Medical experts last night called for the immediate introduction of a prostate cancer screening programme. At a conference organised by the Irish Cancer Society, the Minister for Health was asked to set up a pilot study for the disease, which is a major killer.
Prostate cancer is the second most common internal male cancer, following lung cancer, according to Mater Hospital consultant urologist Prof John Fitzpatrick. By the time it is diagnosed, it has generally spread outside the prostate or into the bones.
"However, in the US the opposite is true. It is diagnosed when it is localised to the prostate and potentially curable. The reason is that there is much greater awareness by the public and there are screening programmes. In Ireland people wait until they develop symptoms and it may be too late," he said.
A pilot screening programme should be introduced as soon as possible.
"We need to test the value of a screening programme in Ireland by doing a pilot study. I very much believe this should happen in this country. It has been done for breast cancer and it has worked."
The medical director of St Luke's Hospital, Dr John Armstrong, repeated the call: "We need it set up now. It should be a priority. However we are getting no indications from the Department of Health that one is on the way."
For proper screening, men needed to have a blood test and a digital rectal examination, Prof Fitzpatrick said.
Part of the difficulty, he added, was that men were reluctant to submit to the rectal examination. "Men do not like getting the test done. They are embarrassed by it and do not like the idea of the pain they may get from it."
Effective screening requires both tests. There may be an elevated blood test reading without the cancer being present or the prostate may feel normal even when it is malignant.
If the doctor detects abnormalities it is necessary to proceed to a biopsy. "At the moment people are going to their GPs to be tested and not realising that if there is an abnormality you will have a biopsy."
Explaining the symptoms, Prof Fitzpatrick said since prostate cancer starts in the back of the gland it can develop without causing any symptoms.
It can then cause symptoms similar to the benign form of the disease such as difficulty passing water, poor stream and hesitancy. "I want to point out that not everybody with these symptoms has prostate cancer."
He said he would "certainly recommend" at present that men aged 50 to 70 with a family history of the disease should get tested.
Dr Armstrong said there were 1,000 cases of prostate cancer diagnosed each year. "Five hundred of these are dying. But the others are being caught in time and being treated."
He said it was important that people were treated once it was detected. In some cases doctors were telling patients to come back in a year, he said. "The approach has been to wait and see. I disagree with this strongly. If doctors were to do that with breast cancer they would be brought to court."
Dr Armstrong said radiation and surgery were the two treatment options. The decision should be taken on the basis of discussion with the patient on the side effects.