Understanding Prostate Cancer and the Importance of Early Screening

Prostate cancer is the most commonly diagnosed cancer among Australian men, accounting for around one in five of all new male cancer diagnoses. Despite being highly treatable when caught early, many men — particularly those from Aboriginal and African backgrounds — are diagnosed at later stages when treatment is more complex and outcomes are less certain. Understanding the disease and the importance of early detection can be life-saving.

1. What is the Prostate and What Does it Do?

The prostate is a small walnut-shaped gland located below the bladder and in front of the rectum in men. Its primary function is to produce seminal fluid, which nourishes and transports sperm. As men age, the prostate naturally grows larger. This is normal, but in some cases, abnormal cell growth can lead to prostate cancer.

2. Who is at Risk?

2.1  Age

Prostate cancer is rare in men under 50 but becomes increasingly common with age. The majority of cases are diagnosed in men over 65. Men over 50 should discuss screening with their GP, and men over 45 with a family history should consider earlier screening.

2.2  Family History

Men who have a father, brother, or son diagnosed with prostate cancer have a significantly higher risk of developing the disease themselves. Men with a family history of breast cancer — particularly BRCA gene mutations — are also at elevated risk.

2.3  African and First Nations Men

Research internationally has shown that men of African descent have a higher incidence of prostate cancer and tend to be diagnosed at younger ages and with more aggressive forms of the disease. In Australia, Aboriginal and Torres Strait Islander men have lower screening rates and higher mortality from prostate cancer, reflecting the broader health inequities facing First Nations communities.

Cultural factors play a significant role. In many African and Aboriginal cultures, discussions about men's reproductive health are considered private or taboo, making it difficult to raise concerns with a healthcare provider or to participate in screening programs.

3. Symptoms to Look Out For

Early prostate cancer often causes no symptoms at all. When symptoms do appear, they may include difficulty starting or stopping urination, a weak or interrupted urine flow, frequent urination particularly at night, blood in the urine or semen, pain or burning during urination, and pain in the lower back, hips, or pelvis.

These symptoms can also be caused by non-cancerous conditions such as an enlarged prostate or prostate infection, so it is important not to panic but equally important not to ignore them. See a GP as soon as possible.

4. Screening and Diagnosis

4.1  The PSA Test

The Prostate Specific Antigen (PSA) blood test measures the level of PSA in the blood. Elevated PSA levels can indicate prostate cancer, but can also be caused by a benign enlarged prostate or prostatitis. A high PSA result does not confirm cancer — further investigation including a biopsy is required for diagnosis.

Australia does not have a national prostate cancer screening program. Instead, it is recommended that men discuss the benefits and limitations of PSA testing with their GP, taking into account their individual risk factors.

4.2  Digital Rectal Examination

A digital rectal examination (DRE) allows a doctor to feel the prostate for any abnormalities. While this examination can feel uncomfortable or embarrassing for some men, it is brief, painless, and can detect abnormalities that the PSA test may miss. Men are encouraged to overcome any discomfort and discuss this option with their GP.

5. Treatment Options

Treatment for prostate cancer depends on the stage and aggressiveness of the cancer, as well as the patient's age, overall health, and personal preferences. Options include active surveillance for slow-growing cancers, surgery to remove the prostate, radiation therapy, hormone therapy, and chemotherapy for advanced cancer.

Many men with early-stage prostate cancer can be effectively treated and go on to live full and healthy lives. This is why early detection is so critical.

6. Breaking the Silence in Our Communities

For African and Aboriginal men, talking about prostate health can feel culturally difficult. But silence costs lives. Community health champions, peer educators, and culturally safe healthcare settings can help break down the barriers that prevent men from seeking screening and care.