Men’s Health Awareness Month, known as “Movember”, takes place every year in November. This year marks the 14th anniversary of the Movember Foundation, which was originally set up to raise funds for the Prostate Cancer Foundation of Australia. The charity has grown on a global scale since then and the month is now used to raise awareness of various health issues that affect men, including prostate cancer and testicular cancer.
According to the Movember Foundation website, men die on average six years earlier than women, which is quite startling, and one of the core aims of the foundation is to increase early detection and diagnosis of these devastating diseases. This article focuses on prostate cancer.
The Movember Foundation website describes prostate cancer as the most commonly diagnosed cancer in men in the UK, responsible for hundreds of thousands of deaths worldwide every year. It develops when some of the cells of the prostate reproduce more rapidly than normal, resulting in a tumour. It often grows slowly, but can spread to other parts of the body.
Signs and symptoms that patients should look out for include needing to urinate more often than usual, especially at night; difficulty urinating; a weak flow; burning during urination; painful ejaculation; and blood in urine.
The first step for detecting whether a patient may have prostate cancer is a PSA test. This is a routine blood test that is used to determine the prostate specific antigen (PSA) concentration in the blood. The higher the number, the greater the risk that prostate cancer may be present. Movember suggests that men should start discussing PSA testing with their GP from the age of 50.
If a patient is diagnosed with prostate cancer, they should be advised of various options for management and treatment. If the cancer is at the early stage, and is not causing symptoms, then active surveillance is an acceptable recommendation. If, however, the patient is symptomatic, then treatment is indicated. Treatment options generally include prostatectomy, radiotherapy, hormone therapy and chemotherapy.
Any patient who undergoes treatment for prostate cancer should be advised of the known and recognised side effects, which can include incontinence (involuntary leakage of urine), erectile dysfunction (difficulty achieving or maintaining an erection), weight gain and hot flushes (as a result of hormone therapy) and depression. In very unfortunate cases, a patient’s prostate cancer will be incurable.
The Movember Foundation focuses on early detection and diagnosis of prostate cancer because the earlier the diagnosis, the greater the chance of survival. Earlier treatment, when the tumour is smaller, may also reduce the risk of side effects. For example, a smaller tumour may allow the surgeon to perform surgery with a technique to protect the patient’s nerves, and which may result in the patient avoiding the side effects of erectile dysfunction and urinary incontinence.
Early detection and appropriate advice at the detection stage is therefore incredibly important, but unfortunately, this does not always happen. We see in our work cases where patients have been diagnosed with prostate cancer later than they should have been, and/or advised wrongly about the treatment options available to them. This can be because of mistakes made either by GPs or the urologists at the hospital, and can result in patients suffering worse outcomes than they would otherwise have done.
Arran Macleod, a solicitor in the clinical negligence team at Penningtons Manches LLP, said: “I have worked with a number of clients who have suffered poor treatment in relation to their prostate cancer. In one case our client attended his GP because of symptoms that can be associated with prostate cancer. He wanted reassurance and asked for a PSA blood test. When the result came back to the GP practice, it was raised above the normal limit and the GP noted that the result was abnormal. Our client should have been told of the adverse result, but the GP failed to do anything.
“It was not until the following year, when our client re-attended for a repeat test, that his PSA had become significantly raised. He was then referred to hospital and diagnosed with advanced prostate cancer. Because the tumour was much larger than it was one year earlier, he required more advanced treatment, and suffered a worse outcome than would have been likely had he been treated earlier.
“We fully support the work being done by the Movember Foundation. The first step to increasing early detection of prostate cancer is to raise awareness of the symptoms associated with it. Patients should not be worried about seeing the doctor for symptoms that some may find embarrassing. Doctors also have to be alert to any adverse test results for prostate cancer and to the implications of a delay in appropriate treatment.”