For Immediate release

MEDIA RELEASE: Prostate cancer is now the most common cancer in Australia, overtaking breast cancer as the country’s leading cause of cancer. That brings with it a serious mental health issue currently unaddressed by much of the medical profession. Living with a diagnosis of prostate cancer brings many men and their partners a level of psychological distress that compromises both their mental and physical health.

A prostate cancer diagnosis is almost always accompanied by feelings of fear, shock, anger, deep sadness and confusion. It’s what psychologists call ’a major life stress’ — an event that causes a threat to the things that matter to us most. This level of stress can cause serious harm. 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.

Such significant levels of psychological distress also harm a man’s ability to navigate the complex journey required for successful outcomes from prostate cancer treatment. It can compromise their physical health, their decision-making, their communication with health professionals, and their ability to effectively use social support networks.

Side effects from certain prostate cancer treatments compound the distress with impacts on cognitive capacity, feelings of self-worth, and personal resilience. This distress radiates out, affecting partners, families, colleagues.

There is a decade and more of detailed research and clinical evidence showing that a focus on psychological care improves prostate cancer treatment outcomes. Yet ameliorating psychological distress to improve outcomes is not yet a standard part of medical treatment within Australia. Men continue to report unmet psychological care while undergoing treatment.

The challenge for Australia’s urologists and cancer treatment centres is to first recognise much of the existing psychological distress of their patients is likely hidden from them. Asking for psychological help does not come naturally to many men. Research has even shown that men who say to their doctor they will take action to deal with their prostate cancer are actually those who are least likely to seek help. This hidden impact then has the potential to affect the way in which a doctor’s patients interact with them and make serious decisions about treatment that can affect their lives forever.

The next challenge is how to incorporate such care into medical treatment without major financial investments in the employment of psychologists and specialist counsellors.

The answer is to make proper use of a well-established, evidence-based resource called Facing the Tiger from Australia’s own world leader in the psychology of prostate cancer, Professor Suzanne Chambers AO. Facing the Tiger is part of a tiered level of psychological care specifically developed for a range of healthcare users involved in the treatment and care of prostate cancer.

It is not a book about treatment options, cancer, anatomy, or disease. It does not give any medical advice. It is, in fact, a subtle psychological intervention capable of ameliorating psychological distress around a prostate cancer diagnosis and throughout a man’s treatment journey. 

And it costs around $20 per patient.

Problem solved?

FOR FURTHER INFORMATION CONTACT: stephen@australianacademicpress.com.au

Prostate Cancer is now the most common cancer in Australia, overtaking breast cancer as the country’s leading cause of cancer. Data just released by the Australian Institute of Health and Welfare estimates 24,217 Australian men will be diagnosed with prostate cancer this year, compared to 20,640 women diagnosed with breast cancer. The forecast is a 34 per cent increase on previous year.

That’s a serious assault on mens health – and their mental health in particular. So let’s start doing something about it in urology practices and cancer treatment centres right now for a cost of around just $20 per patient!

Stay with me here. Let’s follow the logic.

A prostate cancer diagnosis is almost always accompanied by feelings of fear, shock, anger, deep sadness and confusion. Why? Because it’s what psychologists call ’a major life stress’ — an event that causes a threat to the things that matter to us most. This level of stress can cause serious harm. The emotional turmoil can compromise a man’s physical health, decision-making, communication with health professionals, and ability to effectively use patient support networks. Side effects from certain prostate cancer treatments compound the distress with impacts on cognitive capacity, feelings of self-worth, and personal resilience. This distress radiates out, affecting partners, families, colleagues.

Yet the level of patient distress is often hidden from healthcare providers. Asking for psychological help does not come naturally to many men. Research has even shown that men who say to their doctor they will take action in the face of dealing with prostate cancer are actually those who are least likely to seek help. So why do we persist in waiting for men with prostate cancer to tell us they need psychological help? And how do we begin to give that help without a huge financial investment in psychologists?

