Prostate cancer is often considered an old man’s disease, but it can strike much younger men, without any symptoms, as Paul Bain can testify.

Mr Bain, a Gulf War naval veteran living in the Queanbeyan area, was only 50 when he was diagnosed with prostate cancer. In 2020, shortly after his birthday, his wife encouraged him to see his GP for a check-up.

“I had never really needed to go to a doctor too often,” Mr Bain said. “I was reasonably lucky and in reasonably good shape; I always tried to exercise, etc. No problems to report.”

Two days later, his doctor called asking to see him: Mr Bain had an elevated level of PSA (prostate-specific antigen) in his blood.

“I wasn’t expecting that,” Mr Bain said. “I didn’t report with any symptoms [but] as it turned out, I had a very aggressive and high-grade cancer. That was a shock to the system.”

Mr Bain’s only treatment option was to have a radical prostatectomy. The surgery, he said, was “confronting”, and the side-effects related to continence and sexual function challenging. Four months later, Mr Bain endured eight weeks of radiotherapy. He was in remission, but the cancer never entirely left his system.

“Unfortunately, the PSA never dropped completely to zero,” Mr Bain said. “There was always the chance that something was going to rear its head at some point.”

Last year, Mr Bain’s PSA levels quadrupled, and the cancer spread to his ribs. He began another course of radiotherapy this week for a cancer spot on his ribs.

“It can be targeted fairly effectively … but the risk is always going to be there,” Mr Bain said. “At this point in time, it’s fair to say that it will probably never be cured, but it’s just going to be a matter of keeping the check-ups regular and then going after it if it rears its head again.”

Survivorship Toolkit released

What has helped, Mr Bain says, is a Survivorship Toolkit, an online web app released this week by the Prostate Cancer Foundation of Australia, the peak national body for the disease.

“This Toolkit is going to be so useful not only for people who have been diagnosed for the first time, but for repeat offenders,” Mr Bain said.

The Toolkit provides evidence-based information and advice, on risks and symptoms, testing and diagnosis, treatments and side-effects, advanced prostate cancer, and expert nursing services.

“Men often feel isolated when they are diagnosed with the disease,” PCFA CEO Anne Savage said. “Until now, the information has been hard to find in one place. Our Survivorship Toolkit will change that, becoming the first in Australia to be the single source of expert information to help men navigate their diagnosis and treatment.”

Mr Bain says the “incredible initiative” makes it easy for people to find information depending on their particular situation. It is accessible, clear, and concise.

“Just to have that information in one spot – it’s easy to decipher,” Mr Bain said. “You can track through some of your own scenario and then get all the relevant information, because there’s a lot of information out there which can be hard to get your head around, particularly if you’re not familiar with any of that stuff…

“It’s been really good for myself and my family to get a down-to-earth handle on what’s happening to me now. The doctors are brilliant, obviously … [but] quite often you don’t get that layman’s term level of information that you might need.”

‘Get checked – never think it can’t happen to you’

Prostate cancer is the most common cancer in Australia: one in five men will contract the disease. Conventionally, it is seen as “a stereotypical old man’s disease”, an ailment that people die with, not from, Mr Bain said.

But, although the average age at diagnosis is 70, prostate cancer is increasing in younger men: in the USA, for instance, 10 per cent of men newly diagnosed with it are under the age of 55. In Australia, Mr Bain said, men in their thirties and forties are dying from incurable prostate cancer. In rare cases, even teenagers can get it.

“You just do not realise how many men, young men, are impacted by this disease,” Mr Bain said.

He urges men to see their GP and get tested.

“Get checked – never think it can’t happen to you,” Mr Bain said. “It doesn’t have to be present in your family for you to be susceptible to it.”

There is, however, a genetic link between breast cancer and prostate cancer; men whose first-degree relatives had breast cancer have an 18 per cent increased risk of lethal prostate cancer, according to BMC Cancer.

“You don’t have to have symptoms to have prostate cancer,” Mr Bain said. “I’m a walking example of that. I had the most aggressive … and most dangerous … prostate cancer you could get, and zero symptoms. I would not have known I had it unless I was lucky enough to have a GP who randomly did the PSA test because of my age. I didn’t ask him to do it, didn’t know he was going to do it, so I was very lucky.

“If it happened to me like that, there are thousands of men that aren’t lucky enough to have found it when I did, or once they do, to have the support.”

Mr Bain urged every man in his age demographic, friends or family, to get tested. One friend did so – and, like Mr Bain, was diagnosed with aggressive prostate cancer, needing an emergency prostatectomy.

“All because I told him, you need to go and get a test after what he’d seen happen to me,” Mr Bain said. “He probably would not be with us today if that didn’t happen.”

The blood test, Mr Bain says, is easy to do, and a good indicator of one’s prostate health.

“It’s no different to any other pathology test you might have done,” Mr Bain said. “We do it all the time for our other bits and pieces: blood pressure, diabetes, cholesterol, and all that sort of thing. They just check the box on the end of the list, so it’s pretty easy.”

If the GP refuses to do the PSA test because the patient has no symptoms, Mr Bain urges him to see another doctor.

“Keep going until you find someone who will do it for you, because you can be asymptomatic,” Mr Bain said.

Since his first diagnosis, Mr Bain has worked with the Prostate Cancer Foundation of Australia to advocate for awareness of the disease. The PFCA, he says, does amazing work promoting awareness of the disease, and helping men with it. Mr Bain has helped them to author papers; raised money in the PCFA’s annual Long Run; and appeared in a campaign for men in country Australia.