Australia now has the highest incidence of prostate cancer in the developed world – the result of effective messages encouraging men to have regular testing. That’s good news. But it also means many of the 22,000 men diagnosed with prostate cancer each year end up receiving treatments that unnecessarily leave them incontinent and impotent.
I was recently speaking about this at a conference when a young doctor launched into a passionate speech, arguing there is far too much treatment of prostate cancer in this country, without enough warning of the devastating side-effects these men might suffer. Most experts agree there’s some truth in what he said, although there’s a welcome trend for more doctors to now encourage “active surveillance” when the cancer is unlikely to be life-threatening. Sometimes it’s the patient who pushes for treatment – in his haste to tackle the Big C he may refuse to consider the consequences.
These consequences are often grim. Shocking figures to emerge from the NSW Prostate Cancer Care and Outcomes Study by Cancer Council NSW show that five years after a radical prostatectomy, three quarters of the men have erectile dysfunction (ED) and 12 per cent are still incontinent. Most other treatments show similar ED figures but less incontinence.
These aren’t just old men, ready to hang up their spurs – almost 15,000 Australian men under 55 have been diagnosed with prostate cancer. Far too many of these men are suffering unnecessary sexual problems due to the fact that they haven’t been properly prepared for the “penile rehabilitation” process necessary for most men to regain their sexual functioning.
It’s shocking how often I talk to men who were given no information by their urologists about how to manage this process. The penis is the urologist’s bread and butter. Looking after this organ is how he or she earns much of his living and it is a major concern that so many totally ignore the sexual functions of this important part of the male anatomy. Of course there are some wonderful doctors doing a great job helping men take care of their sexual equipment but they are thin on the ground.
I’m just back from Perth where I was speaking at some events organized by a wonderful Perth physiotherapist, Jo Milios, who works mainly with prostate cancer patients. Perth men should count themselves lucky, with many good urologists working with a team including sexual physicians and physiotherapists to make sure men are well prepared to deal with both ED and incontinence. They are achieving some very impressive results.
I’m working with the Prostate Cancer Foundation of Australia, who sponsored my talks, to try to find ways of reaching men across Australia, providing them with the education they need to look forward to a fulfilling sex life after prostate cancer. But it’s not easy to persuade men to come along to such events – they seem far too worried that if they turn up other men might think they have a problem.
We’d welcome your ideas for getting them in the door. And we’d love to be on board if you’d like to put together a similar event in your area – contact me for more information.