We start by making proper use of a well-established, evidence-based resource from Australia’s own world leader in the psychology of prostate cancer, Professor Suzanne Chambers AO. Facing the Tiger is not a book about treatment options, cancer, anatomy, or disease. It does not give any medical advice. It is a low-level psychological intervention capable of ameliorating psychological distress around a prostate cancer diagnosis and throughout a man’s treatment journey. The book provides psychological information and guidance for a man and their partner, allowing them to find their own unique path to a sense of ease and coping. Providing as many prostate cancer patients as possible with a copy of Facing the Tiger for around $20 each forms the first part of a tiered care approach capable of having a major impact on the mental health and wellbeing of the more than 200,000 men living in Australia with prostate cancer. It’s an approach that’s already familiar to around 100 trained specialist prostate cancer nurses across Australia.

It’s something we can and should do RIGHT NOW. See – How it works.

• Stephen May

Right when you are trying to rationally work out what the cancer diagnosis means for you and what next steps you need to take, your body is sending out physical fear reactions.

Every day, 49 Aussie men are diagnosed with prostate cancer. That’s why the Prostate Cancer Foundation of Australia’s Walk for Him Campaign for Mens Health Week is so important. Events like these raise funds to help support awareness and early diagnosis campaigns, lobbying activities, and grants for life-saving medical research into better treatments.

It’s also important to remember that behind the stats and the fund raising, 8183 men this year have walked out of their urologist’s rooms in shock after a diagnosis of prostate cancer. As Professor Suzanne Chambers AO, a leader in the psychology of prostate cancer describes it:

“At that moment, the world seems changed. The things that you may have taken for granted are now at threat. While health care professionals and others around you may honestly express their concern and sympathy, this can be a singularly lonely and distressing time. Cancer is a threat that goes to the core of us. It is first and foremost a threat to life and survival. Cancer can also be a threat to a person’s sense of self: ‘Will I be the same as I was before, or will I be changed; less me in some way? Will I still be able to do the things that matter to me?’ Cancer can threaten a person’s relationships: ‘Will I still be loved and cared for? Will people want to be close to me?’ A diagnosis of cancer is almost always accompanied by feelings of fear, shock, anger, deep sadness and confusion.”

Helping men deal with this major life stress can make all the difference to their mental and physical health as they begin their survivorship journey. Men and their partners need a map to find the path that will take them back to a sense of ease and coping; a way to make treatment decisions they can live with; to clearly communicate their healthcare needs; to seek the right level of psychological help appropriate for them.

Suzanne developed a practical guidebook for that path through her research and clinical work with many men and their partners over more than 30 years. She called it Facing the Tiger, illustrating how a person’s mind and body react when faced with life-threatening danger — the ‘flight or ‘fight’ response that gets your body biologically to fight or run.

“Your body does this through an immediate hormonal reaction where your body pumps out adrenalin and noradrenalin that make your heart go faster, your mouth feels dry, your pupils dilate, and your gut stops working. You become poised to respond to the tiger in front of you. And while that’s all quite helpful in the face of an actual tiger, it’s not so helpful when the threat is cancer. Instead, right when you are trying to rationally work out what the cancer diagnosis means for you and what next steps you need to take, your body is sending out physical fear reactions, and the emotions that go with this are inevitably unpleasant, such as feeling sad, anxious, or afraid.”

Facing the Tiger is not a guidebook about treatment options and does not give any medical advice. Its role is to supply the specialist information and guidance that medical professionals don’t have the time or experience to. It suggests different perspectives for men and their partners on where they would like to be as they progress through their cancer journey and proven strategies to help that progress. Personal stories from men and women highlight the issues discussed and provide vivid insights into how others deal with prostate cancer. The book draws from over a decade of psycho-oncology research and practice to acknowledge that everyone’s experience of prostate cancer is their own. There is no one right or wrong way to approach this stressful time, but the right guidance is essential to finding your own way.

