Prostate cancer is the most commonly diagnosed cancer among males in New Zealand yet it can go largely undetected in its early stages. It’s the third highest cause of cancer death among men here. And with one in every 10 Kiwi men likely to develop prostate cancer at some point in their lives – some studies suggest the odds are even higher, at one in eight – we need to start paying attention and accessing early screening and treatment.
The causes of this kind of cancer are uncertain. What we do know is that genetics may play a role, and early detection can be key to successful treatment. But there’s a reason our rates of prostate cancer are so high – there are a number of barriers to cancer care, including cost and access. The cost of cancer drugs can be prohibitive in New Zealand, and the waiting lists for surgery and some forms of diagnostics are very long if you can’t afford to go private.
Learn more about different types of insurance from a licenced financial adviser and see what's best for your circumstances.
Health | Life | Trauma | Total and Permanent Disability | Income Protection
Source: Harold Taitt (American Journal of Men’s Health, 2018). ‘Prostate cancer incidence and mortality rates by geographical area.’ Retrieved June 15, 2022, from researchgate.net.
We look at the symptoms, diagnosis and treatment of prostate cancer in New Zealand, and what you can do to prepare for an unwelcome medical expense, or the cost of ongoing care.
What is prostate cancer?
Prostate cancer develops when abnormal cells start to grow in the prostate, a walnut-shaped gland (normally about 4cm across but increasing in size with age) located below the bladder in men, or people who were born male.
The degree of concern doctors may have about any abnormal cell growth in the prostate depends on whether the growth is found to be benign or malignant.
Benign growths
Benign cell growths are not cancerous and don’t affect the lymph nodes or tissues around them. They don’t have any adverse effects on the rest of the body and, once treated successfully, do not usually grow back.
Malignant growths
Malignant growths are cancerous tumours and could be life-threatening. This type of cell has a tendency to spread to other parts of the body and affect surrounding tissues or organs.
Prostate cancer signs and symptoms
Prostate cancer can go undetected for a long time because symptoms are often not severe or noticeable, particularly in the early stages.
The most common signs of prostate cancer are:
- Blood in urine and/or semen
- Frequent need to urinate
- Pain or discomfort while urinating
- Pain while ejaculating
- Pain or discomfort in the lower back
- Loss of appetite
- Unexplained or gradual weight loss
- Unexplained pain in bones
The most important symptom is blood in urine or semen, which should be reported to a doctor as soon as possible.
Prostate cancer causes
Although studies have not determined one significant cause of prostate cancer, we do know that certain factors may increase the chances of contracting it.
FAMILY HISTORY
Compared to those without a family history of the disease, men are two times as likely to contract prostate cancer if a first blood relative (sibling, parent or child) also suffered from the same disease. And if the family incidence is higher, the risks increase – men with more than one first-order relative have a five to 11 times greater chance of contracting prostate cancer.
Age
Studies show that men aged 50 and above are more likely to be diagnosed with prostate cancer.
Lifestyle
Smoking and carrying excess weight are two factors associated with increased occurrences of prostate cancer. Diet and exercise choices may also play an important part in minimising risks and maximising the rate of recovery.
Testing and diagnosis
There are two main diagnostic methods used to screen for prostate cancer: a blood test and a manual examination.
1. Prostate-Specific Antigen (PSA) testing
The level of certain antigens present in the blood is measured to determine the possibility of cancer. If the PSA level is higher than the normal range, it could be due to the following three factors:
- Prostate gland infection
- Enlarged prostate (non-cancerous growth)
- Prostate cancer
2. Digital Rectal Examination (DRE)
The DRE method is when a doctor examines the prostate gland by inserting a lubricated and gloved finger in the rectum. The presence of unexpected lumps may indicate prostate cancer.
It is important to note that these methods are not the only tools used for diagnosis. If doctors find abnormalities during these initial examinations they may suggest further testing such as an MRI scan, CT scan or biopsy.
Prostate cancer in New Zealand
Statistical overview
Prostate cancer is the third most common cause of cancer death for men in New Zealand, behind lung cancer and bowel cancer (some surveys rank prostate cancer even higher – beating out bowel cancer to take second place in the statistics). In 2020 nearly 4,000 people across the country were diagnosed with prostate cancer and around 750 died from it.
Below, you can see some alarming prostate cancer trends observed in New Zealand over previous decades.
