Dr Kerryn Phelps, Health Editor, Channel 9 'Today'

MOORE: Let's start with the female half of the audience first. The Veda Scope, proving to be the way of the future?

PHELPS: Well, I think that one of the problems that this invention was trying to address was the discomfort that some women feel when they have to go and have a pap smear done. And, unfortunately, I don't think that the invention, having done the training course myself, really addresses those particular concerns. And when they talk about more comfort and less invasive, I think we actually have to look at what the machine does and why it's in any way different to the standard pap smear that we have now. As you can see there, there's a light source attached to a disposable speculum at the front, and that's the disposable part of the speculum there, and that part there that's inserted. In order to do a pap smear, you have to actually load the brush for the pap smear backwards, like so. Insert this, and then air is pumped into the vagina, and one of the problems is that air has to also escape, and so you can get noise that sounds a bit like a farting noise, which can be quite loud.

MOORE: Doesn't help with the embarrassment stakes, does it?

PHELPS: I don't think it helps a lot at all, no. And the other problem is, if you need to look, if you look at the cervix, and say "there is some sign of infection, we need to do a swab", you have to remove this in any case, and then use a standard speculum. And of course, much more commonly these days, are disposable plastic speculums. Very small. You can see that the profile of them is really not much greater than with the Veda Scope one. And I think patients will find these, used by doctors experienced in women's health, would find that there is a reasonable comfort level. And once you've got a view of the cervix, you can also quite easily manipulate the equipment that you need to use. Pathologists are telling me that they actually get a better cell sample with this method than the other method.

MOORE: A lot of the publicity about the Veda Scope is about being more comfortable, the whole aim being to get more women to go for more regular pap smears. I mean, the mere fact that it's portraying the traditional methods as not being a pleasant experience I wouldn't imagine would be particularly helpful for the campaign for regular checks.

PHELPS: I think that the problem with pap smears for many women is the perceived threat to their privacy. Now, that's going to happen with either method, and I think a lot of it is in the technique, and experience of the doctor who is doing the test. So, I would be getting patients to ask whether their doctors use plastic, disposable speculums, not necessarily expecting that a Veda Scope will give them any sort of great benefits, and the doctor will explain to them what the pros and cons of each method might be. And I think the main thing is that women do turn up regularly, every second year, for their pap smear to detect signs of early cervical cancer, so that they can be treated while it is still very much a curable disease. That's the bottom line.

MOORE: Do we have any numbers on how many women are, I mean, I know that there are registries in some states, but is the message getting through?

PHELPS: We still have a lot of women who aren't turning up regularly for their pap smears. They might have one, and then they sort of leave it go for a long time. There are still far too many Australian women, in certain types of ethnic groups for example, who are not turning up for pap smears for different sorts of reasons. And I think that we do need to actually address those reasons, and try and overcome those. I don't think that the type of equipment the doctor uses is necessarily going to be the real factor. One of the things that has concerned me about this advertising campaign, direct to patients, is that patients are, number one, have an expectation that there is something magical about this new machine. And, secondly, that there is something so dreadful about the way that it's being done by the majority of doctors that they wouldn't want to have it done, and it may well even turn people off. And I think that it's very important that women don't get turned off having their pap smears.

MOORE: We'll look at the other half of our audience now. There has been some recent studies about what people know, what people think, about prostate cancer. I find it quite extraordinary that there is an enormous amount of misconception, isn't there?

PHELPS: There are a lot of misconceptions about prostate cancer, and there has also been an international debate, about whether screening for prostate cancer, and that is detecting cancer before it has too much in the way of symptoms, is a valuable exercise or not. And, in fact, in many cases, the governments are still saying "well, we are not so sure about population screening", but certainly on an individual basis, the American Cancer Society is recommending that men aged between 50 and 70 do talk to their doctors about prostate cancer screening. What is available, a combination of two tests. One is, what is called, a Digital Rectal Examination. The prostate, if you have a look at where it is anatomically, you can see that is sits just below the bladder. And, in fact, the doctor's finger inserted into the rectum can feel the prostate from behind, and you can tell if there are any lumps or irregularities in the prostate from the examination. Now, that combined with a blood test called a Prostate Specific Antigen, or PSA, will give you some idea about whether there is a risk of prostate cancer. One in four men, who have an alleviated PSA test, will have a cancer.

MOORE: But is it the point that three in four won't, and that many people will die of old age before they die of prostate cancer?

PHELPS: That is true, but, for the younger men, who have raised PSA, and who are shown to have prostate cancer, will do much better if they are treated, and there is a benefit for those people in having the screening done, and there are further tests that can be done with a raised PSA. The other reasons for those three in four who might have a raised PSA are that they might have an inflamed prostate, or benign, enlarged prostate. But it gives you some guidance as to whether to go looking further.

MOORE: And then, if you do choose to go looking further, there is so much information, and there are various options, from mild to severe interventions, aren't there?

PHELPS: There are, and I think that we are also seeing tremendous advances in the way prostate cancer is treated, particularly at an early stage. There is now a treatment called Brachytherapy, which is where radioactive pellets are actually implanted in to the prostate gland, and simply left there, and that can treat the cancer. And, in some cases, nerve sparing prostate removal, which means that the nerves that supply the penis and are responsible for things like potency are preserved. And that's providing a treatment for men without the side effects that we were seeing some years ago before this new type of surgery was available.

MOORE: Thanks for coming in again this morning.

PHELPS: Thanks, Ali.

Ends