiation, ongoing intermittent hormone therapy, and have undergone a TURP...

In this article, we consider the risks of prostate cancer for people who have transitioned from being assigned male at birth to female in later life, who have a prostate gland which may predispose them to prostate cancer. This may be the case for people who were born with a prostate gland and have had gender affirming surgery (GAS), as well as those who identify as female, but have not had GAS.

For some time researchers have been searching for alternative prostate cancer blood tests. Prostate-specific antigen (PSA) is still the best test that is available. Even though it only detects changes in the prostate it is also affected by factors other than prostate cancer (PCa) such as infections and an enlarged prostate (benign prostate hyperplasia). This results in several unnecessary prostate biopsies in those with rising PSAs. A PSA isoform (Protein similar to PSA) called [−2]proPSA (p2PSA) has been shown to be more .....

Approximately 25% of Australian prostate cancer patients are diagnosed with low-risk prostate cancer (LRPC): approximately 5500 per year. They may be offered curative treatment options such as a radical prostatectomy (RP), radiotherapy (RT) and brachytherapy (BT), or may be managed with routine monitoring called active surveillance (AS). It is postulated that up to 50% of all prostate cancer cases do not require curative treatment up to 12 years after diagnosis, with evidence suggesting ...

Pre-prostate biopsy MRI can yield a 27–49% reduction of patients undergoing transrectal ultrasound (TRUS)-guided biopsy. A meta-analysis of seven clinical trials with 2582 patients found that MRI with or without a targeted biopsy offered a 57% increase in clinically significant prostate cancer (csPCa) detection, a 33% decrease in the total number of biopsies, and a 77% reduction in cores per biopsy procedure¹. The PRECISION trial .......

A previous blog addressed the different focal therapies for prostate cancer and brachytherapy is classified as another treatment modality. It is the implantation of radioactive sources directly into the tumour, also known as interstitial brachytherapy. Brachytherapy is used to...........

Financial toxicity is an expansive term which refers to the economic ramifications and subjective burden brought on by a cancer diagnosis and treatment¹. Escalating costs include direct, or out of pocket (OOP) payments, as well as indirect costs associated with foregone earnings for both patient and caregiver, which amplify financial burden. The notion of financial toxicity arose from fears that escalating costs of anti-cancer medications coupled with insurers’ increased cost-sharing with patients may lead to undesirable outcomes similar to traditional toxicities associated with treatment, such as ......

For now PSA (prostate specific antigen) is the most widely used screening test (as discussed in previous blogs). But there is a large amount of research examining other ways to determine who gets screened and how they will be screened. Prostate cancer screening was very topical at the recent European Association of Urology (EAU) virtual meeting in July. Some new blood tests and formulas have been suggested along with imaging to guide algorithmic developments. This blog will focus on

Screening is a means of detecting potential conditions or risk markers for disease. These programs identify conditions which could turn into disease in the future. One could deduce that by doing this the disease can be detected and treated earlier, reducing morbidity and .....

Prostate specific antigen (PSA) is an enzyme produced only in the prostate and acts on a protein in semen called seminogelin to give the semen a more liquid consistency. PSA shows up in the blood when sampled. Prostate cancer can raise the level of PSA in the blood but so can age related prostate enlargement causing trouble with urination (benign prostatic hypertrophy); infections (prostatitis); surgical procedures (prostate biopsy, cystoscopy) and natural increase with age. The PSA level may be ........

One of the treatment options for locally advanced non-metastatic prostate cancer is external beam radiation therapy in conjunction with androgen deprivation (testosterone blocking) therapy. If there are no lymph nodes (glands) that are obviously involved, then radiation would be confined to the prostatic bed. However, within the radiation oncology fraternity there has .....

The focus on this year’s meeting was on advanced cancer. Two types of cancer were presented: those that would respond to anti-androgen therapy (Castrate sensitive prostate cancer – CSPC) and those who have had anti-androgen therapy and developed resistance to treatment (Castrate resistant prostate cancer- CRPC) .......

Current imaging trends for prostate cancer

New imaging technology, using prostate specific membrane antigen (PSMA) PET combined with computerised tomography (PET/CT), has proven highly useful for staging prostate cancer in both the newly diagnosed and recurrent setting (disease that has returned after primary treatment). Benefits include greater utility in making treatment decisions and lower radiation doses.

