Campaign issues prostate cancer health alert for men over 45

Older men are being encouraged to "act for their prostate health" in a new campaign by the Marie Keating Foundation.

The cancer charity is advising men to be “more open about their health” and to speak to their GP about a PSA [Prostate-Specific Antigen] test when they turn 50, or 45 if there is a family history of prostate cancer.

Prostate cancer is the most common form of invasive male cancer in the Republic, with an estimated 3,890 cases and about 530 deaths a year.

However, thanks to increased awareness, early detection and improved treatments, survival rates have never been higher, according to the charity.

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Prostate cancer has a five-year survival rate of 92 per cent, more than for any other form of the disease other than testicular cancer.

Internationally, Ireland ranks sixth in Europe for survival rates for prostate cancer, up from 10th two decades ago.

Rates of prostate cancer are "higher than ever before", the charity asserted, citing National Cancer Registry data. However, the registry clarified that while caseloads have increased over time, age-standardised rates, taking population growth and ageing into account, have stabilised and even come down slightly.

Prostate cancer survivor and Marie Keating Foundation "ambassador" Raymond Poole urged men to get their prostate checked with a PSA test. "My prostate cancer diagnosis has impacted almost every aspect of my life, but it doesn't have to when it's detected early," said Mr Poole.

PSA testing is a blood test that checks for protein markers that can help indicate issues in the prostate early.

"When it comes to PSA testing, it is recommended that men start having that conversation with their GP around the age of 45," according to consultant urologist at St Vincent's hospital David Galvin.

“The difficult aspect of prostate cancer is that many men don’t experience any symptoms or if they do, the warning signs of prostate cancer can be overlooked or easily dismissed.”

Risk-benefit analysis

According to Health Service Executive guidelines for GPs relating to men aged under 70 years, PSA testing should not be considered a routine test and informed consent should be obtained.

If PSA is being considered, the doctors should consider the patient’s concerns, along with the benefits, risks and harms of prostate assessment.

While prostate assessment can lead to the early detection of treatable cancer, it can also lead to potential false positive and false negative results, the guidelines state. There is also a risk of side-effects from investigations and treatment as well as unnecessary anxiety for patients and their families.

For men aged over 70, the HSE advises that PSA testing should not be considered routine and that testing of men of this age is unlikely to affect their overall survival.

The UK national health service says routine PSA screening is a controversial subject in the medical community. It says PSA tests are unreliable and can suggest prostate cancer when no cancer exists. Up to 15 per cent of men with prostate cancer have normal PSA levels, so many cases can be missed.

“The PSA test can find aggressive prostate cancer that needs treatment, but it can also find slow-growing cancer that may never cause symptoms or shorten life. Although screening has been shown to reduce a man’s chance of dying from prostate cancer, it would mean many men receive treatment unnecessarily.”

The Marie Keating Foundation campaign is supported by Astellas, a pharmaceutical company that makes treatments for prostate cancer.