Campaign to tackle prostate cancer, Australia’s ‘most expensive cancer’
In revealing his prostate cancer diagnosis, a decorated local politician is pleading for nationwide tracking for the most expensive and most commonly diagnosed cancer form.
Prostate cancer urologists, oncologists and sufferers are lobbying for a national re-evaluation of how the condition is tracked and diagnosed, arguing a national register could stem rampant spending and sickness.
Shortly after revising the national guidelines for prostate cancer detection, the Prostate Cancer Foundation of Australia has begun campaigning for a national register of prostate-specific antigen tests results, modelled on existing programs for the detection of breast or bowel cancer.
It hopes the system-wide push for modernisation would rid the disease of its status as Australia’s most expensive cancer. It comes after former US president Joe Biden revealed his metastatic prostate cancer diagnosis.
Closer to home, one of the Brisbane City Council’s youngest yet longest-serving councillors has lent his voice to prostate cancer’s neglected sufferers.
Ryan Murphy was diagnosed with stage two prostate cancer in March at the age of 36, 30 years younger than the average. Catching it required a mix of luck and vigilance, given Mr Murphy had only begun to see a GP regularly after the birth of his daughter, Elodie.
“When you have your first child, I think it changes your mindset about your own mortality and your own indestructibility,” he said.
A four-term LNP councillor who heads the city’s transport plan, he dived headfirst into researching cancer policy as he grappled with his diagnosis.
“Prior to diagnosis, I had a very strong view that we have had the best health system in the world, and preventive health was a big part of it. I still believe it is, I just think, with this cancer, we’re missing the mark,” Mr Murphy said.
“I’m absolutely an outlier, and you can never design a system to catch all outliers … But once I had a positive diagnosis, these other men in my life, in my work and in my family came forward to talk to me about their own experiences, and most of them weren’t monitoring it. They found out when they became symptomatic, or they found out too late.
“It is very much a patient-led process to find out if you’ve got prostate cancer, and this process places a lot of emphasis on the individual to act … and the men I’ve talked to with the worst outcomes are the ones where that chain broke down.
“Sometimes fault was on the GP side, sometimes it was on their own side. Sometimes it just didn’t happen until they were actually pissing blood, and it was all through their pelvis and in their bones, and they were dealing with stage four diagnosis.”
Mr Murphy is mulling over a potential robotic surgery treatment, wary of the lifelong effects that could come with radiation therapy.
“We send you a reminder to get your mammogram, your pap smear, we send you a bowel cancer screening kit. We don’t even send you a pamphlet for prostate cancer,” he said.
“We have an incredible health system, and we’ve found ways to systemise screening for bowel cancer, breast cancer and cervical cancer. How have we not found a way to screen for prostate cancer, which catches these men before it’s too late?”
While very treatable, prostate cancer remains the most expensive cancer in Australia, presenting an annual $1.8bn health burden, according to the Australian Institute of Health and Welfare, of which $644m is spent on medicines from the Pharmaceutical Benefits Scheme used to treat symptomatic prostate cancer, a progressed form of the condition that can be prevented with earlier detection.
It kills 11 men a day in Australia.
“We have the technology, the evidence and the momentum to establish a national register for PSA testing equivalent in scale to the programs currently in place for breast and bowel cancer screening,” PCFA research head Jeff Dunn said.
“The establishment of a national register could prevent late diagnosis and the unnecessary loss of many thousands of lives, saving hundreds of millions of dollars in health system expenditure every year.
“We’re very happy to talk about how we go about it, what might be the steps, how we ensure that it’s set up to be world standard best practice and delivers on our objectives, but we’ve actually got to make sure we have those conversations and we get something happening.”
Prostate cancer accounts for 15.7 per cent of cancer-related expenditure on the PBS, and more than 12 per cent of cancer spending in the health system.
“I’ve just seen too many young men and older men come unstuck from late diagnosis, because once prostate cancer has spread from the prostate, it’s not curable,” Mr Murphy’s urologist, Peter Heathcote, said.
“You’ve got to be clever about how you apply the testing regimen, but by doing an organised testing program, you do a couple of things: you diagnose men in their younger years, you avoid over-testing older men who won’t benefit, and you also decrease the incidence of metastatic disease.
“An organised testing program pays for itself by just decreasing the pharmaceutical burden and the metastatic burden.
“Four thousand men will die this year from prostate cancer. That’s all preventable with a proper, organised testing program.”
Prostate cancer remains the most commonly diagnosed form of the disease, constituting 16 per cent of adult cases.
“For too long we have tolerated a primary care approach to prostate cancer that has not kept up with the evidence,” PCFA chief executive Anne Savage said.
“We have the knowledge we need to create an evidence-based framework for the early detection and management of prostate cancer on a national scale, beginning with a simple PSA blood test at a cost of less than $40 per test.
“If we fail to act, we’re setting ourselves up for system failure, allowing men to die.”
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