It’s not enough to just treat prostate cancer

Survivorship rates for prostate cancer are very good these days. Men live longer due to advances in early detection and medical treatment options.

But that’s just half the story.

Compared with men in the general population, men with prostate cancer are twice as likely to experience depression and three times more likely to experience anxiety. The risk of suicide for these men is greatest within the first year after diagnosis.

Many men will walk out of their urologist’s rooms after a diagnosis of prostate cancer into a world of private hurt and hopelessness. Lost, confused, with a head full of survival statistics, treatments, and contact details where they might find ‘support’, they will strive to cope with a major life stressor that cuts to the core of their belief about themselves and their place in the world.

Their ability to deal effectively with this stress impacts themselves and their partner. They face a complex life journey. Treatment for prostate cancer is rarely straightforward. Men are not told how they will be treated; they are offered options. These options have different side effects — side effects that can challenge their masculinity and way of life. They must decide what is best for them and their partner.

Yet, in most urologists’ rooms and specialist cancer treatment centres across Australia, men are expected to do this without much consideration that they may require an extra level of care beyond information and medical support.

The fact is that just as medical science knows what prostate cancer can do to a body, psychological science knows what major life stressors do to one’s mind and body. High levels of distress can compromise a man’s physical health, decision-making, concentration, social interactions, and their ability to effectively use patient support networks, including those most commonly referred by their medical team.

To achieve the best treatment outcomes for prostate cancer, psychological care must be included alongside medical care.

Health psychologist Professor Suzanne Chambers AO is working hard to bring this about.

Based on the ground-breaking Australian developed Prostate Cancer Survivorship Essentials Framework, Chambers is introducing to health professionals a way to provide individualised, male-centric psychological treatment and support when and where it is needed. She is currently being kept busy training specialist nursing staff across the country and seeing men and their partners in her private practice.

She makes heavy use of a simple tool to start the process of psychological care — a slim self-help resource called Facing the Tiger: A Survivorship Guide for Men with Prostate Cancer and their Partners. The book is based on decades of psycho-oncology research and practice and was created in response to requests from men she worked with who said they needed clear guidance on coping with what they were feeling about their disease and its impact on themselves and their partners. The book is now endorsed by Australia’s urologists, urology nurses and the Prostate Cancer Foundation of Australia.

Chambers believes that if every man was handed a copy of the book upon diagnosis, not only would it lessen the burden of psychological suffering for many men with prostate cancer, it would allow medical treatment to incorporate higher psychological care where needed in a sustainable patient-centred way.

For now, though, getting that message across to urologists and prostate cancer treatment centres takes time. One encouraging sign, however, is that Chambers’ current clients are now loudly telling fellow prostate cancer survivors to ask why their doctor hasn’t given them a copy of Facing the Tiger.

Facts & Figures: Prostate cancer is the most commonly diagnosed cancer in Australian men. Estimates suggest that more than 18,000 Australian men will be diagnosed in 2022. Prostate cancer is the second most common cause of cancer-related deaths in Australian males after lung cancer. It is estimated that around 3,300 men will die from prostate cancer in 2022. For Australian males affected by prostate cancer, evidence suggests those in regional and rural areas and those who live in areas of relative socio-economic disadvantage experience lower rates of survival.

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