PROSTABLOG NZ: The ideological debate about prostate cancer screening hasn’t moved along much in New Zealand over the past few years.
I’m judging this from an anecdote a guest speaker at my journalism course told students this week.
An experienced journalist, she said a few years ago she was writing a piece for NZ Listener magazine about PSA screening, and the Ministry of Health would speak to her only on the condition they got to see the resulting article prior to publication.
That usually causes journalists to feel apprehensive, and in this case her fears were realised.
The Ministry people hit the roof over what she wrote (basically, that all men over 50 should be urged to get PSA tests), and made this plain to her editor.
Judging by what I heard from the Ministry team at the Health Select Committee hearing into prostate cancer screening late last year, the official view is still the same: PSA bad.
Speaking of which – I wonder when we’re going to hear anything further from the committee?
Chairman Paul Hutchison made the MOH people promise to deliver their final views last November.
Did they?
Are there more hearings?
When will we see the results?
Prostablog 
Yes, I wrote a letter to Paul Hutchinson last year (2009) when the Prostate Cancer Guidelines were before the select committee. He didn’t even bother to acknowledge receipt of my letter. I have found this to be the attitude of the NZ health system regarding prostate cancer. Prostate cancer is still regarded as an ‘old man’s disease’ as far as the New Zealand doctors are concerned. Try convincing my husband of that. He was screened vigilantly because of a family history. In 2004 his PSA results were above the arbitrary cut-off for his age. His GP refused to refer him for a biopsy, and at the end of 2006, with a PSA of 9.3 he finally got one. Surgery January 2007 revealed extracapsular spread, his PSA was 0.2 post-op. Salvage radiation did nothing and his PSA has steadily risen since this time. He was 56 at time of diagnosis, and top of his game in his business, hardly an old man. Angry? Not anymore; frustrated and bewildered.
Chris,
A family history of prostate cancer, an elevated PSA and a GP refuses referral for a biopsy for a man aged 56. Is this a case for the Health & Disabilities Commissioner? It might not help your husband but it might help some other men. Let me know.
Barry.
Hi Barry
I’m the woman who had meetings with you when Mark was embarking on his salvage radiation August-Sept 2007. I know I’ve disappeared, much to my shame, but I think I’m “over” prostate cancer, so frustrated am I at the attitude of the NZ health system, and also the negative response to the salvage radiation. I, we, are over our anger at the GP and indeed still have him as the family GP. I really don’t feel that this is a case for the Health & Disabilities Commissioner as I don’t believe our GP was being deliberately malicious,rather he was following the guidelines of the Prostate Cancer Committee. He was testing Mark vigilantly, pity about the interpretation of the results.To be fair, Mark could have over ridden the advice from the GP, that the risk from infection was too great to warrant a biopsy. The urologist, when he did have a biopsy informed him that the risk of infection was only 1%!! However, at that time a friend did have a biopsy and did develop an infection. His biopsy was positive and he went on to have a radical prostatectomy and now has an undetectable PSA. C’est la vie? Our GP is now bending over backwards to do anything for us. He has never alluded to the ‘cock-up’ (pun) and neither have we . We truck on with the 3-monthly rise in PSA sitting like a monkey on the shoulder and frustrated that there have been no inroads in treatment for over 30 years. Hormone therapy looms on the horizon, but as per the Americans and Johns Hopkins we are saving that until Mark is symptomatic, contrary to the advice we receive from our NZ oncologist. It is interesting that I have either had a tardy or no response from doctors in New Zealand but when I emailed Mike Carducci, a reknowned researcher from the Brady Urological Institute attached to Johns Hopkins, I received an almost instant reply. He could not offer anything in the way of drug trials but his empathy gave us a real boost and made us feel as if we had been heard.
The solution to the prostate cancer issue lies with the Guidelines Committee. We don’t need national screening but GPs need to be well informed so that they can then inform the patients. And they need to stop the “most men will die with prostate cancer, not of it” before Mark and I have a hissy fit and hit someone.
It is unbelievable the money poured into cervical cancer screening when 60 women in NZ die of cervical cancer a year vs 600 men of prostate cancer. Go figure.