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ABC News
13-07-2025
- Health
- ABC News
Psychological side effects for common prostate cancer treatment raise concerns
There are calls for urgent reform of the way a widely used prostate cancer treatment is prescribed following a number of suicides by men undergoing the therapy. Androgen deprivation therapy — known as ADT — is a hormone treatment that's commonly prescribed for men with advanced prostate cancer because it blocks the testosterone on which the cancer feeds. It slows the progress of the cancer, but the side effects can be so debilitating that some men have chosen to take their own lives. Prostate Cancer Foundation of Australia (PCFA) wants all men diagnosed with prostate cancer to be screened for distress and referred to a specialist nurse trained in providing ongoing psychological care. This should include conversations with partners or loved ones when appropriate, education about the potential side effects of the treatment and strategies for maintaining quality of life. PCFA chief executive Anne Savage said both doctors and patients need to be made more aware of the mental health risks of ADT. "We are aware of a number of cases where ADT is believed to have played a role in the deterioration of men's mental health, leading to suicide," she said. "Overall, around 12 per cent of men impacted by prostate cancer will experience suicidal ideation, which is significantly associated with hormonal treatment." Every year, more than 26,000 Australian men are diagnosed with prostate cancer. About 4,000 of these men have stage 3 or 4 cancer, which will likely require ADT. Many more previously treated for prostate cancer will be recommended for the therapy if their cancers recur or progress. Research reported by PCFA has warned that men on ADT for prostate cancer face a higher risk of suicide. According to Ms Savage, the potentially deadly side effects have been well established by international and Australian studies, but are not well known. But she said it's important to remember that ADT remains an effective method to slow the cancer for most patients. "What we don't want is for men to stop taking hormone therapy. This is a life-saving treatment that stops prostate cancer from spreading," Ms Savage said. Melbourne prostate cancer specialist professor Declan Murphy said no-one would argue with the call to provide better support to patients. He said the likelihood of suicide is extremely low, but it does appear to be higher in men who have started ADT. "I think it's likely that the burden of being diagnosed with metastatic prostate cancer itself is also contributing to depression and suicide risk, so the relative risk increase may be overstated," he said. Surfing writer Tim Baker had just turned 50 when he was diagnosed with advanced prostate cancer, which had metastasised into the bone. Put onto ADT hormone treatment, he soon began to feel emotionally vulnerable. "The hormone therapy amounted to chemical castration. It meant loss of libido, loss of erectile function, loss of bone density, and it causes breast swelling, genital shrinkage and loss of muscle mass," he said. "I remember thinking, 'I'll never be whole again, and I'm not sure how I survive this. The treatment, let alone the disease.'" He doesn't remember any warning about the risk of suicide, but within months, he found himself lying awake at night feeling that his family would be better off without him. "I felt like the warnings around ADT were entirely inadequate, and I do think prescribing ADT to men and not providing better support is medically negligent." Unknown to Mr Baker, his experience was one shared by a stranger on the other side of the country. WA farmer Craig Heggaton was diagnosed with prostate cancer at age 56 and soon after underwent a prostatectomy, which he assumed would be the end of the matter. But the cancer returned four years later. His doctor recommended he go onto ADT, a treatment that his wife, Liz, queried at the time. "I asked the specific question about how it may impact Craig's mental wellbeing because he's on antidepressants," she said. When the doctor told her he'd only had one patient with an adverse reaction to ADT, she didn't think much more about it. Within two months, she noticed him becoming irritable, not sleeping well and having zero libido — something that troubled Mr Heggaton himself. "It was just this insidious slide of him not being his normal happy-go-lucky self," Ms Heggaton said. But it was a shock when Mr Heggaton took his own life last year while on a camping trip with friends to the Big Red Bash music festival near Birdsville in Central Australia. At first, his wife had no answers as to why her husband had taken such an extreme step. Months later, she listened to an ABC Conversations interview with Mr Baker and had a "light bulb moment" when he described his emotional meltdown while on ADT. "The night that Craig died, I hadn't really suspected that it was the ADT. The thing that really struck me was that Tim had been on the same treatment that Craig was on," she said. "This drug, the power of this drug could in fact have caused Craig's suicide." She emailed Mr Baker and was "shocked and excited" to receive a response from him within 30 minutes. "Liz's story about her husband's suicide touched me so deeply because I'd been there," Mr Baker said. "I'd been in his position where I'd questioned whether life was worth living, and I could entirely relate to his decision." After hearing more of Mr Heggaton's story, he believes the popular farmer and sheep breeder was given inadequate warning about the side effects of ADT treatment, particularly since he was on antidepressants. "He should have been told that the drug carries the very real risk of inducing depression and mood swings, and that it carries an increase in your risk of suicide," Mr Baker said. Mr Baker and Ms Heggaton have now joined forces to drive an awareness campaign about prostate cancer, which is the most commonly diagnosed form of cancer in Australia. They describe themselves as an odd pairing, an unlikely alliance of a WA farmer and a northern NSW surfer, who would otherwise have never crossed paths. With the support of PCFA, they hope to start an annual sporting event — like the Pink Test for breast cancer — to raise funds and research into prostate cancer. Mr Baker has written a book, Patting the Shark, about his cancer experience and has since become a respected patient advocate. After 10 years on and off ADT, he has come to accept the treatment as a necessary evil. "Oh look, if I hadn't done ADT hormone treatment, I don't think I'd still be here," he said. But the effectiveness of the treatment for him is waning, which means he'll have to consider targeted radiation or look for a clinical trial of an alternative approach. "But there are no curative options ahead of me. So it's really a matter of managing it and staying fit and healthy for as long as I can," he said. Ms Heggaton believes every man and his partner need to be counselled about the side effects of ADT before going on the drug, to ensure they are fully warned about how their body is going to feel when they start treatment. She hopes that something good may flow from her husband's tragic death. "I want to find my voice and not let Craig's death be in vain. Make good of a really shitty situation, and try and help others through this process."
