02-11-09
Catherine Henry Partners Lawyers Newcastle
Prostate cancer is frequently in the media.
Yet there remains a lot of confusion about the prostate. Where is it situated? What are the symptoms of prostate cancer? What treatments are available?
What is the prostate?
The prostate is a small gland (about 3 cm long and shaped like a doughnut) located deep in the pelvis directly under the urinary bladder and immediately in front of the rectum. The urethra passes through the middle of the prostate gland. As the gland enlarges with age, it can constrict the urethra and bulge upwards into the bladder (giving a false sense of bladder fullness).
Some facts about prostate cancer
In Australia, prostate cancer is the second most common cause of cancer deaths in men after skin cancer. Advanced prostate cancer is not curable and as with most cancers, detection at an earlier stage with appropriate treatment may lead to cure.
The number of recorded cases of prostate cancer has increased significantly in recent years. This is because of the increased use of the PSA test (see below) which has resulted in more cases being detected. Prostate cancer is more common in the older population and very rare in men under 50.
Prostate cancer is a very variable disease. Some tumours are very slow growing and often remain undetected for many years. Others are aggressive, grow quickly and become life threatening.
Are there clinical symptoms of prostate cancer?
The main symptoms are: difficulty passing urine, inability to urinate, passing urine often (particularly at night) , weak or interrupted urine flow, pain on urination, blood in the urine and pain in the lower back, hipsa dnd upper thighs. All of these symptoms can be caused by other conditions such as benign prostate enlargement. .highnipuos diuMost prostate cancer sufferers do not have any symptoms and many don’t get any treatment. Cancer of the prostate can grow very slowly. Most sufferers are in excess of 50 years of age.
What tests can be used to detect prostate cancer?
An enlarged prostate can be felt on digital rectal examination by your doctor but this of itself does not mean that the prostate is cancerous.
If the level of Prostate Specific Antigen (PSA) in the blood is too high, prostate cancer could be a cause. But there are other reasons for raised blood PSA levels.
Ultrasound examination of the back passage and a biopsy of the tissue from the prostate are other means of detecting prostate cancer.
Who should have PSA testing?
PSA screening is controversial. There are two schools of thought.
Here in Australia, the Urological Society of Australia takes the position that there is no reason to screen for prostate cancer by regular PSA testing. They point to the fact that men with a normal PS have a 25% chance of having prostate cancer that can be felt on digital examination.
The alternative view such as that promoted by the Association for International Cancer Research is that men over 50 should have a PSA test every 2 years along with information about what the result may mean. 2 out of every 3 men found to have a raised PSA will not have prostate cancer. One third of men with cancer will not have a raised PSA level. Regular PSA testing however, can give an indication of whether further testing is advisable.
Routine screening for prostate cancer is not performed in any country.
Examples of medico-legal cases
There have been a number of cases including cases run by Catherine Henry principal of Catherine Henry Partners which have flowed from the failure to follow up patients’ raised PSA levels.
Links:
Australian Doctor Article 8 May 2009 - The value of screening
Sydney Morning Herald Article - Negligent cancer doctor rebuked
Back