Improving the standard of care for men with prostate cancer


St Vincent’s Hospital Melbourne Prostate Awareness Nurses Molly Tretheway (left) and Gail Tzounos (right), with patient Leonard Lord (second from left) and Oncologist, Associate Professor Anthony Dowling (second from right).

Each year in Australia, more than 24,000 men are diagnosed with prostate cancer, making it the most commonly diagnosed cancer in the country.

St Vincent’s Hospital Melbourne (SVHM) is committed to supporting men at all stages of their prostate cancer journey with innovative treatments and holistic support.

Innovating to deliver novel treatment alternatives

Eight years ago, Leonard Lord, now 80, was diagnosed with metastatic prostate cancer. He came to St Vincent’s for his care, and medical oncologist Associate Professor Anthony Dowling provided him with a new treatment option.

“I invited Leonard to enrol in the Enzamet study, which is a large international clinical trial that investigated the then-current standard of care for prostate cancer treatment (androgen deprivation therapy (ADT)) compared with an alternative course of treatment that added a drug called enzalutamide,” A/Prof Dowling said.

The Enzamet study was led by the Australian and New Zealand Urogenital and Prostate Trials Group in collaboration with the NHMRC Clinical Trials Centre, and A/Prof Dowling is the primary investigator for SVHM.

The study showed extremely positive results.

“The men who received ADT and enzalutamide are living much longer than those who received ADT alone,” A/Prof Dowling said.

“Leonard has now been on enzalutamide for eight years. He is tolerating it well, and it is working spectacularly.

"The updated survival analysis, published recently in Lancet Oncology, after following these men for six years, showed a 30 per cent reduction in risk of death for the men who received ADT and enzalutamide. This translates into a 67 per cent chance of being alive after five years on the combination, compared with a 57 per cent chance for those who receive ADT alone.”


St Vincent’s Hospital patient, Leonard Lord and Oncologist, Associate Professor Anthony Dowling.

Improving patient outcomes

For Leonard, the treatment has been life-changing.

“In the early days, my prostate count went from about one or two to about 10 and then, in just a few months, to 62. I initially had radiation treatment, but it failed, so it was quite concerning,” Leonard said.

It was at this point that Leonard was referred to A/Prof Dowling, who is better known by his patients as Tony, for his care.

“Tony offered me the choice of going on a clinical trial or receiving a standard hormone treatment; I didn’t know what I should do, so I put the decision into Tony’s hands.

“He said ‘well, how would you like to go on a trial?’ and then, in just a short time, everything started to come down, it worked pretty well.”

Leonard continues to take the medication daily, and travels from his home in Woodstock to SVHM every three months.

“I try to be a good patient – during the eight years, I’ve only missed taking my medication once!

“I’m still here, and I’m thankful for that. I’ve got a few problems in my body, but who cares – as long as I’m still here."

A new standard of care for advanced prostate cancer patients

The Enzamet study, and similar trials, mean that using ADT with newer hormonal agents (such as enzalutamide) is the new standard of care for advanced prostate cancer patients.

In more positive news for patients, enzalutamide was listed on the Pharmaceutical Benefits Scheme (PBS) in August 2023, improving access to this life-changing treatment for men with newly diagnosed metastatic prostate cancer.

“Patients like Leonard have played in important role in history, changing how we treat advanced prostate cancer and achieving better patient outcomes,” said A/Prof Dowling.

“The improved patient outcomes could not have been achieved without the excellent work that SVHM’s Oncology clinical trial unit does.”

Leonard is equally delighted with this news.

“When Tony told me about the PBS listing, I was quite proud as there is real benefit there,” Leonard said.

“To go from having the cancer level I had, to getting it down to almost nothing in a couple of months was astounding – I amazed myself, and if I can help any one person get on the right track with their treatment and their life, that’s wonderful.

“If people are offered a trial opportunity, I’d say put your hands in people like Tony and his colleagues, and go for it.”

A holistic approach to care

In addition to offering patients access to novel therapies through clinical trials, SVHM ensures patients are supported at all stages of their prostate cancer care. This includes having two dedicated prostate cancer specialist nurses who support patients from diagnosis through to treatment and beyond.

Our prostate cancer nurses can be contacted at any stage, and the supportive nursing care service includes providing:

  • reliable information about diagnosis and treatment options
  • information, care and support to help manage the side effects of treatment
  • holistic, wellbeing support which aims to optimise our patients quality of life

To read more about clinical trials at SVHM, please visit our website.