Advances in prostate surgery are fighting the disease, but early detection is still key, writes CLAIRE O'CONNELL
THE MOST famous moustache in Ireland right now is that of a certain ex-minister for defence. But think back to November, when a number of well-known faces were suddenly sporting hirsute upper lips. That was “Movember”, when gents grew moustaches to raise awareness of prostate cancer, which affects one in 12 men in Ireland during their lifetime.
The initiative started with the support of the Prostate Cancer Foundation of Australia, explains the foundation’s former director, Prof Tony Costello, who was in Dublin last week to receive an honorary fellowship from the Royal College of Surgeons in Ireland.
A pioneer of advances to treat prostate cancer, he has been increasing the profile of the condition since he noticed it was not sufficiently on people’s radars.
“It seemed to me at the end of the last century there was a gap between men’s awareness of the most common male cancer and women’s awareness of breast cancer,” says Costello, a consultant urologist at the Royal Melbourne Hospital.
For decades, castration has been used as a treatment to deprive tumour cells of the hormone testosterone that they need to grow, but there are drawbacks, he says. “Most men are quite attached to their testicles, they don’t like to lose them. There’s a myriad side effects from doing that – obesity, osteoporosis, depression, anaemia, loss of libido and sexual function.”
Advances in early diagnosis have now opened up more treatment options, and if the cancer is caught early enough it can be surgically removed from the prostate, he explains.
“There are good studies to show that if you have localised prostate cancer taken out you cure the condition,” says Costello, who has been using a robot developed by a US company to facilitate a less invasive form of prostate surgery.
“It harnesses imaging systems used by Nasa,” he says, describing how the machine digitises the surgeon’s hand movements and links them to robotic arms that are inserted into the patient’s pelvis through small incisions.
He is also a pioneer of using lasers to treat non-cancerous, enlarged prostates. “One of the biggest bugbears for benign prostate surgery is bleeding and the laser makes it safer because as it vaporises it coagulates,” says Costello, who adds that using a green-light laser can help target the tissue.
As there are no symptoms in the early stages of prostate cancer, Costello stresses the importance of getting tested. “There’s some good work being done that shows if you have a single PSA test at age 40-45 and it’s abnormal, then you are at high risk of prostate cancer,” he says. “We would like to put up to government that all men should get a single test when they hit 40. Then you can say you don’t have to worry for 10 years, or else you should come back in two years or yearly.”