Australia has been leading the world in its practice of performing prostate biopsy via the skin (Transperineal Biopsy) instead of via the rectum (Transrectal). Movember’s Prostate Cancer Outcomes Registry shows that in Victoria, the majority of prostate biopsies are now performed via the skin. In 2013, it was only 5%.

Please click through to read more from Dr Jeremy Grummet on TREXIT.

Receiving a diagnosis of prostate cancer is a major life stress for most men and their loved ones. Suddenly, the things that matter most seem threatened and it is very normal to experience a wide range of feelings and emotions.

Sometimes you may feel more distressed than at other times. Your feelings might be more intense while waiting for test results, making treatment decisions or just before commencing treatment. Side effects from treatment may also cause stress and upset. After treatment, you may worry about the cancer returning.

Today, there are over 220,000 men living after a diagnosis of prostate cancer. For most men the long-term outlook is very good - relative to the general population and considering other causes of death, 95% of men with prostate cancer will survive at least five years after diagnosis and 91% of men with prostate cancer will survive 10 years or more.

To help improve the lives of men living with prostate cancer, there is a need for more evidence-based strategies to help them manage the challenges of living with the disease. There is growing evidence that mindfulness is one strategy that can be used to reduce symptoms of anxiety and depression associated with prostate cancer. 

Prostate cancer is the most commonly diagnosed cancer in Australian men, with about 17,000 men newly diagnosed each year. For most men the long-term outlook is very good - relative to the general population and considering other causes of death, 95% of men with prostate cancer will survive at least five years after diagnosis and 91% of men with prostate cancer will survive 10 years or more. Today there are around 220,000 Australian men alive after a diagnosis of prostate cancer.

Of concern to our mission, for men who develop advanced prostate cancer, the outlook is not as good. Prostate cancer kills more than 3,000 men in Australia every year, representing about 12% of all male deaths from cancer. So, what is advanced prostate cancer, how is it detected and how is it treated?

Medicare data suggests that up to 21% of Australian men aged 45–74 choose to have a Prostate Specific Antigen (PSA) Test each year, and about 19% of men aged over 74 also undergo testing.

While PSA testing helps to identify men with an increased risk of undiagnosed prostate cancer, and can help to diagnose prostate cancers earlier, it can also produce false positive results, and in some men picks up cancers that are so slow growing that they do not affect a man’s life expectancy, a finding known as over-diagnosis. False positives and over-diagnosis can cause harm, which means men and their doctors need to carefully consider the pros and cons of testing, based on each man’s age and other individual characteristics.

For men with no family history of prostate cancer and no symptoms, the current guidelines recommend that men who decide to undergo regular testing should be offered PSA testing every two years from age 50 to 69.

For men with a family history of prostate cancer who decide to undergo testing, the guidelines recommend men be offered PSA testing every two years from age 40/45 to 69, with the starting age depending on the strength of their family history.

What if a simple blood test could predict the effectiveness of a treatment for metastatic castration-resistant prostate cancer (mCRPC)? A recent Australian study suggests this is a possibility. Using a blood test, researchers were able to detect circulating cell free DNA and RNA for altered androgen receptors in the blood of men with mCRPC. Men who had altered androgen receptor DNA or RNA in their blood had a poor response to treatment.

Alarming new research has revealed about 70 per cent of Australians don’t know the signs and symptoms of prostate cancer, prompting Prostate Cancer Foundation of Australia to call for greater public investment in targeted community awareness activities.

The findings have been reported in the Not All Prostate Cancer is the Same report, released by the Prostate Cancer Patient Coalition – Asia Pacific (PCPC).

In a recent study, researchers have found that not all high-grade prostate cancers are the same. The research examined Gleason grade group 5 prostate cancers which are associated with aggressive disease and poor outcome and found that some cancers of this type were more aggressive then others based on differing patterns of gene expression. This is important work that may one day help clinicians decide how best to treat different subgroups of Gleason grade group 5 prostate cancers. The advantage of this is that men with less aggressive cancers may be spared the side effects of intensive treatment while those with more aggressive cancers receive intensive and more targeted treatment.