David was a keen runner when back pain led to an unexpected diagnosis at 53

David Southward was a keen long distance runner when he started to experience back pain towards the end of 2022.

"I started getting pain in my lower back, right hip and the upper right thigh," Southward told 9honey.

"I was a runner. I had done a few marathons, some 50km ultramarathons and lots of half marathons, and I had had a previous back injury so I thought it was that."

Southward, then 53, of Brisbane, saw a physiotherapist but put off seeing a doctor until January 2023. The GP was concerned enough to order tests, including a prostate specific antigen (PSA) test.

When Southward received a text from the GP clinic asking him to book a follow-up appointment, he 'procrastinated', waiting weeks until a receptionist called and asked him to come in.

There he was told his PSA level was 27 – nine times what is considered normal, according to Cancer Council NSW.

Suspecting he could have either prostate cancer or an infection, he was referred to a urologist who ordered more tests, including an MRI, which showed a mass in his prostate.

A biopsy and bone scans were ordered before Southward and his partner Bron returned to see the urologist.

"All the referrals said 'positive for cancer' so I had prepared myself that I might have to have my prostate out," Southward recalled.

Instead, he was told in March 2023 he had an aggressive form of stage four prostate cancer that had metastasised to his bones.

"It had spread to my pelvic bone and spine and a little bit in my ribs, and was also around my urethra," Southward said.

"It was definitely a shock."

The couple made it to the carpark before bursting into tears.

That day, Southward called his adult son to break the news. He in turn offered to tell Southward's daughter, who was overseas.

Southward was referred to a team of specialists to come up with a treatment plan. Luckily, scans had shown no cancer in his lungs or brain.

He began an intensive course of daily radiotherapy for a week to treat the by-then severe bone pain.

He then embarked on six rounds of chemotherapy delivered every three weeks.

At the same time, he started hormone therapy in a bid to reduce the testosterone in his body.

At the end of his course of chemotherapy, he underwent more tests.

"My scans showed there had been a reduction in activity and no new cancers, [although] it did not get rid of anything, but they saw some shrinkage," Southward said.

Plans to undergo more radiotherapy were put on hold, with Southward instead starting on another type of hormone therapy.

He now has six-monthly injections of one drug and takes two tablets twice a day of another.

With the cancer not contained to the prostate, it was decided there was no need to remove his prostate.

Southward, now 55, is living with stage four cancer and the side effects of medication, including reduced bone density, but counts himself lucky to be alive.

He did not ask doctors about his long-term prognosis, or the five-year survival rate for men with stage four prostate cancer.

Instead, he is focusing on the positives. Southward was able to resume running while undergoing chemo.

He was searching the internet soon after his diagnosis when he came across the Prostate Cancer Foundation of Australia (PCFA) website and its The Long Run event, which asks people to walk, ride or run 72km during September to raise money and awareness of prostate cancer.

"I saw The Long Run and thought, 'That is something I can do'," he said.

"I ended up running 100km and raising $3330."

He competed in the event again in 2024, raising more money.

He also joined the PCFA Life Force Program, which raises awareness of prostate cancer in workplaces and communities across Australia, and prompts men to take better care of their health.

"I hate public speaking but I thought I could give something back," Southward said.

"In 2024, I did six presentations at Men's Sheds, the Salvation Army and in workplaces."

He is also a member of a support group. There he met a man in his 40s who was recently diagnosed with prostate cancer.

Southward said he had been told more younger men were being diagnosed with the disease.

Southward said he did not have a GP prior to his diagnosis and never had regular check-ups.

He had one PSA test when he was 49 after experiencing what were now thought to be symptoms of prostate cancer, but it came back normal, however, he had not had another one until his diagnosis.

"I just think men should get regular check-ups and make sure they get their PSA test," he said.

"And if you are having any symptoms like going to the toilet more frequently or if you have a family history, get it checked."

Prostate cancer facts

Prostate Cancer Foundation of Australia (PCFA) is raising awareness of the disease that claimed almost 4000 Australian lives in 2024.

PCFA says prostate cancer is now the most commonly diagnosed cancer in Australia, accounting for 16 per cent of all cancer diagnoses.

An estimated 26,368 Australian men were diagnosed with prostate cancer in 2024. Prostate cancer now accounts for almost one-in-three cancers affecting men.

Each day in Australia about 70 new cases are detected and 11 men will die of the disease.

The foundation is urging men over 40 to speak to their GP about getting a PSA blood test, which can indicate prostate cancer early.

Cancer Council NSW says prostate cancer rarely causes symptoms in its early stages and even those with advanced cases may have no symptoms.

"Difficulty passing urine is not always a symptom of prostate cancer, but you should see your doctor if you are worried or the following symptoms are ongoing," it said.

Symptoms include:

• frequent or sudden need to urinate
• blood in the urine or semen
• a slow flow of urine
• needing to get up at night to pass urine
• feeling like your bladder is not empty after passing urine
• unexplained weight loss
• pain in bones, e.g. the neck, back, hips or pelvis

You can learn more about prostate cancer here or the foundation here