Men need to know about the importance of early diagnosis and some of the myths about prostate cancer, writes Marko Koivuneva
I am a prostate cancer patient, father of six and grandfather of eight, Chairman of the Finnish Prostate Cancer Association and Board Member of Europa Uomo. As a patient and a patient representative, my heart breaks when I read articles against prostate cancer screening. I receive hundreds of contacts from men from Finland and Europe who are in the same situation as I was: the disease was detected too late.
How can it be that my grandfather and father died of this cancer and I was still not considered to be in the risk group? How can I fix the situation for my three sons and sons-in-law? How can we get rid of the perception in healthcare that diagnostics cause side effects and a decrease in quality of life? That is history. Prostate cancer can be diagnosed without touching the patient. No contact is needed, no disgusting tests, no rubber gloves, no unnecessary samples. Everything can be done in a modern and cost-effective way.
Early, organised diagnostics of prostate cancer does not cause overdiagnosis or side effects of treatments. It saves lives and unnecessary suffering with the disease!
We patients know it. Too many of us are in a situation where the disease has been detected too late, at a stage where treatments are necessary. And if prostate cancer is detected too late, often the treatments are long-term and expensive.
On the other hand, modern early detection is economically advantageous, very effective and non-invasive for the patient. The European Association of Urologists (EAU) and Europa Uomo, along with the European Commission, recommend pilot projects across Europe to investigate the benefits of early diagnostics.
The starting point is a blood test that shows the PSA value in the blood. According to information collected, 98% of blood tests do not result in any further measures – the patient is normally asked to take another blood test after 2-5 years, depending on the circumstances. He can continue his life without fear of cancer and without invasive treatment. The remaining 2% are examined in more detail, but it is no longer necessary to take early tissue samples . An ultrasound scan tells whether the elevated PSA is due to an enlarged prostate or whether it is necessary to go for an MRI scan. The MRI scans tell whether there is something suspicious in the prostate, and if there is, then a tissue sample can be taken directly from the tumour with millimetre precision using minimally invasive procedures.
After the results of the sample collection come through, decisions are made about treatment. In some cases, where the tumour appears not to be aggressive and unlikely to do harm, "active surveillance" is recommended, where no treatment is administered but the patient is carefully monitored. In other cases, active treatments such as radiotherapy, surgery and hormone therapy will be recommended. No treatment is without side effects - but these are much greater if disease is advanced, rather than caught early.
In my country, Finland, prostate cancer is detected too late. There is no other way to change this than through organised early detection. All other talk, from professors and doctors, is against the patient's best interests.
It is time that the most common cancer in Finland, prostate cancer, is taken seriously. Every one of the 5,500 patients diagnosed too late in Finland is heard. It is time that the 900 people who die of prostate cancer each year did not die in vain, and that the mortality rate is reduced.
Let's make a change for the better together and save the lives – and quality of life – of men, fathers, grandfathers.