9 News
13-06-2025
- Health
- 9 News
More Australian men to be tested for prostate cancer in world-first reforms
Your web browser is no longer supported. To improve your experience update it here More men will be tested for prostate cancer as part of world-first reforms to boost early detection. There are 26,000 new cases each year in Australia and about a third are diagnosed late. A steering committee was formed to revamp 2016 testing guidelines, which were deemed too confusing, out of date and inadequate. More men will be tested for prostate cancer as part of world-first reforms to boost early detection. (Nine) Following consultation with leading experts and the public, the changes will be put to the National Health and Medical Health Research Council for approval. The new guidelines include offering a baseline PSA blood test to men aged 40 and a stronger push for GPs to offer twice-yearly testing to all men aged 50 to 69. There is also a recommendation to scrap a 2016 stance to avoid testing men over 70. Importantly, it recommends earlier and more frequent testing for men at higher risk. "We have stronger recommendations about men with family histories of prostate cancer because if you have a father, brother, an uncle with prostate cancer, your risk is higher," said Professor Jeff Dunn, Steering Committee Chair and PCFA Chief of Mission. There is also a recommendation to scrap a 2016 stance to avoid testing men over 70. (Nine) Dunn said significant advances in technology such as multiparametric MRI has helped drive the push for better early detection. The use of MRI has become standard practice to investigate elevated PSA levels, reducing the number of invasive procedures performed. "It was important that we update these guidelines to factor in the latest evidence, the latest clinical practice," he said. "We will detect prostate cancer earlier and we will save lives." health national cancer medicine CONTACT US
Courier-Mail
10-06-2025
- Health
- Courier-Mail
What Health Checks Should Men Do at Every Age?
1/11 As we kick off Men's Health Week, new data exploring the state of men's health in Australia has experts pleading with the public to take their well-being seriously. According to research conducted by the Prostate Cancer Foundation of Australia (PCFA), an overwhelming majority of Aussie men are choosing to delay health check-ups and visits with their doctor, as well as cutting back on vital prescription medication, and sadly, the reason behind their health-related apprehension is all too familiar to most Australians. Just as it's forcing us to forgo life's little luxuries and switch to a more affordable grocery list, the rising cost of living is having a detrimental impact on Australians' ability to proactively take control of their health needs, with men in particular forgoing their medical needs in pursuit of saving money.
ABC News
19-05-2025
- Health
- ABC News
What does Joe Biden's prostate cancer diagnosis mean? What are the symptoms?