Prostate cancer new registrations and deaths
Source: NZ Ministry of Health. ‘Cancer: Historical summary 1948–2018.’ Published 10 December 2021. health.govt.nz
Source: NZ Ministry of Health. ‘Cancer in New Zealand: Trends and Projections ’ Retrieved June 15, 2022, from moh.govt.nz.
Treatment of prostate cancer
Radiation therapy
This therapy uses radiation to kill or reduce the pace of growth of cancer cells. Although this treatment can produce great results when prostate cancer is detected at an early stage, it can also cause some unwelcome side effects that require ongoing management, including incontinence and urinary or bowel problems.
Surgery
Surgery is another way to treat prostate cancer. The two most common surgical procedures are:
- TransUrethral Resection of the Prostate (TURP) is a procedure to treat blockages in the prostate gland by removing excess tissue.
- Radical Prostatectomy is a procedure to remove the prostate gland if the cancer is confined within the prostate and has not spread to surrounding tissues.
Side effects of these surgeries may include difficulty in urinating, erectile dysfunction or infection.
Chemotherapy
Chemotherapy, or ‘chemo’, is a treatment option that uses drugs to destroy cancer cells. Doctors may recommend this option for patients in both early or advanced stages of prostate cancer.
Typical chemotherapy side effects include fatigue, hair loss, frequent indigestion, diarrhoea, and more.
Hormone therapy
Also known as androgen deprivation therapy (ADT), this treatment method uses drugs to either block or reduce male sex hormones that cause cancer.
Active surveillance
Although active surveillance doesn’t directly treat prostate cancer, it monitors the growth of cancer cells through PSA, DREs and biopsies. Active surveillance is considered an important step as it helps doctors suggest further treatment options.
Cost of prostate cancer drugs in New Zealand
Non-funded medications are those that don’t receive public funding from the Ministry of Health, and as a result can be unaffordable for many patients.
Here are some of the most expensive non-PHARMAC funded drugs that are approved for use in the treatment of prostate cancer, and their prices in NZD per treatment cycle:
The cost of related treatments and procedures is also very high, as illustrated below:
-
Darolutamide $16,883 (2 to 3 weeks)
-
Cabazitaxel $21,253 (every 3 weeks)
-
Leuprolide Acetate $14,570 (per month)
-
Abiraterone Acetate $9,652 (per month)
-
Nilutamide $6,027 (per month)
-
Abiraterone $16,051 (per month)
-
Erleada $22,885 (per month)
-
Darolutamide $20,732 (per month)
-
Enzalutamide $21,994 (per month)
The cost of related treatments and procedures is also very high, as illustrated below:
-
Radiotherapy: Up to $55,000
-
Robot-assisted surgery: Up to $35,000
-
Brachytherapy: Up to $26,000
-
Cryotherapy: Up to $25,000
-
Open radical: Up to $16,000
Financial impact
Prostate cancer remains one of the most common cancer types in New Zealand. The ability to access suitable healthcare facilities, testing, diagnosis and treatment can make a huge difference in the overall journey for prostate cancer patients.
The recorded number of prostate cancer patients has increased in New Zealand in recent years, mainly due to higher testing or screening rates. On the flip side, the death rate has decreased thanks to better healthcare facilities and early diagnosis.
Living with prostate cancer
In New Zealand, 95% of men diagnosed with prostate cancer are expected to live at least five years after detection, and 91% are expected to live at least 10 years.
Impact on emotional wellbeing
Prostate cancer diagnosis, treatment and post-treatment can have a significant impact on emotional or mental health. Anxiety, depression, sleep disorders, eating disorders and nausea are some of the most common side effects observed in men with prostate cancer.
Men who have their prostate cancer cured might continue to experience stress and anxiety due to the fear of cancer coming back.
Health insurance coverage in New Zealand
Having the right type of insurance coverage at the right time can be a huge help if you’re at risk of developing any kind of cancer.
Here are some of the benefits that you can get with health insurance:
- Shorter waiting lists
- Access to better treatment
- Private hospitalisation
- Access to non-funded drugs and medication
Policywise’s advisers can compare different health insurance policies to find the best one for your current level of need – so you can access the private hospital system without tapping into savings or raising funds some other way, and reduce the amount of time spent on waiting lists.
Book your consultation with us today to get expert advice on the right health insurance coverage for you.
Disclaimer: This article is for general information only. Nothing in this blog or on this website is intended as medical, dietary, or financial advice. Although we aim to update our content regularly, you are advised to consult a Policywise adviser, health professional, or an appropriate specialist before acting on any information herein. They can factor in your personal circumstances or preferences and help guide your decision-making process.