HELPING HAND: MBH Prostate Support Clinic prostate cancer specialist nurses Kylie Harry and Craig Millard with patient Steven Osborne.
By JOHN DOOLEY
FOR many men a visit to their doctor for a regular health check is a low priority task, or indeed not even on their agenda, but it’s an apathy that can have deadly consequences if an otherwise curable cancer isn’t detected early.
Bowel and prostate cancers are two such diseases, that if diagnosed in their early stages, in most cases, can be treated successfully.
In the case of the prostate, a simple blood test known as a Prostate Specific Antigen (PSA) is the usual form of detection.
Prostate cancer is the second most common cancer among men worldwide, with almost 20,000 diagnosed each year with the disease in Australia alone resulting in an average of 3300 deaths.
The good news for patients, and their loved ones too, is that Ramsay Health Care’s Mildura Base Hospital (MBH) offers a great support service in the form of its Prostate Support Clinic (PSC), headed up by prostate cancer specialist nurses Craig Millard and Kylie Harry.
“We’re employed to look after men with prostate cancer, and to support their families,” Craig said.
“That support begins at diagnosis, and goes through to cure, or in the worst case scenario, death.
“At any time during that phase we are here for the patient and their families. It’s our job to help them through what can be a difficult period.”
The Mildura PCSN has been operating for more than four-and- a-half years, with Craig being in his role throughout that period and being joined 12 months ago by Kylie, giving the clinic a valuable added resource.
Craig said the initiative to establish PCSNs was rolled out nationally more than six years ago, however it wasn’t until the second round of funding two years later that Mildura was included.
“Initially there was funding for around 14 clinics. Ongoing funding allowed the program to grow to 28, and with the injection of additional Federal funds the service now boasts around 35 PCSN clinics across Australia and we’re lucky to have one in Mildura,” he said.
The Mildura clinic sees in the order of 100 patients a year, with 50 to 60 men in our region diagnosed with prostate cancer each year.
“Throughout the course of any year you have people moving to the area, and this adds to the numbers of patients, and then you also have some with metastatic-disease seeking support,” Craig said.
Metastatic cancer, or metastatic tumor, is one that has spread from the primary site of origin into different areas of the body. Prostate cancer is usually diagnosed as being ‘localised’ or ‘advanced’, the latter being metastatic.
“In these situations patients will return and re-engage with the support system, and with some patients you may only see them for a short period of time,” Craig said.
“Those patients receive information and attend the clinic for a couple of weeks and they are fine, and then there are those people who you don’t discharge, who are kept on our books ongoing.
“Patients undergoing chemotherapy would generally stay within our support group and we’d see them quite regularly with the oncologist and the same applies to radiotherapy patients.”
One of the clinic’s patients currently undergoing treatment for prostate cancer is Steven Osborne, a former resident of Berri, South Australia and who now lives in Mildura.
“Back in 2015 my PSA level was ever-increasing and I was referred to the Royal Adelaide Hospital (RAH) where I was given ‘Brachytherapy’ because removing my prostate wasn’t an option,” Steven said.
Brachytherapy allows the use of a higher total-dose of radiation to treat a smaller area in less time than conventional, external-beam radiation therapy and is used to treat cancers throughout the body.
After initially receiving treatment at the RAH, Steven was referred to the Mildura PSC by his doctors there. Steven’s treatment required him to undergo high-dosage, targeted radiation.
“I was given ‘local-radiation’ because they felt there was a possibility the cancer cells may have ‘escaped’ from the prostate and travelled to other parts of my body,” he said.
Following the course of treatment, a period of time elapsed and Steven said he missed a scheduled PSA check, and when he eventually had another test, the levels were on the rise again.
“At that point, the medical advice was that I had to undergo chemotherapy and follow-up hormone treatment,” he said.
“Right from start to finish Kylie and Craig have supported me and my partner, with ongoing programs including the gym and the prostate cancer support group, where men get together and have dinner and chat about various things, any problems and so on There’s lots of support here in Mildura which is fantastic.”
Steve, 57, is currently enjoying reasonably good health as he undergoes his treatment, and is very positive about his prognosis.
