Prostate Cancer

It is paramount that you’re able to conduct Men’s Business and uphold protocol during your cancer journey. You can request cultural protocol to be followed where gender-specific cancer is present or symptoms resulting from a cancer diagnosis are impacting your reproductive organs

This means that you can:

• Request the assistance of male health practitioners throughout your cancer journey.
• Have another male (father, uncle, brother, partner, friend etc.) attend medical appointments and procedures with you as a support person.
• Call on the men in your family and community to conduct Men’s Business to help you through your cancer journey.
• Ask for a male advocate to assist you navigate your medical treatment.
• Request that health practitioners and providers are competent in upholding Men’s Business protocols.

Remember, our families and mob are our best teachers. Lean on your Elders and family to help you uphold Men’s Business protocol during your cancer journey.

Find out more on Men’s Business.

Many men might not notice any changes in their body. Some men have found out that they had prostate cancer without ever knowing there was a problem, until they saw their doctor for something else.

 However, there are a number of symptoms to look out for:

• problems having a pee, including weak flow when you’re peeing, pee that stops and starts, needing to pee urgently, difficulty starting to pee, or feeling like you haven’t completely finished peeing
• pain or burning when having a pee
• blood in the pee (urine) or semen
• pain in the back, hips or chest
• weak or numb legs or feet
• feeling really tired, breathless or dizzy

Having these symptoms may not mean you have cancer, but it is really important to check. 

Blood in the pee (urine) should never be ignored.

If you have any of these problems, or are worried about something else, yarn with your doctor, nurse or Aboriginal and Torres Strait Islander Health Worker.

You won’t know if you have prostate cancer until your doctor has talked to you, completed a physical examination and done some tests. The tests might include:

• a digital rectal examination (DRE)  where the doctor inserts a gloved finger into your backside to feel the prostate through the rectal wall

• a blood test to look for PSA, or prostate-specific antigen. Read more about PSA.
• an ultrasound, where a probe is put into your backside and sound waves are used to have a look at your prostate
• other tests such as a CT scan or MRI scan to see what your insides looks like
• a biopsy, where they take a tiny bit of your prostate and look at it with a microscope.

Most men who have these tests find out they don’t have cancer. But it’s really important to check.

If you have prostate cancer, you might be told it’s at a certain stage. This describes whether or not it has spread to other parts of your body, and how far. Knowing the stage of your cancer helps you and your doctors to decide on the best treatment for you.

• Stage 1: the cancer is only in the prostate and the tumour is a small size
• Stage 2: the cancer is still only in the prostate, but the tumour is bigger in size
• Stage 3: the cancer has spread just outside the prostate, but not to the lymph nodes or surrounding organs
• Stage 4: the cancer has spread to other parts of the body, such as nearby lymph nodes, surrounding organs such as the liver and the bones. This is also known as metastatic cancer.

With all types of prostate cancer, there are options of treatment and support that can help you including traditional healing and cultural practices.

There are many ways to treat prostate cancer. The main ones are to wait (and not treat for now), or to have surgery, radiotherapy, or cryosurgery, which freezes the prostate to destroy the cancer.

Some men may need hormone therapy, and some have chemotherapy although this is less common. If you have prostate cancer, you might need one of these, or a combination of them.

Your doctors will talk to you about what treatments they recommend and what your options are, so there won’t be any surprises.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander Health Worker about which treatment you might have.  

Watchful waiting

Watchful waiting means your doctors and you wait to see what happens. Sometimes prostate cancer doesn’t grow much and doesn’t cause any problems. You’ll see your doctor regularly, and you might have regular blood tests or other tests.

If there are signs the cancer is growing, you can discuss treatment with your doctor.

Surgery

Surgery is a procedure done to take out the cancer and help to stop it from spreading to other parts of your body. Surgery involves staying in hospital and having an anaesthetic and an operation.

There are different types of surgery, and how you will feel afterwards depends on what type you have.

Most men have a catheter, which is a long tube from their bladder through their penis. It drains their urine into a bag. It is usually taken out in a week or two.

The doctor will talk to you beforehand about what is going to happen. Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander Health Worker about your surgery and what support you and your family need before, during and after surgery.

Being away from Country and family can be distressing so making sure you have the right support is important.

Read more about surgery.

Radiotherapy

Radiotherapy, or radiation therapy, uses X-rays to destroy cancer cells in one part of your body.

Some men have radiotherapy from the outside, where a machine beams X-rays at their prostate. Men having this radiotherapy have it 5 days a week for 4-6 weeks, and each session takes around 15 minutes. But it might be different for you.

Other men have radiotherapy from the inside. Little capsules are put in your bladder. They give off radiation, hoping to kill the cancer.