Facing the Tiger has the potential to ease the fear, shock, anger, deep sadness and confusion facing those over 8000 men right now, as well as the more than 8000 who will follow them in the second half of this year. It does not replace psychological therapy for those who require it, nor does it replace a simple once-off talk with a psychologist post-diagnosis or pre a first treatment round. It is designed specifically to sit within a tired model of psychological care as immediately accessible upfront support. At the cost of around $20.00 a patient, it’s an inexpensive addition to urology practices and cancer treatment centres. It’s also an easy first step to take toward embedding evidence-based psychological care into everyday prostate cancer treatment. All of Australia’s Prostate Cancer Specialist Nurses are already trained in the psychological care of men with prostate cancer by Suzanne and have their own comprehensive manual for delivering tailored interventions based on patient need and using practical strategies from Facing the Tiger.

The book is endorsed by the Prostate Cancer Foundation of Australia, The Australia and New Zealand Urological Nurses Society and the Urological Society of Australia and New Zealand. In fact, the USANZ has told all its urologist members that Facing the Tiger represents best-practice psycho-social care and encourages them to recommend it to men and their partners facing prostate cancer. So, this Mens Health Week, if you are a health professional working to diagnose and treat men with prostate cancer why not extend your patient care now to include handing them a copy of Facing the Tiger.

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.

The short answer is no, but they soon can be because now we have the means.

Tens of millions of dollars are invested towards saving lives and helping more men survive prostate cancer — delivering research breakthroughs and new medicines. Treatments for prostate cancer have dramatically altered. Robot-assisted surgeries, refined methods of radiation therapy, a range of different hormone-blocking treatments, new chemotherapy regimens, and personalised medicine based on genomic profiling are now available. Survival rates for prostate cancer have soared. Over 95% of men are likely to survive at least five years post-diagnosis.

Yet, with all this medical intervention, being a prostate cancer survivor brings many men and their partners and their families a level of psychological distress that compromises both their mental and physical health. 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 statistics, they will strive to cope with a major life stress that cuts to the very core of their beliefs about themselves and their place in the world. They will likely do that without obviously seeking help or even admitting they are under that much stress. “She’ll be right mate”. They will try to ‘man up’; to make sense of how to proceed using strategies and ideas from their life experience. Some will find it harder than others — too many in fact. 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.

That’s a tragedy. But it’s also not good medicine. Such significant levels of psychological distress harm a man’s ability to navigate the complex treatment journey required for prostate cancer survivorship. It can compromise their physical health, their decision-making, and their ability to effectively use patient support networks, including those most commonly referred by their medical team.

What then is the value of a ‘successful’ surgical, drug, or radiation treatment outcome if the patient is unable to properly process what this success means to their day-to-day survivorship and how they will live with their disease?

In 2019, after extensive collaboration between Australian medical, nursing and research leaders, the Prostate Cancer Foundation of Australia (PCFA) and the National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Prostate Cancer Survivorship released a monograph and position statement to address psychosocial care for men with prostate cancer.

The statement recommended that: “After the diagnosis of prostate cancer and regularly through treatment and surveillance, men who have been diagnosed should be screened for distress, and their psychological and quality of life concerns should be explored. Men who have high distress or need for support should be referred to evidence‐based intervention matched to their individual needs and preferences for support.”

This statement was endorsed by:

• The Urological Society of Australia and New Zealand,
• Australia and New Zealand Urological Nursing Society,
• Royal Australian and New Zealand College of Radiologists,
• Medical Oncology Group of Australia,
• Australia and New Zealand Urogenital and Prostate Cancer Trials Group,
• European Association of Urology Nurses,
• and universities across Australia.

It was announced as the game-changer it is: “This is the next frontier in innovative care … to restore hope in a future free from both physical and psychological pain.” The initiative was expected to result in “much greater regard for each man’s right to enjoy a satisfactory quality of life.” Yet, in Australia in 2022, despite routine medical follow-up, many men with prostate cancer do not receive regular distress screening and psychological intervention in a timely manner, if at all.

This month, another edition of the monograph and statement will reiterate that psychological care is an essential part of best practice prostate cancer survivorship care. This time around though, health professionals finally have access to a psychological intervention designed precisely to address the need for regular distress screening and easy access to a tailored stepped care model approach for better prostate cancer survivorship.

