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Monday, 2 June 2003
Page: 15560


Mr LLOYD (12:46 PM) —I move:

That this House:

(1) acknowledges that prostate cancer is now a major cause of death in Australian men with more than 2,500 men dying from prostate cancer annually;

(2) recognises the importance of prostate specific antigen (PSA) testing as a reliable and effective method of diagnosing early prostate cancer, providing the best possibility of a successful outcome;

(3) notes the reported collapse of a proposed national television awareness campaign about prostate cancer; and

(4) calls on the Federal Government to examine funding options which will enable increased research into prostate cancer, and provide additional and more effective awareness programs to assist in the early detection of prostate cancer.

More than 10,000 Australian men are diagnosed with prostate cancer every year and, typically, 2,600 men die annually from this disease. This makes it the second most prolific cancer for men, next to skin cancer. Many lives could be saved through the combination of a nationwide campaign, increased funding for research and a better understanding of the prostate specific antigen—PSA—test as a useful tool in the early diagnosis of the disease.

I take issue with comments from Ray Lowenthal of the Cancer Council. He stated, `We do not yet know whether early detection saves lives.' As with all cancers, early detection is critical in the treatment and possible cure. Once cancer has spread outside the prostate gland, it almost certainly cannot be cured. It can be treated and managed, but usually not cured. There is much debate, even controversy, over the importance of the PSA test. Certainly in my own case I firmly believe that the PSA test saved my life, and I know I am not alone. I have received many letters, and I would like to read part of one. It states:

... I owe my survival to my enlightened GP who put me on annual PSA tests some 10 years ago. The significant rise which occurred about 2 years ago was immediately followed up, an early cancer detected and dealt with.

In contrast my brother-in-law did not have PSA tests and when he finally and reluctantly went for examination of symptoms he had been ignoring, he had a rampant cancer which had already spread to his bones. He died 18 months ago of Prostate Cancer. His widow and I feel that had he had PSA tests, and an early diagnosis he might well still be alive today.

In March 2000 my local GP recommended that, despite having no symptoms, I have a PSA test, and the results showed a slight elevation. Six months later I had another test, which showed further elevation. A biopsy confirmed a moderately aggressive prostate cancer, and I underwent a successful radical prostatectomy on 17 February this year, at the Sydney Adventist Hospital.

Prior to being personally involved I, like most Australian men, knew very little about prostate cancer—despite my father also suffering from the disease. I knew nothing about the PSA test or about the incredible incidence of the disease. Recent research conducted on behalf of the Prostate Cancer Foundation of Australia indicates that only 10 per cent of men in the 50- to 70-year age bracket had undergone an appropriate test for prostate cancer, and many of them did not feel that they were adequately informed about prostate cancer. This appalling lack of knowledge could be costing countless lives and must stop. An awareness campaign for both the public and health professionals should be implemented as a matter of urgency. It will save lives.

Some of the letters we have received are very sad. I will read part of a letter that was written to Prime Minister John Howard. It says:

Both my G.P. and I were relying upon digital examinations. In my case I was simply unaware that such a test was useless. My G.P. should have known better, but didn't. Why is it that men's lives are exposed to such lack of knowledge of simple facts?

The letter goes on to say that we should do everything we can `to ensure that fewer Australian fathers end up putting their families through the agonies that I have imposed on mine'. It is a very sad letter.

Since the listing of my private member's motion on the Notice Paper, I have received hundreds of letters from prostate cancer sufferers and their families all over Australia. I know that most other members have also received many supportive letters. The fact that so many of my colleagues, on both sides of the House, are in the chamber today indicates the level of interest that this motion has generated.