You can only have radiotherapy in cities and some big towns – see this list. If your doctor thinks radiotherapy would help, and you don’t live near a radiotherapy site, there is help to find somewhere to stay, support to keep you connected to family  and assistance to cover expenses. Having family with you during radiotherapy treatment is an important support that helps keeps you strong.

Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander Health Worker or social worker about your radiotherapy and what support you and your family need before, during and after treatment. Being away from Country and family can be distressing so making sure you have the right support is important. You can also read more about radiotherapy.

Brachytherapy

Radiation therapy can also be given internally. This is called brachytherapy. It involves giving radiation via a needle or another device. The device stays in place from a few minutes to a few days. Depending on the treatment and the dose of radiation you receive, you might need to stay in hospital or make a daily visit for treatment.

Your doctor, nurse or Aboriginal and Torres Strait Islander Health Worker will be able to yarn with you about which type of radiotherapy is right for you.

Read more about brachytherapy.

Cryosurgery

Some men have cryosurgery, also called cryotherapy. In this treatment, long needles are put into your prostate, then very cold gases run into them. They freeze the cancer cells and kill them.

Read more about cryosurgery.  

Chemotherapy

Chemotherapy involves taking strong drugs to kill the cancer cells.

Many people have chemo in cycles – usually one day every two or three weeks. But this can be different for each patient.

Most chemo comes as injections into your arm or hand that drip in over an hour or two. You usually need to go to a hospital or clinic to get the drip. You don’t need to stay in hospital for chemo. Some chemo comes as tablets. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Chemo can make people feel sick for a while, but there are things they can do and take to help. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker. Read more about chemotherapy and side effects.

Androgen Deprivation Therapy (Hormone therapy)

Some types of cancer, including prostate cancer, need certain hormones to grow. By reducing the levels of these hormones in the body, the cancer can slow its growth or even shrink. In the case of prostate cancer, the hormones used by the cells are called androgens, such as testosterone.

Hormone therapy for prostate cancer is called Androgen Deprivation Therapy (ADT). This can be achieved through a few ways:

• Orchiectomy – removal of one or both testicles as these normally make testosterone and androgens for the body
• Medicine that stops testosterone from being made (Luteinising hormone – releasing hormone analogues) -these can come in the form of tablets or injections that you need every few months
• Medicine to stop androgen production at different sites
• Medicine that stops androgen from binding to the cancer cells.

Your treating team will discuss these different options with you and recommend the best treatment based on your circumstances.

Read more about hormone therapy.

It is important for you to understand why you are getting the treatment your doctors recommends and how it is supposed to help you. Different treatments try to do different things. It depends on what cancer you have, and whether it has spread to other parts of your body, where you live, and what you want. Ask your doctor or specialist if the treatment they suggest:

• is meant to cure you, by getting rid of the cancer and stopping it spreading, or

• won’t cure you, but is meant to make you feel better, or prolong your life, and

• how you can include traditional medicine and cultural practices as part of your treatment plan.

Your doctors should talk to you and explain this. You can talk to them and tell them what you think, and what you want. Some people will want to try everything possible to kill the cancer to stay alive. Others want simpler treatments, or don’t want to leave family or Country for treatment, or don’t want any treatment. It’s your choice. You can include traditional medicine and cultural practices. You can also talk to another doctor to help you decide.

It can take time to decide about treatment. There are usually some options to hear about and choices to make.

It can be helpful to write things down, or have someone else come to appointments to help remember information.

Talk to your doctor, specialist, nurse or Aboriginal and/or Torres Strait Islander Health Worker.

Read about treatment.

Always ask about the cost of treatment. Many treatments are free through public hospitals, but some are not. Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker or social worker.

Learn more about financial support.

It all depends on the type of treatment you’re having. People will have treatment for different lengths of time. After your treatment is finished, your doctor will keep in touch with you to check on how you’re going. During treatment you will have an opportunity to build trusted relationships with people who care for you, including your doctors, nurses and Aboriginal and/or Torres Strait Islander health workers.

It is not possible to say what causes prostate cancer in a single man. We do know there are some features that are more common in men who develop prostate cancer. These features are called ‘risk factors’.

But it is usually hard to be sure whether a risk factor contributed to the development of the cancer. And having one or more risk factors for prostate cancer does not mean that someone will definitely develop this cancer. In fact, many men with prostate cancer have no obvious risk factors.

Risk factors for prostate cancer are:

• getting older
• having a family history – men who have a father or brother with prostate cancer are more likely to develop it
• having genetic conditions in your family – for example, mutations in BRCA1 or BRCA2 genes may increase the risk of developing prostate cancer and may be passed down on the mother or father’s side of the family.

If you have any of these risk factors or you’re worried about your risk for prostate cancer, yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker.

Clinical trials might be an option for you. Talk to your doctor to help you decide if taking part is a good option. Read more about clinical trials

Read more detail on prostate cancer here.