“Men are living longer and the number one risk factor is age. So the longer men live, the more likely they are to develop prostate cancer.”
What are the signs and symptoms of prostate cancer?
The earlier it’s diagnosed, the better the chance of curing it, Duthie says. However, early prostate cancer is usually asymptomatic.
“That’s why PSA [prostate-specific antigen] testing is so important.
“If the cancer’s progressed to the stage where it’s causing bladder symptoms or pain in the bones, often that’s an indicator that the horse has bolted and you’ve missed your opportunity for a cure.”
Symptoms of prostate cancer may include the sudden need to urinate often, difficulty or pain when urinating, blood in the urine, bone pain or pain in the lower back, hips and thighs, as well as sudden weight loss.
As men age, many of these symptoms are common – and may indicate other, non-cancerous prostate conditions.
When should you get tested?
Duthie says men should get regular testing for prostate cancer from the age of 55, as it’s less common in younger men.
“If there is a family history [with] two or more close family members, the testing should start 10 years younger than the youngest person who had prostate cancer,” Duthie says.
For example, if a 47-year-old man has been diagnosed with the disease, his son should start getting tested from the age of 37.
Some medical professionals say PSA screening is ineffective, but Duthie says this is based on outdated data.
“We’ve got really good evidence that it’s effective.”
The PSA is a blood test which indicates whether there is a problem with your prostate – not necessarily cancer – and whether further testing is needed.
A prostate exam, or a DRE (digital rectal examination), won’t necessarily confirm whether or not you have cancer.
“That’s only a limited additional benefit on top of the blood test. So if men are a bit squeamish about having that done, it’s fine. They don’t have to have it,” Duthie says.
What causes prostate cancer – and can you reduce your risk?
About a dozen different genes have been associated with prostate cancer. That doesn’t mean if you have the gene you’re certain to get cancer, but it does increase your risk.
“One of those genes is the BRCA2 gene, which is the breast [and] ovarian cancer gene for women. In men, that can cause prostate cancer,” Duthie says.
“There’s an increased risk in the Māori population, in people of African descent. If you’ve got a family history of two close family members who’ve had it, your personal risk is up to 40%.”
However, most men diagnosed with the disease don’t have a family history of it.
“It’s just bad luck, because it’s so common.”
Heavy alcohol intake, smoking and obesity can increase your risk slightly.
Duthie says many older men with less aggressive prostate cancers are more likely to die of heart disease than of the cancer, and a heart-healthy lifestyle is also good for their prostate.
Evidence shows that for men who have recurring prostate cancer that’s no longer curable, diet can have an impact on their quality and length of life, he says.
“Those guys live longer and with a better quality of life if they have a diet that’s rich in leafy green vegetables – specifically the brassicas, broccoli, cauliflower, cabbage, silverbeet, Brussels sprouts – and if they exercise at least four times a week for at least half an hour.
“That’s good for everybody.”
What treatments are available in New Zealand?
Treatment options include surgery and radiation, or active surveillance for less aggressive cases.
“Surgery and radiation both have pros and cons, and it’s really something that has to be tailored to the individual,” Duthie says.
Advanced prostate cancers may require medical management with chemotherapy, hormone therapy or immunotherapy.
Diagnostic equipment, techniques and treatments are all getting better, Duthie says.
However, several of the effective drugs used to treat prostate cancer aren’t funded in New Zealand.
Last year, NZ First introduced a member’s bill to establish a prostate cancer screening programme.
Duthie says it’s “disappointing” that the Government did not allocate funding for this in the 2026 Budget announced in May.
“Not only was that going to be good for reducing the amount of harm that happens to these guys, it’s actually financially savvy. It makes good sense for a country, because it’s way cheaper to treat early prostate cancer than late-stage prostate cancer.”
Going to the GP not a sign of weakness
For some men, “it’s like a badge of honour to say, ‘I haven’t been to my GP in 10 years’,” Duthie says.
“It’s born out of fear, because men are terrified that they’re going to find out that they’re sick.”
Kiwi men can do everyone a favour by seeing their GP regularly and getting checked, he adds.
“It’s the same as car maintenance. It’s foolish to wait until it falls over.
“Get in early and things are treatable, curable [and] have much better outcomes. It’s much simpler treatment and it’s better for everybody.”
Bethany Reitsma is a lifestyle writer who has been with the NZ Herald since 2019. She specialises in all things health and wellbeing and is passionate about telling Kiwis’ real-life stories.