Much of the controversy over the PSA test relates to the effectiveness of treatment and the possible side effects. Unfortunately, many of the negative comments are based on outdated information. After the publication of my letter on this subject in the Sydney Morning Herald on 10 March 2003, I received a critical email from Simon Chapman, Professor of the School of Public Health. In a typically academic approach, he claimed that he had consulted the world's largest database of published medical research and then proceeded to provide me with data that showed incontinence levels could be up to 50 per cent. Dr Phillip Katelaris, a noted urological surgeon, responded to Professor Chapman's claims in a letter dated 11 March 2003. The letter reads, in part:

It is every man's right to know whether or not he may have early prostate cancer and whether or not he chooses to avail himself of potentially curative therapy. This goes to the very crux of consumer rights in our society. Furthermore, it is every man's right to know best practice morbidity for curative prostate cancer, not to be told by `Experts' like Professor Chapman that incontinence rates are 50%. It is interesting that Professor Chapman makes no reference to contemporary epidemiological studies, such as the Austrian study indicating a distinct advantage for early screening and intervention. I would have thought that it was a man's right to know about these studies as well.

It is not just an issue of long term cure with early prostate cancer detection, it is also a matter of avoiding the misery and complication of progressive untreated prostate cancer. That relates to recurrent bladder obstruction, pain, bleeding, retention and metastatic bone pain. Simon Chapman would not detect this human suffering by reading “the world's largest database”. It is a shame that he has no clinical experience in this field.

You can see Dr Katelaris to be very passionate about this issue. I recently attended a meeting of a prostate cancer support group and met with many survivors and their wives. At that meeting there were many men with advanced prostate cancer undergoing radiation and hormone treatment. When I left that meeting I was overwhelmed with sadness and guilt. Why? Because I feel so well and because I was lucky enough to be diagnosed early and receive successful treatment. I saw sadness in the eyes of these men and their wives. I saw suffering. I saw pain. It made me determined to do what I can to end this suffering.

Government funding for research and education into prostate disease is minimal when compared to funding provided to fight breast cancer, despite the incidence of both these diseases being similar. Could it be the fact that almost 90 per cent of all prostate cancers occur in men over 60 years of age? I hope not, because 60 or 70 years of age these days is not exactly the end of a man's meaningful contribution in his life. Even if you accept this ridiculous proposition, it still means that more than 1,000 men aged between 45 and 60 will be diagnosed with prostate cancer this year and every year. The government is funding Andrology Australia, an Australian centre for excellence in male reproductive health, to the tune of $4 million over the next four years. This is an important initiative, but just $1 million per year is not enough. Much more needs to be done. Australia has already made significant progress in research into medical procedures, and one way in which the department of health can show it is serious is to be financially supportive of these endeavours.

The Sydney Adventist Hospital currently has a research project utilising an endorectal MRI with spectroscopy to accurately diagnose prostate cancer. I personally volunteered to be part of this research program. We are very fortunate at the Sydney Adventist Hospital to have a dynamic, cooperative interface between clinical medicine and research scientists. I believe it is the only institute in the world that is able to coordinate a study that includes preoperative MRI assessment to correlate these findings with radical proctectomy specimens post-operatively. Yet all this is being placed at risk. The MRI monitoring and evaluating group has rejected an application for Medicare funding for this MRI machine simply on the basis of geography—the fact that there is another MRI machine in the area. This is not good enough. The losses being incurred by the Sydney Adventist Hospital on this MRI project are simply unsustainable. If the government wants to show that it is serious about increased funding for prostate cancer research, it should immediately provide Medicare support for this project, otherwise all this world leading research could be lost.

There seems to be a serious culture of resistance within the federal department of health in funding prostate cancer research and education programs. I know that there is debate and even controversy between the academic and clinical experts in this field, but this should not be a reason for resistance. Early detection is vital and will stop men suffering misery, pain and early death from untreated prostate cancer. I hope that it is not a factor of finances, because the costs of biopsies and PSA tests are minimal compared to the costs of treating someone with advanced prostate cancer.

I thank my colleagues for being in the chamber, and I thank the member for Lilley, Wayne Swan, for seconding this motion. I also thank the people in my family and my support group who have rallied around me in my battle and my recovery process. I hope that this motion does achieve some positive initiatives for the many thousands of men and their families who are suffering from this terrible disease. (Time expired)