In a world-first, Australia’s leading psycho-oncology and health psychology researchers have developed a guide for a wide range of health professionals on how to incorporate effective psychological support in the care they deliver to men with prostate cancer. It represents best practice in prostate cancer survivorship, and indeed, for cancer survivorship in general. Patient-centred, it makes use of a comprehensive knowledge base of psychological care and cancer control.

Its unique approach empowers the patient as a survivor, placing the man and his family at the centre of care throughout their treatment journey. The guide encourages oncology care coordination so that the man receives the best care possible in the right place at the right time. It allows for cost-effective support and a clear referral pathway for more specialist care through distress screening.

The guide makes use of the Facing the Tiger psychological care approach, developed by Professor Suzanne Chambers, who has worked with men with prostate cancer for many years and is a recognised world leader in the psychology of prostate cancer. This approach allows health professionals to support men with mild (or hidden) distress levels about their cancer diagnosis and treatment by simply providing them with a copy of a slim self-support book. Follow-up with a low-intensity care intervention for moderate levels of stress by nursing or allied healthcare workers can be provided through guided intervention sessions tailored to the needs of the patient. Referral to specialised care can then be made from information and assessments gathered with help from these sessions.

Embedding awareness, use, and understanding of this resource within prostate cancer treatment teams from diagnosis through to treatment or watchful waiting means Australian men will receive the best of care for prostate cancer. So just do it. Do it now.

After a diagnosis of prostate cancer, up to 40% of men will experience poorer quality of life and face a heightened suicide risk. Professor Suzanne Chambers AO, one of the world’s foremost experts on the psychology of cancer, has written a powerful mental health resource in the form of a self-help book that works to address this.

Entitled Facing the Tiger, it incorporates evidence-based science and the lived experiences of prostate cancer survivors to achieve better survivorship outcomes through better mental health. It helps patients: manage stress and anxiety, improve decision-making, understand their unique treatment journey, access appropriate support, and increase the effectiveness of communication with their health care team.

However, research tells us that simply asking (or telling) men with prostate cancer to buy a copy of Facing the Tiger isn’t actually the best way to help them. Older men are often reluctant to seek help for, or even recognise, their mental health issues.

Yet, Suzanne’s book is the most sought-after patient resource in those prostate clinics where copies are made available to specialist nursing staff to provide to patients. For example, Kath, a specialist prostate cancer nurse working in a large regional hospital, found the book so useful to her patients that she recently ran out of supplied copies and had to raise funds to get more.

It seems then that the best way for Suzanne’s work to make the most difference is by having urologists, specialist prostate cancer nurses, urology nurses, oncology nurses, GPs and other appropriate health professionals disseminate the book to patients rather than asking men to buy their own copy.

It is hoped then that the most recent initiative by the Prostate Cancer Foundation of Australia and the Urological Society of Australia and New Zealand to send a book to over 600 urologists along with a letter urging them to use it with patients might encourage some investment from urological practices. Such private health investment has already been taken by Mens Health Downunder, an affiliate of the Canberra-based Life Pharmacy Group, who sent out 100 free copies to support the men in their care.

Making the case for this investment by medical practices, a website has been established for health professionals [www.facing-the-tiger.com] which focuses on the how and why of the modern cancer treatment survivorship approach. It calls for a high care focus on the wider psychosocial impacts of cancer as well as medical intervention. The website features research and resources as well as information on the Australian developed best-practice guidelines for psychosocial care for men with prostate cancer.

As a trained psychologist of an age where a PSA test is a regular part of my medical check-ups, it’s not surprising that I find it so important to publish and promote Facing the Tiger as the powerful tool for better mental health that it is. I have worked with Suzanne Chambers for some years now and remain in awe of her energy and commitment to men’s health and her amazing talent for communicating in language that men understand. Her book is so much more than just something to suggest to men and their partners that they “might find helpful”. It is a mental health intervention that works. I would urge you to look seriously at incorporating the book into your work with prostate cancer patients and help create a step-change in prostate cancer care.