Prostate cancer research – knowledge is power

Prostate cancer is the most common type of cancer in Australia, with between 17,000 to 20,000 new cases diagnosed each year. With the number of men living with prostate cancer expected to rapidly increase over the next few years, we must advance our understanding of how to best meet the needs of this growing population.

To achieve this, Cancer Council NSW is driving vital research projects that tackle prostate cancer from a range of angles, including increasing our knowledge of risk factors and trends, the impact it has on patients, and improving survival.

Prostate cancer risk factors and trends

This year Cancer Council NSW released a study that looked at patterns of prostate cancer progression – that is, how often the cancer spreads from the prostate to distant parts of the body (a process known as metastasis). When prostate cancer spreads like this, survival is generally poor. Over 30,000 men in NSW who initially had non-metastatic prostate cancer were included in the analysis.

Key points:

• Several years later, 1 in 5 of these men had developed cancer in distant parts of the body.
• Men who lived in regional, rural or low socio-economic areas had a higher risk of their prostate cancer spreading.
• The median survival time after being diagnosed with metastatic prostate cancer was only 6 months.

Impact: Geographic location or lack of access to care might put some men at a higher risk of experiencing prostate cancer spread. Surprisingly there is very little international data on these risks. Our results can go towards developing cancer services that address this inequality and provide targeted support to these men.

Our research division has also published a report which compared prostate cancer trends in Aboriginal and non-Aboriginal men in NSW. There were 35,214 men diagnosed with prostate cancer between 2001 and 2007, and 259 of these were Aboriginal men.

Key points:

• Aboriginal men were more likely to die from prostate cancer than non-Aboriginal men.
• One possible reason for this disparity is that Aboriginal men were significantly less likely to have surgery or radiotherapy when diagnosed with prostate cancer than other men.

Impact: There is a significant gap between Aboriginal and non-Aboriginal men when it comes to prostate cancer survival. This research will be used to direct efforts that ensure Aboriginal men have equal access to the best care and treatment options.

The effects of prostate cancer on survivors

One of our most important pieces of research, the NSW Prostate Cancer Care and Outcomes Study (PCOS) resulted in a suite of papers being published internationally. This project included approximately 2,000 men in NSW who were diagnosed with prostate cancer between 2000 and 2002. We followed-up these men for 3 years and monitored their health.

Key points:

• The various treatments for prostate cancer each had persistent effects on patient quality of life.
• Sexual dysfunction was more common than urinary dysfunction.
• Bowel function was more impaired in men who had radiotherapy.
• The issues that men want to avoid most relate to severe urinary and bowel problems

Impact: Patients and doctors should be aware of these potentially negative side effects of prostate cancer treatment, and ensure they discuss the risks and weigh up the relative benefits before undergoing treatment. This research is being used internationally to guide efforts to improve the quality of life and long term outcomes for men with prostate cancer.

The Cancer Council NSW research division has also been investigating another way prostate cancer can affect people – financially. Our researchers recently collaborated in a national study which looked the economic burden of prostate cancer on 289 men.

Key points:

• Costs of treatment varied considerably, however, men recently diagnosed with prostate cancer had average out-of-pocket expenses of approximately A$8,000.
• Twenty percent of men stated that the costs of treating their cancer caused them “a great deal” of distress.

Impact: The financial burden of prostate cancer is often overlooked, but can cause men with prostate cancer a financial and psychological hardship. Out-of-pockets costs of treatment must be considered when developing health policy to minimise additional stress for patients and their families.

The future

The research division of Cancer Council NSW has been undertaking or collaborating on several key studies and reports, which will be released over the next year. Each will continue to enhance our understanding of prostate cancer and support survivors. These include:

• New national guidelines, in collaboration with Prostate Cancer Foundation of Australia, on prostate cancer treatment and testing.
• Analysing the relationship between vitamin D and prostate cancer.
• A 15-year follow up of the men included in the original PCOS study.
• A national trial on mindfulness-based techniques to support men with advanced prostate cancer.