Austin, Fred, and I enjoyed a good lunch together in late July 2018. Our conversation ranged over many topics, one of which was prostate cancer. We had several things in common: our ages ranged between 69 and 79; we all felt very fit; we were all still working in our chosen fields and expected to do so for some time; and we had all had been diagnosed with prostate cancer. Our prostates had been removed and subsequent tests were clear.
We are the lucky ones. In 2016, 3,243 deaths were attributable to prostate cancer in Australia. Over 17,000 new cases are diagnosed each year and one in five men will develop prostate cancer by the age of 85. Furthermore, men diagnosed with prostate cancer are at a 70 per cent increased risk of suicide compared with other men. More than half of the suicides occur within a year of diagnosis. It is confronting to receive the diagnosis and one is faced with a complex array of possible treatments.
In 2017 the number of deaths from prostate cancer was 3,275 and the average age at death was 82.3 years.
In 2013, the Australian Institute of Health and Welfare (AIHW) released the first ever comprehensive report on prostate cancer in Australia. While more men are being diagnosed with prostate cancer, survival rates are high and are improving.
Prostate cancer mortality rates have fallen, from 34 deaths per 100,000 males to 31 deaths per 100,000 between 1982 and 2011.
This drop is projected to continue, expected to fall to 26 deaths per 100,000 males in 2020.
In 2006-2010, the proportion of males who had survived five years after a prostate cancer diagnosis (92%) was higher than for all cancers among males (65%), as well as other leading cancers among males, included melanoma of the skin (89%) and lung cancer (13%).
The annual rate of new cases of prostate cancer rose from 79 per 100,000 males in 1982 to 194 per 100,000 in 2009.
It is expected that the number of cases of prostate cancer diagnosed will continue to increase, reaching 25,000 new cases per year in 2020. This is due to increases in the number of men presenting for testing, changes in diagnostic practices and also the ageing of the population.
The prevalence of prostate cancer increases rapidly from the age of 45, suggesting that men should start regular testing from the age of 40. This should be via blood tests for the level of prostate specific antigen (PSA).
Given that there is a bulge in the age distribution in the age range 25 to 34, there is a wave of new cases of prostate cancer coming unless we can find ways to reduce the risk of developing prostate cancer. A significant reduction now seems possible via diet and lifestyle and this will be a major focus of my research.