In a column in The Weekend Australian earlier this month, the former Queensland Premier Peter Beattie described his personal experience of being screened for prostate cancer and encouraged other men to get tested.
“The real challenge is to get men to be tested,” he wrote.
The article concluded with the rallying call:
“As I get older I hate the thought of getting prostate cancer. But I know my annual check-up, notwithstanding the affront to my dignity of the digital rectal examination, enables me to manage my fears and early detection can be the difference between life and death. It is an easy choice really.”
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Actually, it’s not an easy choice at all, and someone in Beattie’s position, of influence and with access to high quality information, should know better than to reduce such a complex health decision to a simplistic punch line.
For the sake of balance, and to give readers some idea of the complexities that men need to consider when deciding whether to be screened for prostate cancer, posted at Croakey is an edited transcript of remarks made by health broadcaster Dr Norman Swan at the recent launch of this book, Let sleeping dogs lie? What men should know before getting tested for prostate cancer (which is freely available here.)
My perception of Norman Swan is as someone who is careful with his words, as you’d expect from a broadcaster, especially one who is forensic in his investigations of the evidence base of health care. He is not prone to hyperbole or dramatisation.
In my view, this makes his comments — suggesting that prostate cancer screening has led to “mutilating men unnecessarily” and as “a really dark moment in the history of medicine” — even more significant.
Swan also said that the good urologists are changing their practice, to be much more conservative, and stressed that men should think very carefully about the potential ramifications of having a PSA test — “… because once you have this test, you’re on the bus and it’s very hard to get off the bus”.
You can download his full remarks here.
Beattie repeatedly mentioned federal Treasurer Wayne Swan, who has been a prominent advocate for prostate cancer testing since his own treatment for the cancer.
Some years ago, Swan horrified many when he launched a vicious personal attack on former Cancer Council Australia CEO Professor Alan Coates, who had said he wouldn’t personally have a PSA test, questioned the evidence base for prostate cancer screening, and encouraged men to get informed and make up their own minds.
“What Professor Coates just said is absolutely outrageous and rejected by 95% of urologists in this country and for that he ought to be removed from his current position because what he’s advocating is ignorance, not information. And what he will do, if that succeeds, is condemn many young men in this country to death.”
One of the new book’s authors, the University of Sydney’s Professor Simon Chapman, told its launch that Swan’s attack on Coates was one of the reasons he and his colleagues decided to do their book.
The country owes Coates “an enormous debt” for putting the issue of prostate cancer screening on the agenda for debate, Chapman added. Coates was present at the launch, and received a round of applause from the crowd.
Before high-profile figures such as Beattie hit the public stage pushing prostate cancer screening, they could do worse than read the book.
Or have a quiet word with Swan — not Wayne, but Dr Norman.
*Declaration: Melissa Sweet has an honorary appointment at the University of Sydney and is co-author, with Ray Moynihan, of a book, Ten Questions You Must Ask Your Doctor, that encourages patients to ask plenty of questions about PSA screening in particular, and screening in general.