Northern Beaches Hospital experts, Urologist Dr Matthew Winter and Psychiatrist Dr Ranil Gunewardene have a crucial message- prioritising mental and physical health, including regular prostate checks, is imperative for men’s overall well-being.
Northern Beaches Hospital has one of the most unique Mental Health Services in Sydney. It offers comprehensive inpatient and outpatient mental services and a range of sub-specialty services—both public and private—on the same site.
Dr Gunewardene was instrumental in establishing the department in 2018, ensuring that it encompasses adult, adolescent and child mental health issues, including anxiety, depression, substance dependence, addictions, ADHD, counselling, and the trialling of world-first treatments.
While most private in and outpatient care and day programs at Northern Beaches Hospital are covered by private healthcare, Medicare also subsidises treatments and counselling.
Northern Beaches Hospital’s Dr Matthew Winter specialises in advanced urological oncology
Sydney Urological Care – NBH Dr Matthew Winter
Prostate cancer is the most common cancer among Australian men, with the average age of diagnosis at 70, and one in six males diagnosed by the time they are 85.
Northern Beaches Hospital’s Dr Matthew Winter, specialist Urological Surgeon, stresses the importance of regular screenings to significantly increase the chances of successful treatment.
“Many men may feel uncomfortable or embarrassed about discussing prostate health, but it’s essential to overcome these barriers,” he says.
Dr Winter completed urological training in Sydney, including an Australian Fellowship, and then undertook an additional two-year fellowship in Advanced Robotic Urological Oncology at the Institute of Urology, University of Southern California (USC) in Los Angeles.
“Detecting prostate cancer in its early stages drastically improves treatment outcomes and can save lives.”
There, he specialised in advanced urological oncology, including laparoscopic and open surgery, with a treatment focus on robotic surgery.
When You Should See A Urologist
- Trouble urinating or decreased force of stream
- Blood in the urine or semen
- Bone pain and swelling in the lower extremities, especially when accompanied by urinary, erectile or ejaculation dysfunction.
- Unexpected weight loss
- Unexplained fevers
Prostate cancer is generally an asymptomatic condition, with men realising too late that they have it, as they have no symptoms in the early stages.
“The only way it can be picked up is with a clinical history, an increased PSA via a prostate specific antigen (PSA) test or via a digital rectal examination or an MRI,” he states.
Dr Winter says men who are motivated to know about their health, particularly with a family history of prostate cancer or BRCA mutations [a genetic test that shows increased risk of prostate cancer] should be getting a PSA.
“It could be early as 40 or as late as 50, but they should be having that conversation with their GP to check they have a baseline PSA at 40,” he says. “And if the PSA or symptomatic issues are concerning, the GP will activate a referral to a urologist.
“A concerning PSA or symptoms doesn’t always mean cancer; however, symptoms should always be checked out.”
Gold Standard in Prostate Surgery
Dr Winter provides minimally invasive robotic surgery for all urological cancers. He offers Focal Interstitial Laser Treatment for prostate cancer and all forms of endoscopic treatments for kidney stones and enlarged prostate glands.
He also carries out TURP, laser prostatectomy and robotic simple prostatectomy.
“The robot can be used to treat a benign enlarged prostate gland,” he says. “Historically, when someone’s prostate is enlarged, the most common way to reduce it surgically was by going through the eye of the penis to shave it away.
For very large prostate glands, I now do a robotic simple prostatectomy. This is keyhole surgery to remove the inside of the prostate.
“It’s the gold standard for treating very enlarged prostates and is a relatively new operation.
If someone is young with cancer severe enough to treat and they are expected to live for more than 15 years, I would advocate doing a robotic radical prostatectomy or consider radiotherapy.
“It’s a routine procedure, and I do about 150 robotic cases a year. Continence and sexual function can be preserved in the right patient with the right cancer.”
Dr Winter also uses focal laser, a new experimental treatment gaining traction around the world. It’s a minimally invasive procedure that inserts a laser into the prostate and burns the cancer from the inside. It is a day procedure with minimal to no complications.
Dr Winter says men are often hesitant to see a specialist in case there’s a knock-on effect, especially when it comes to sexual function, explaining that “urological conditions can severely affect your quality of life.
“There’s a big issue in society today because, as well as prostate issues, a lot of men are suffering from low testosterone.
“They’re suffering in silence and our focus is now on finding these men who have lost their zest for life, lost their erectile function, or lost their libido due to a deficiency in testosterone and treating them.
“There are all kinds of treatments available, including being treated for low testosterone with simple daily application of cream, similar to the hormones women take for menopause.
“They’re revolutionary.”
During Men’s Health Month, the message is clear: taking care means prioritising both physical and mental health by scheduling regular check-ups and seeking support for mental health concerns. By doing so, our Northern Beaches men can lead healthier, happier lives!
Mental Health Matters
Mental health is an issue on the Northern Beaches – one out of every 8 Australian men will experience depression, and one in 5 will experience anxiety at some stage in their life.
Associate Professor Dr Ranil Gunewardene, Director of Mental Health Services at Northern Beaches Hospital, says addressing mental health concerns early can prevent them escalating into more significant problems.
“As a result of social and cultural conditioning men tend to bottle things up because of the perceived stigma,” he says, “Anyone can have a difficult period or struggle to adjust to something, but if difficulties are lasting more than a few weeks and it’s unlikely to shift, they should seek help before it becomes more severe.”
Depression, anxiety, and other mental health disorders can profoundly impact various aspects of a man’s life, including relationships, work performance, and physical health. By seeking support from mental health professionals, Dr Gunewardene says men can learn effective coping strategies and improve their quality of life.
Associate Professor Dr Ranil Gunewardene is Director of Mental Health Services at Northern Beaches Hospital.