“Everybody says I look remarkably well, and given I’m not working at the moment I can take it easy, but nonetheless, I’m finding there’s some muscle depletion occurring due to the hormone treatment and I’ve lost some weight,” he said.
“At times I do suffer from some anxiety and low moods and fatigue. If I push the lawnmover around I get very tired and need a rest, but basically that’s all side-effects from the hormone implant treatment.
“But in spite of that I walk regularly and exercise in the gym to keep as fit as I can, but the most important thing to have is a positive mindset and remain hopeful for a good outcome. I’m maintaining that.”
The other statistics surrounding prostate cancer are quite startling. Men have a one-in-five chance of developing prostate cancer by the age of 85, and it’s the most commonly diagnosed cancer in Australia.
On average, 55 men are diagnosed with prostate cancer every day in Australia, with 98 percent of them being 50 years of age or older.
Since becoming readily available in the early 1990s, the PSA test has seen a dramatic increase in the number of diagnosis’s of men in their 50s, which has increased 11-fold.
In regard to the issue of identifying high-risk groups, Craig said if a man has a ‘first-degree’ relative, for example their father or brother, who have, or have had prostate cancer, then they will have twice the chance of contracting it.
“It doesn’t mean they will, but their chances are significantly increased,” he said.
“The medical experts recommend if you have a father or brother with the cancer, you should start having your PSA checked at 40. For other men it’s suggested that you discuss your prostate with your doctor, but in any event, to commence regular checks from the age of 50.”
While not absolutely definitive, the blood-test is the best option available and in most cases it will detect the likelihood of cancer being present in the prostate.
“The doctor will take history into account in accessing if a digital rectal examination is required for a more definitive result, it’s certainly not compulsory, but the Urologist may request it be done, but the PSA remains the best we’ve got and most prostate cancers are identified by a raised PSA level.
In stressing the underlying importance of men in our region being tested, Kylie said a raised PSA will indicate to the GP to refer their patent to a urologist who will make an assessment and decide if a biopsy is required
“It’s interesting to note a statistic which really resonates with me. That is, men in rural areas are 21 percent more likely to die from prostate cancer than their metropolitan counterparts, and so a regular annual health check is strongly recommended for men over the age of 50,” Kylie said.
“Country blokes are particularly notorious for not having regular health checks, and when early detection is the best cure that isn’t a good thing,” Craig said.
“The best weapon we have against any cancer is early detection. If you’ve got it, you want to know.”
“There is a lot of relevant, up-to-date, factual information available about prostate cancer through the Prostate Cancer Foundation of Australia, so rather than people going onto a whole lot of different websites, they would be well advised to visit this site,” Kylie added.
Kylie, who is also a clinical nurse specialist in the chemotherapy department supporting oncology patients, enjoys working with men with prostate cancer alongside Craig in the PCSN Role.
“I think it’s nice to have a balance and so having a male and a female nurse in our clinic works well, and in many cases the men being treated will bring their wives and partners along with them on their visits and we engage them in the conversation as well, and so from that aspect it works well.”
Craig added that it’s essential for the partners of patients to be involved in the treatment and recovery process.
“It’s really helpful for them and having Kylie there seems to put them at ease, which is comforting for the partners,” he said.
“On one occasion a patient said to me that everyone was asking him how he was? but no-one asked his wife how she was, and so we always ensure that it’s an inclusive process to the degree that people are comfortable.”
“It’s important that the public are aware that even though Craig and I are based at the hospital, we are able to see community patients, public and private patients, they don’t have to be a patient at the MBH, they can be anyone living with prostate cancer, and importantly it’s a free service,” Kylie said.
The Mildura Prostate Cancer Support Group, which is supported by Craig and Kylie, meets on the first Wednesday of the month at the Working Man’s Club.
The meetings offer support to individuals and families affected by prostate cancer, and also provide an opportunity to listen to guest speakers, ask questions and enjoy informal social discourse.
For further information about the support group, call Sunraysia Cancer Resources on 5025 8866.
If you are seeking information regarding Prostate Cancer visit www.prostate.org.au.