STRIDING across the lightly timbered paddock, Brendon Young is a portrait of robust health.
He can see what the future holds.
For one thing, he’s about to turn 60.
What’s more, Mr Young has recently bought this 5-hectare block near Woodville, so that he and his wife Margaret can build a new house and lead a more self-sufficient life, raising chickens and growing vegetables.
“This is where the house will go,” Mr Young says, pointing out the surveyor’s pegs and gesturing to the view the couple will enjoy from their new home.
From this rise on their property, the Youngs can look over river flats, across farming communities, all the way to the distant hills. It is a beautiful, life-affirming view.
Not that Brendon Young needs a view to illustrate the beauty of life. He has survived prostate cancer twice.
He was first diagnosed when he was 50. He had just returned from walking the Kokoda Track and was feeling fit when he had a regular check-up. From a blood test, his GP picked up that Mr Young’s levels of prostate-specific antigen, or PSA, were a little high.
At the time, Mr Young says, “I didn’t know what a prostate was”.
But he quickly learnt more about the prostate, when he was told by a urologist he had cancer.
In early 2009, Brendon Young decided to have the prostate gland removed.
Mr Young says while the removal led to impotency, he believes, “I took the right step. Then the bloody thing came back.”
In 2015, cancer was detected in Mr Young’s prostate bed. He had radiation therapy to treat it.
Now, he says, his PSA readings are low and steady, and he feels healthy.
Brendon Young is concerned many men are not having their PSA levels tested and could be missing out on early detection, if there is cancer.
“You ask blokes my age, ‘What’s your PSA level?, and often it’s, ‘I don’t know. I’ve been meaning to get it done’,” Mr Young says. “It’s fear. They don’t want to know.”
PROFESSOR Jim Denham is tracing the line of a graph for prostate cancer detection rates in the Hunter New England local health district.
“So this is the age-standardised incidence rate, the detection rate,” explains the radiation oncologist based at the Calvary Mater Newcastle and leader of the University of Newcastle’s Prostate Cancer Trials group.
His finger climbs from about the year 2000 until it reaches a peak just beyond 2007.
Professor Denham explains this line plots an encouraging ascent out of unenviable statistics for prostate cancer in the Hunter New England local health district in the early 2000s.
“We had the lowest detection rate and the highest mortality rate [in the state],” he says.
A string of education and awareness campaigns helped prod the climb in the detection rate.
One in particular was tailored for the men of the Hunter and New England regions. It had the cheeky title of “Get a Little Prick”, and the campaign began in 2007. Through advertisements and promotional literature, men over 50 were encouraged to have a blood test.
“It was enormously successful,” recalls Ron Bender. “People were coming in droves to talk about [prostate cancer] and get tested.”
Mr Bender had become involved in the campaign for a very personal reason. After an illustrious career in the NSW Police Force, Ron Bender spent the first day of his retirement in 2004 undergoing a prostatectomy.
He believes the PSA test saved him from a painful and shorter life: “I’ve had nearly 15 years so far; so far, so good.”
And he has “absolutely no doubt” the “Little Prick” education campaign helped many others lead longer lives, because there was “a massive rise” in cases of early cancer detection.
Professor Jim Denham, who was instrumental in establishing the awareness campaign, believes it was a great success, as Hunter New England’s detection rate rose to be the highest in the state.
“Clearly there were a lot of men with unpleasant cancers who were actually cured as a result of the Little Prick campaign,” he says.
Professor Denham refers to another graph, which tracks the mortality rate due to prostate cancer in the Hunter New England local health district. From 2007 to 2014, the last date on the graph, there was a 36.5 per cent reduction.
The Little Prick awareness campaign ran for about 18 months, costing about $400,000, predominantly from private sources.
“It does look rather like people, the general public, even perhaps ourselves, said, ‘Look, that’s it, we’ve done it now. So that’s it’,” Professor Denham says.
But it wasn’t. Professor Denham returns to the detection rate graph, to track the line from 2007 to 2014. His finger descends. In those seven years, there was a 35.4 per cent drop in the local health district.
“I’m certainly sorry and concerned,” Professor Denham says of that drop after the education campaign finished. ““It is disappointing that the Little Prick campaign seems to be the end of it, and things have lagged on since then.”
What adds to his concern is that while the health district experienced a drop in the mortality rate, Hunter New England has continued to rank among the highest in the state in that category.
In 2014, 150 men in the Hunter New England local health district died from the disease.
“I was hoping we’d get nearer to the Sydney groups, who have done better,” he says. “To see us not in that band with the Sydney groups was disappointing for me.”
Terry Wheeler, from the Hunter Prostate Cancer Support Group, believes the detection rate would have dropped even further since 2014, because awareness of the disease has slipped. He says he has noticed the number of requests for support group members to speak at clubs and organisations about prostate cancer awareness has dwindled in the past three or four years.
“The time is now to reach out to a new group of people,” Mr Wheeler says.
Professor Jim Denham says what’s needed is a new awareness campaign directed at local men, particularly those over 50. He believes the campaign would require “a real round-table performance”, with GPs and urologists, along with cancer support groups, contributing.
PSA testing has been at the centre of a long-running debate. Many doctors have questioned the test’s effectiveness, because it doesn’t necessarily indicate prostate cancer. There have also been concerns that tests could lead to over-treatment, potentially causing more harm to a man’s life than the disease itself.
Professor Denham says raising awareness and getting people talking is not enough; there has to be effective treatment. In many cases, he points out, patients who have slow-developing cancers require only to be regularly monitored.
He also believes there needs to be more than a one-off test; men should be encouraged to be tested every three to four years: “That would, I’d hope, pick up the men with the most advanced cancers over a decent period of time.”
He says while all of that has to be considered in setting up a program, the worth of PSA testing in the region is there in the figures.
“I think the mortality data in 2014, that drop in mortality, it’s difficult to argue with,” Professor Denham says.
As for funding a new campaign, Professor Denham says there is $80,000 from private sources that could go towards advertising.
Prostate cancer survivor Ron Bender believes the state and federal governments should also contribute to an education campaign, as it would lead to the saving of lives and money in health budgets.
The Hunter Prostate Cancer Support Group’s Terry Wheeler believes the campaign’s focus could be as simple as encouraging men, and their partners, to keep tabs on prostate health.
“Men have a real aversion to talking about prostate cancer,” he says. “Often the women will.”
“It’s so important to get the message out there. ‘Be aware of your prostate’ is the message right up front.”
As for a name for any new campaign, Professor Denham offers, “I think the round-table [group] should choose this. I would prefer something less tacky than the Little Prick campaign.”
Out on his small farm with the expansive view, Brendon Young reckons the theme from the earlier campaign should continue.
“Why don’t we rehash it?,” Mr Young says. “‘Oh No, Not That Prick Again!’. It’s back!”
Whatever the name, Brendon Young reckons a campaign is more important than ever, because the level of awareness among many men is “not good”.
“I think they are hiding behind this false barrier, ‘I’m OK’,” he says. “I think they’re scared because it could affect their sex life, but isn’t their life more important than that?”