Global Best-practice Project Has Potential to Save Thousands of New Zealand Lives    

Prostate cancer is the most commonly diagnosed cancer in New Zealand, and there are significant disparities in terms of diagnosis, treatment, and outcomes. A contribution of $50,000 and a further $50,000 pledge from the Perpetual Guardian Foundation’s Medical Research Fund, underpinned by two legacies, is supporting an advanced approach to prostate cancer diagnosis with holistic benefits for New Zealand. The pathway has so far enabled more accurate scans of around 100 men in Gisborne-Tairāwhiti and is part of a joint funding effort that is helping to pave the way to potentially save thousands of lives.      

The ongoing project at the non-profit Mātai Medical Research Institute in Gisborne-Tairāwhiti uses advanced MRI techniques to improve how prostate cancer is diagnosed. A clinical partnership with Te Whatu Ora Tairāwhiti, the innovative diagnostic pathway promises greater diagnostic accuracy, less inequalities in prostate cancer outcomes (especially for Māori and men in under-served and remote communities), and potential broader benefits such as shorter wait lists. In the last few years, the pathway has become more widely available in New Zealand but is still mainly limited to urban and private settings.       

Every year, around 700 New Zealand men die from prostate cancer. The 5-year survival rate is 98% with early diagnosis and drops to less than 20% if diagnosed late. The project’s advanced MRI techniques help determine whether a biopsy is needed and assist in performing targeted biopsies. A targeted biopsy allows for better understanding of the size, grade, and location of prostate cancers. The best practice approach reduces the overall need for biopsies, helps diagnose more serious prostate cancers, and reduces diagnosis of less serious cases.   

Dr Daniel Cornfeld, Head of Radiology at Te Whatu Ora Tairāwhiti and Mātai Clinical Lead, who spearheaded an MRI prior to targeted biopsy pathway in Tairāwhiti, says that they can avoid an initial biopsy 45% of the time, which reduces the “risk” of having a biopsy.  

“Eighty-five percent of patients we biopsy have prostate cancer. Approximately 10% have a low-grade cancer that most likely can be watched as opposed to treated.  Approximately 75% have a high-grade cancer that should be treated (but in some cases can be watched). Exact treatment or follow-up is based on image characteristics, biopsy characteristics, and patient preference. This means that we are avoiding unnecessary biopsies, which is good for men and good for the efficiency of the system.” 

The new diagnostic pathway introduced in Tairāwhiti in 2022 has been supported by the Hugh Green Foundation, the Prostate Cancer Foundation of New Zealand, KOELIS and others, as well as the Perpetual Guardian Foundation – thanks to the legacy of both Shirley Cooper and Nanette Cooper, two legacies that now underpin the Medical Research Fund in the Perpetual Guardian Foundation. Dr Shirley Cooper (of Auckland) left her legacy to Medical Research in memory of both her and her brother Dr Alaster Winston Coopers’ careers in medicine following her passing in 2017. Her obituary noted her being a “Loved friend to all her medical fraternity and wider circle of friends.” Nannette Cooper was Shirley’s sister-in-law, Alaster’s wife, and she joined their philanthropic legacy also donating the proceeds of her Estate to medical research in memory of her husband and sister-in-law.   

Perpetual Guardian head of philanthropy, Kirsten Kilian-Taylor, says “This legacy funding is a wonderful example of how impactful philanthropy and family philanthropy can be through the Perpetual Guardian Foundation. Careful stewardship of such funds ensures that every dollar is maximised for its intended purpose, making a tangible difference in the community while honouring the underlying legacies of Nanette, Shirley and Alaster. Through accuracy and equity in prostate cancer diagnosis, this research has proven its ability to save the lives of thousands of New Zealanders and especially those in underserved communities in rural New Zealand.”   

Men living in rural locations face higher mortality rates from prostate cancer and have lower screening rates, less intensive diagnostics, longer wait times, and later diagnoses. The pathway aims for an equitable service to improve prostate outcomes for all men in Tairāwhiti/Gisborne with the goal of eliminating late diagnosis of prostate cancer in the region. 

The model of care pathway is already standard in some overseas jurisdictions, such as Europe and Japan, and the work at Mātai Medical Research Institute is intended to serve as a benchmark for the rest of New Zealand. The funding from Perpetual Guardian Foundation also supports verifying the approach towards it becoming the general standard for prostate cancer diagnosis in New Zealand. 

“New Zealand was 10-15 years behind the rest of the world in embracing this pathway, so we have worked hard to implement the pathway here,” says Dr Daniel Cornfeld, who is working on demonstrating the results so that model of care pathway is an example for the rest of the country. “I hope the demand for this type of care will necessitate that it become the standard.” 

Peter Dickens​, chief executive of the Prostate Cancer Foundation of NZ, says: “This is an important initiative in efforts to bring Aotearoa New Zealand into line with best diagnostic practice globally – we absolutely need more accuracy and equity in prostate cancer diagnosis in New Zealand. Over 700 men died of prostate cancer last year and these numbers are increasing and forecast to double by 2044. The government hasn’t yet committed to funding a screening programme for a cancer that is specific to men.” 

The optimised pathway at Gisborne’s Mātai Institute has potential for widespread healthcare system efficiencies and lower costs, including through the triaging and faster scan times of its MRI model.   

The institute’s world leading work notably includes brain imaging, and it is running a longitudinal study, the Tairāwhiti child well-being study, where participants have whole-body scans to track and model organ, system and body development across time. 

The Mātai Institute is currently developing a collaborative, multi-million-dollar campus facility dedicated to advancing New Zealand’s medical and health infrastructure, socioeconomic landscape, and cultural aspirations through state-of-the-art medical imaging, transdisciplinary research, education, and innovation. 

About Perpetual Guardian Group 

The Perpetual Guardian Group is New Zealand’s leading and premier provider of the full suite of estate planning services including Wills, Trusts, Enduring Powers of Attorney, Investment Advisory, Investment Management and Philanthropic ventures. 

Our origins date back more than 140 years, and today we have offices nationwide, with over 125,000 client relationships, $2.8 billion in funds under management, and $8 billion in total assets under management. Innovation, fiduciary expertise and a rich history go hand-in-hand at Perpetual Guardian Group and we also stand as New Zealand’s largest Trustee for Charitable Trusts – supporting clients in their familial, financial, and philanthropic goals. 

The Perpetual Guardian Group comprises organisations offering complementary specialist services to support clients at all stages of life, including Perpetual Guardian, Perpetual Guardian Investments, New Zealand Trustee Services, and Givealittle.