Former US president Joe Biden has been diagnosed with an aggressive form of prostate cancer. The Prostate Cancer Foundation of Australia says he has good prospects for survival thanks to recent medical advances. The 82-year-old's office says his cancer has a Gleason score of nine, or a grade group five, with metastasis to the bone. Here's what that means. A Gleason Score is a system for grading the aggressiveness of prostate cancer, meaning how quickly it could spread. However, the Prostate Cancer Foundation of Australia (PCFA) points out that the newer ISUP grade — which was referred to by Biden's office as a "grade group" score — system is more accurate and easier to understand. They're both given after analysing a sample of a patient's prostate and are different to the cancer staging numbers. "If prostate cancer is found in a biopsy sample, the pathologist will assign it a grade, which is based on how abnormal the cancer looks under the microscope," the American Cancer Society's website explains. "Higher-grade cancers look more abnormal, and they are more likely to grow fast." The Gleason score system works by identifying the two most common patterns of cells, the PCFA website says. Those patterns are assigned a score from one to five — one is non-cancerous and five is the most aggressive. "However, the one and two scores are rarely used anymore, so the lowest Gleason score pattern is three," the PCFA website explains. Those two numbers are then added together to get a number between one and 10. For example, a patient might have a sample scoring a three, while the other is a four, making their overall Gleason score a seven. "The higher the Gleason score, the more likely that the cancer will grow and spread quickly," the Prostate Conditions Education Council's website says. Mr Biden's Gleason score of nine means his cancer is quite aggressive. Jeffrey Kuhlman, who was the White House physician from 2000-2013, told the ABC a Gleason score of nine was "the score you do not want to have". Overall Gleason scores range from two to 10, with 10 being the most aggressive. For context, doctors will generally say a person has prostate cancer if their score is between six and 10. A grade group five is considered the most aggressive and highest risk. His office didn't say. "While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management," it said. And this is good news for Mr Biden's prospects. "We would expect him to outlive his disease," PCFA chief executive Anne Savage says. "With immediate and effective treatment, he has very good prospects to outlive his disease." Dr Kuhlman said the five-year survival rate for this type of metastatic prostate cancer was only about one in three. But Ms Savage pointed out there were newer ways to treat cancers like Mr Biden's. "We've recently seen the development of a whole new class of medicines which are increasingly effective as keeping the disease at bay and extending survival time," she says. Compared to other cancers, prostate cancer has one of the highest survival rates if diagnosed early, the Cancer Council NSW's website says. "Prostate cancer often grows slowly — even aggressive cases of prostate cancer tend to grow more slowly than other types of cancer." "Metastasis to the bone" means the cancer has spread the patient's bone. This usually means the patient has what's described as "advanced or stage 4 cancer", the Cancer Council says. "Cancer cells can spread from the original cancer, through the bloodstream or lymph vessels, to any of the bones in the body," it says. "Secondary bone cancer can't be cured, but treatment can reduce symptoms and improve quality of life. "In some cases, treatment can keep secondary bone cancer under control for many years." Dr Kuhlman said there was usually a lag time between the presentation of cancer and its spread to the bones. "It is quite surprising to me that he presented as metastatic," he said. "Only about 10 per cent of prostate cancer presents as metastatic and often it's in patients that don't have good access to care." There are a few different ways to treat prostate cancer: But this all depends on the grade of prostate cancer. And the type of treatment doctors recommend will also depend on the patient's age and overall health, the Cancer Council says. Mr Biden's office said the former president was still reviewing his treatment options and pointed out that his cancer appeared to be hormone-sensitive. Hormone therapy can be used to treat prostate cancer that has spread to the bone, the Cancer Council says. "This treatment uses synthetic hormones to block the effect of the body's natural hormones," it says. "The aim is to reduce the hormones that the cancer cells receive. "This can help slow down the growth and spread of the cancer." This kind of treatment could be administered via tablets or injections. Ms Savage says Mr Biden could go with a combination of treatments, including newly-developed nuclear medicinal treatments, which are still at the trial stage in Australia. The PCFA's website says a new treatment called PSMA therapy uses a radioactive molecule to target and kill cancer cells. "PSMA therapy has shown promising results in prostate cancer trials and has the potential to have a major clinical impact on the diagnosis and treatment of prostate cancer, especially in those with aggressive forms of prostate cancer," the website says. "Clinical trials are underway with more research needed to fully understand the effectiveness of this therapy." However, the treatment is not yet approved by the Therapeutic Goods Administration and isn't available as a conventional treatment. There usually aren't any symptoms for early stages of prostate cancer. But here are the symptoms for advanced prostate cancer listed on the Cancer Council's website: Advanced prostate cancer symptoms can include: If the cancer has spread, it may also cause pain, unexplained weight loss and fatigue. The most common way is via a blood test. It's called a prostate-specific antigen test, but it's more commonly referred to as a PSA blood test. From there, a biopsy might be taken, which involves removing small pieces of prostate tissue with the aid of a rectal ultrasound Digital rectal examinations (DRE) used to be part of the routine screenings, but this hasn't been the case for the past decade, Ms Savage says. DREs are not recommended as a routine test for men who don't have prostate cancer symptoms. Once they hit 40, Ms Savage says. This is earlier than the current guidelines that say men over 50 should be tested, but Ms Savage says new guidelines have been drafted and are out for public comment. She says men should be asking their doctors for a PSA blood test. "At its earliest stages, prostate cancer has no symptoms," Ms Savage says. "Men cannot afford to be complacent." That depends on their age, health and family history. But Ms Savage says men with a high risk of prostate cancer should be tested once a year. A family history of prostate, breast and ovarian cancer increases a man's risk of prostate cancer. Men from families with BRCA1 or BRCA2 gene mutations are also at increased risk.
