With Atticus Urologist, Dr Weranja Ranasinghe
Dr Floyd Gomes:
Welcome, all. Glad to have you, I’m Dr Floyd Gomes and I’m joined today by Weranja Ranasinghe, our in-house urological surgeon who has quite a history and has done a lot of work in the area of prostate cancer. So I thought we’d certainly get him here and we’re very happy to have him here to talk about prostate cancer. Welcome, Weranja.
Dr Weranja Ranasinghe:
Thanks, Floyd. Nice to be here.
Dr Floyd Gomes:
Oh, look, it’s great to have you here and thanks for coming. So, prostate cancer. You know, as you’re telling me before, is something that as a diagnosis is on the rise. What are the symptoms of prostate cancer and how do you diagnose it?
Dr Weranja Ranasinghe:
Prostate cancer is the most commonly diagnosed cancer in Australia and is certainly the most commonly diagnosed cancer amongst Australian men. On a given day, there are 66 men who are diagnosed with prostate cancer, and about 10 men die daily from the disease. So it is pretty common, and there is a significant rate of death associated with it. And that comes to the point of early diagnosis of this disease. Now, prostate cancer is unlike a lot of other cancers, men don’t present with a lot of symptoms. And it’s usually picked up on a blood test called a PSA test, or rectal examination with your GP or your specialist. So those are the most common ways that prostate cancer is detected. And people are men who present with symptoms usually present a bit later, and that’s not a very good thing.
Dr Floyd Gomes:
Yeah, definitely. So it is something as you’re saying that we really need to proactively think about almost to pick it up early.
Dr Weranja Ranasinghe:
Correct. I think one of the critical things is having an understanding that it’s a common diagnosis and talking to your GP about getting screening and there are lots of conversations which need to be had about a PSA test. That’s something which you should certainly approach with your GP.
Dr Floyd Gomes:
Weranja, the PSA test. It’s often talked about and I suppose the question is from your side, could you let us more know more about the PSA and who you think should have one.
Dr Weranja Ranasinghe:
So a PSA test is a blood test, which detects an enzyme secreted by your prostate gland. The prostate gland is a gland which oil males have, which sits at the bottom of your bladder. Now the PSA tests is not specific for prostate cancer, which means that it can be raised in other instances as well, such as an infection of the urine or prostate. An enlarged prostate can give you a higher PSA, or masturbation or sex can also increase your PSA levels as well as cycling or more vigorous exercises. So it’s important to know that just one PSA test does not mean a lot. So you need to have second PSA which is elevated, which then can lead to further investigations. So, the NHMRC guidelines recommended PSA testing in between men aged between 50 to 69. And that can be offered every couple of years. Even in younger men who have risk factors such as having a family history of prostate cancer, which means having a father or a brother with prostate cancer. And we shouldn’t forget the same genes which affect prostate cancer, such as BRCA are the genes which lead to breast cancer as well. So if you do have a family history of breast cancer, and also ovarian cancers, those can put you at a higher risk of prostate cancer as well. So if you do have a family history, or especially the close siblings or parents who have had these cancers, it’s important to ensure that you’ve had a PSA test done to make sure that you don’t have a risk of prostate cancer. So those are the guidelines done by NHMRC, and the backing of multiple organizations, including the RACGP.
Dr Floyd Gomes:
That’s very comprehensive. Thank you Weranja. What comes to my mind as a GP is oftentimes we think of what we can do to prevent disease. What if any modifiable or lifestyle factors are known to contribute to prostate cancer?
Dr Weranja Ranasinghe:
It’s an interesting question. There’s not a lot in terms of prostate cancer, which are modifiable, as opposed to other cancers. Certainly, there is some evidence to suggest having a healthy lifestyle and keeping fit and losing weight, potentially could reduce the risk of prostate cancer. But there’s no good evidence to suggest that there are modifiable risk factors, unlike other cancers.
Dr Floyd Gomes:
Sure. So it really comes down to the screening, as you outlined, and making sure that you talk to your doctor about that to work out what when might be appropriate for for you to commence that.
Dr Weranja Ranasinghe:
Correct. For this lot of evidence, the well designed screening. studies show that there is a benefit in having a PSA test done if you’re 50, or between ages of 50 to 69. Definitely worthwhile, talking to your doctor about it.
Dr Floyd Gomes:
Weranja. Just on the point of treatment, I’m sure it depends, you know, what stage you’re at, if you do get found to have a cancer, but do you mind just outlining basically the types of treatment that are possible?
Dr Weranja Ranasinghe:
That’s a very good question. Not all prostate cancers need treatment, that’s probably the most important thing to say. There are most prostate cancers which are diagnosed, often low grade, which means that it’s unlikely to cause problems to the to your life. And those can be safely watched. That’s why it’s important to diagnose these cancers early. There are also more aggressive cancers which will need treatment and those treatments are surgery, having your prostate removed. Nowadays, more and more patients are having robotic surgery with which and patients have a faster recovery and better technique. And also, radiation therapy is the other option, which has also evolved over time to give a much more precise dose of radiation to the prostate without many side effects. So a lot a lot has evolved in the area of the diagnosis and the treatment of prostate cancers. Talking about the diagnosis as well, MRI has come into the equation so we are picking up the cancers that we need to treat and we can identify those that can be safely watched.
Dr Floyd Gomes:
That’s great to know that things are advancing. Look, that’s been terrific. Thank you so much for for talking about prostate cancer today with us. Im sure people have found that helpful, particularly that PSA test, as you describe which is really quite important in helping to pick up things early. So yeah, look, Weranja, thanks again for being with us today. Really appreciate your time.
Dr Weranja Ranasinghe:
It’s been great thanks so much Floyd, nice to talk to you.
Dr Floyd Gomes:
By all means Weranja works with us here at Atticus Health. So if you’ve got any further questions or concerns, please get in touch. Thanks all.
