Accurate testing makes for difficult treatment options that impact partners and families.
In 2010, Statistics Canada reported that most men were significantly more likely than women to report being without a regular doctor1. Anecdotal evidence suggests that women continue to play a significant role in maintaining their family’s health by scheduling regular check-ups and initiating doctors’ visits to address health issues, including for those diseases specific to the men in their lives, such as prostate cancer.
“One of the most striking things I’ve noticed over my 35 years in prostate cancer research is how frequently men bring their wives or daughters to survivor group meetings,” says Dr. Ralph Buttyan, senior scientist at the Vancouver Prostate Centre and professor at the Department of Urologic Sciences at UBC.
“Women's involvement is important because the type of therapy men chooses and the side effects of these therapies will impact their partners and families.”
There exists a North American cultural understanding that men will only see a doctor when significant symptoms of a health problem appear. In turn women often “nudge” the men in their lives, typically husbands and fathers, to better monitor their health and test for possible issues such as prostate cancer in their 50s and 60s, before it’s too late.
“In the past, prostate cancer was typically diagnosed only at a late stage,” explains Dr. Buttyan. “The classic symptom for men advanced prostate cancer was intense lower back pain indicating that the cancer had metastasized, into the vertebrae, but we don’t see as much of that today with the tests currently available.”
“It doesn’t hurt to get the Prostate-Specific Antigen (PSA) blood test,” adds Dr. Buttyan. “However, the complication is deciding what a positive test result means to a patient - that’s a real uncertainty.”
Effective and efficient testing for prostate cancer a blessing and a curse
The Prostate-Specific Antigen (PSA) blood test is highly accurate in detecting the abnormal presence of the PSA protein in a man’s bloodstream early on. Although the PSA test is considered the most effective test for any cancer, its sensitivity can be a double-edged sword.
If a PSA test is positive, supplemental tests and observation methods can identify whether the tumor is growing very slowly, making treatment unnecessary at that time, or if it’s very aggressive and requiring an immediate, specific course of action.
“The problem is that most men fall somewhere in the middle of the spectrum – the tumor is neither slow growing nor extremely aggressive – and we don’t yet have tools to precisely determine where on this spectrum they are,” says Dr. Buttyan. “This makes the decision to embark on treatment, with side effects such as incontinence and erectile dysfunction, or to not treat and monitor the situation instead, very difficult for many patients.“
In either case, the presence of a female family member can be incredibly valuable.
“If the patient chooses not to undergo treatment, they’ll likely experience the day-to-day anxiety of knowing there’s a tumor in their body that could possibly kill them. And choosing to undergo treatment means dealing with the aftermath of therapy," says Dr. Buttyan.
“Support from a wife or daughter, and their better understanding of the disease and treatments, will prove invaluable for getting them all through a difficult time.”