Stage 1: Early Stage Prostate Cancer

Stage 1 prostate cancer means the cancer is small and contained entirely within the prostate. At this stage:

• The cancer cannot be felt during a digital rectal exam
• The cancer is microscopic and only found through a biopsy
• PSA levels are usually below 10 ng/mL
• The Gleason score is typically 6 or lower

Stage 1 prostate cancer is part of the "low-risk" category and has an excellent prognosis in New Zealand, with many treatment options available.

In New Zealand, most Stage 1 prostate cancers are detected through PSA blood tests, followed by either transperineal or transrectal biopsies. Transperineal biopsy (where the needle passes through the skin between the scrotum and rectum) is now the preferred method in New Zealand due to lower risk of complications.

Understanding Stage 1 Diagnosis for Māori Men

Being diagnosed with Stage 1 prostate cancer can be a challenging time for Māori men and their whānau. At this stage, the cancer is confined to the prostate and is generally considered highly treatable. However, research shows that Māori men are less likely to be diagnosed at this early stage compared to non-Māori.

Treatment Considerations

When considering treatment options for Stage 1 prostate cancer, Māori men may wish to incorporate traditional healing approaches alongside Western medical treatments:

• Discussing treatment impacts on all aspects of hauora (wellbeing) with your healthcare team
• Considering how treatments might affect your role within whānau and community
• Understanding the balance between immediate treatment and active surveillance
• Exploring how rongoā Māori (traditional medicine) might complement medical treatments

Cultural Support During Treatment

The concept of manaakitanga (showing respect and care) is important during cancer treatment. Ways to incorporate cultural support include:

• Bringing whānau members to appointments for support and to help understand medical information
• Requesting a Māori health navigator through your DHB or cancer treatment center
• Asking for cultural support or access to a kaumātua (elder) at your treatment facility
• Discussing with your doctor how treatment schedules can accommodate cultural obligations

Addressing Barriers to Care

Some barriers that Māori men might face when dealing with Stage 1 prostate cancer include:

• Geographic distance from treatment centers, particularly for those in rural communities
• Financial considerations, including work absences and travel costs
• Communication challenges with medical teams who may not understand cultural contexts
• Discomfort with discussing intimate health concerns

Many hospitals now offer Māori health liaison services to help address these barriers.

Resources Specific to Māori Men with Stage 1 Prostate Cancer

• Te Whatu Ora (Health New Zealand) - Information on Māori health equity
• Hei Āhuru Mōwai - Māori Cancer Leadership Aotearoa - Advocacy and support for Māori cancer patients
• Health Navigator NZ - Resources for Māori men with prostate cancer

"He aha te mea nui o te ao? He tangata, he tangata, he tangata."
What is the most important thing in the world? It is people, it is people, it is people.

Remember that maintaining connections with whānau and community is an important part of the healing journey. Early-stage prostate cancer treatment offers excellent chances for full recovery, and with proper support, most Māori men can expect to return to normal activities.

Talking with Whānau About Your Diagnosis

For many Māori men, discussing prostate cancer with whānau can be challenging but important. Consider:

• Choosing a trusted family member to help share information with the wider whānau
• Using straightforward language and explaining what Stage 1 means (early and treatable)
• Discussing how whānau can practically support you during treatment
• Encouraging male whānau members over 50 to consider their own prostate health

Active Surveillance

For most Stage 1 patients in New Zealand, doctors recommend active surveillance rather than immediate treatment. This involves:

• Regular PSA tests (every 3-6 months)
• Digital rectal exams (every 6-12 months)
• Repeat biopsies (usually every 1-3 years)

Data from New Zealand shows that 80% of low-risk patients are managed with active surveillance, which has increased from 66% in recent years as evidence shows this approach is safe and effective.

Radical Prostatectomy

Surgical removal of the entire prostate gland and some surrounding tissue. In New Zealand, this may be performed as:

• Open surgery
• Laparoscopic surgery
• Robotic-assisted surgery (available at some hospitals)

Radiation Therapy

The Canterbury Regional Cancer and Haematology Service and other cancer centers in New Zealand provide radiation therapy options including:

• External beam radiation therapy (EBRT)
• Brachytherapy (internal radiation)

For low-risk prostate cancer in New Zealand, radiation therapy alone (without hormone therapy) is used in approximately 16% of cases.

All treatments may have side effects. Based on data from New Zealand patients one year after treatment:

Active Surveillance Side Effects

• Generally minimal physical side effects
• Some patients (7%) report feeling depressed
• Some patients (12%) report lack of energy
• Approximately 8% report urinary function as a problem
• Sexual function concerns affect about 24% of patients

Surgery Side Effects

• About 31% require more than one urinary pad per day
• Around 45% report sexual function as a problem
• About 10% report feeling depressed
• Approximately 13% report lack of energy

Radiation Therapy Side Effects

• About 7% report bowel issues as a problem
• Around 9% report urinary function as a problem
• About 34% report sexual function as a problem
• Approximately 18% report lack of energy

The Canterbury Regional Cancer and Haematology Service and other cancer centers in New Zealand provide comprehensive support for managing these side effects.

New Zealand offers various support services for prostate cancer patients:

• Cancer Society New Zealand: Located on hospital campuses with information resources and support services
• Prostate Cancer Foundation NZ: Provides support groups throughout New Zealand
• District Health Board Services: Including dietitians, social workers, occupational therapists, and psychological support
• Local Support Groups: Available in most regions of New Zealand. You can find them here

Financial assistance may be available through Work and Income New Zealand and the National Travel Assistance programme for those who need to travel for treatment.

Reliable New Zealand-specific resources for Stage 1 prostate cancer:

• Ministry of Health
• Canterbury Regional Cancer and Haematology Service
• Cancer Society of New Zealand
• Prostate Cancer Foundation NZ
• HealthInfo Canterbury - For Canterbury-specific health information

Can I drive during treatment?

In most cases, you can drive yourself to and from treatment appointments. However, it's useful to bring someone to your first treatment appointment for support.

Should I restrict my activities or diet?

As long as you feel capable, it's OK to continue with normal activities and diet. You may become more tired than usual, so it's important to look after yourself and avoid excessive tiredness and stress.

Should I continue to take my regular medications?

Please check with your oncology team about any medications you're taking. It's helpful to bring a list of all medications to your appointments.

Can I have immunisations while receiving treatment?

It is safe to have the flu vaccine while on treatment. The shingles vaccine (Zostavax) is a live vaccine and should NOT be given while receiving treatment.

Can I visit my dentist while receiving treatment?

It's important to maintain good oral health. Ideally, any dental problems should be addressed before starting treatment. If you develop problems during treatment, you can still have dental treatment, but timing should be discussed with your oncology specialist.