Taking the Panic out of a Prostate Cancer Diagnosis

USANZ President A/Prof Prem Rashid was interviewed by Jill Margo, Health Editor of the Australian Financial Review about the potential changing of prostate cancer screening guidelines. The article was published on 29 October 2021.

Access the article: Taking the Panic out of a Prostate Cancer Diagnosis
Please note that the full article is only available to AFR online subscribers.

In the article A/Prof Rashid made the following comments:

• Screening guidelines are about testing asymptomatic men for prostate cancer. Improvements in technology, diagnosis and treatment had outrun current guidelines, with several aspects requiring a review.
• As a reconstructive urological specialist he is seeing fewer complications from both surgery and radiation, but for many men, retaining their full natural erectile function remains an ongoing challenge.
• Doing PSA testing every 2 years may be too long a gap between tests. Done more frequently, they can be tracked and the rate of change monitored. There is no harm in tracking it yearly, and it remains funded by Medicare on an annual basis.
• Many men in their 50's and 60's have low-ish PSAs. I think anything from 3 is a reasonable start, at least for starting a discussion about seeing a urologist and deciding if an MRI could help to see if a biopsy is necessary or if things are acceptable.
• Unless there is a family history, men should have an annual test from 50 and track results. If they rise consider a urologist. If treatment is needed, take time to decide.
• There are nuanced differences between the options, depending upon age, stage of disease, preferences and the risk appetite for potential side effects.
• The rush to treatment is not necessary in many cases. We need to slow down so men can explore all options with sound advice.
• As men are living longer, men over 70 should be screened too.