Articles tagged with: Prostate Cancer Research

28
November
2014

Should I have a PSA test?

Should I have a PSA test?

This short article may help you with the decision about having a PSA test (also known as PSA screening) to look for prostate cancer

Australia has one of the highest rates of prostate cancer in the developed world. The PSA test is the first investigation that can be done to look for prostate cancer. It is not a perfect test, and there are problems associated with the test, which is why you should be as well informad as possible about PSA.

Information for Patients Considering Prostate Cancer Screening

Background

  • Prostate cancer is common. Most men will develop prostate cancer if they live long enough. Despite this, only about 3% of all men will die of prostate cancer.

  • This indicates that most prostate cancers do not cause trouble in a man’s lifetime (‘low-risk’ or ‘indolent’ cancers). However, there are some more aggressive cancers that can cause trouble, and these benefit from detection and treatment.

  • Screening studies do show that the number of prostate cancer deaths can be reduced by screening with PSA. However, quite a large number of men need to be diagnosed by screening and treated to prevent one prostate cancer death.

  • One study (the Goteborg study) showed that 12 men need to be diagnosed to prevent one prostate cancer death. That means that 11 men were unnecessarily diagnosed. Another larger study demonstrated that (ERSPC) that 781 men need to be screened and 27 men need to be diagnosed to prevent one prostate cancer death. Thus 26 men are unnecessarily diagnosed.

  • Screening will detect many of these indolent cancers, and if they are detected, they may go on to be treated, perhaps unnecessarily.

  • Treatment is associated with long term complications in men, such as incontinence, erectile dysfunction (impotence) and bowel problems. Therefore, some men (indolent cancers that are treated) may have unnecessary treatment and suffer side effects.

The aim of screening

  • The aim of screening should be to identify aggressive or high-risk prostate cancers early, before they have spread beyond the prostate.

  • Some men are at higher risk of aggressive prostate cancer than others. These are men with a family history of prostate cancer, or with a strong family history of breast or ovarian cancer in females of the family, men of African-American decent, and men who have been exposed to some environmental agents (fire-fighters possibly, and veterans exposed to Agent Orange).

  • Most prostate cancers found by screening are low risk and do not need to be treated, and can just be closely followed by active surveillance (click for link to AS).

  • If you choose to be screened, there is a reasonable chance you will be diagnosed with low-risk prostate cancer, and may be in a position where you have to consider treatment that may be unnecessary.

Your decision to be screened – what sort of person are you?

  • If you have risk factors for prostate cancer (see above), your risk of prostate cancer may be higher than the general population, and this may impact your decision to be screened.

  • If you are the sort of person who would be uncomfortable not being treated if low risk prostate cancer was discovered, screening may not be the right decision for you.

  • If you are the sort of person who would accept treatment for aggressive prostate cancer, but would be happy to observe (active surveillance) things if you just had low risk prostate cancer, then you may be a good candidate for screening.

Categories: Updates, Prostate Cancer

01
November
2013

Movember Hits Town

Movember Hits Town

November sees the yearly highlight of Movember, where mens' health and cancer support is highlighted. Urologists have a particular interest in this area. Rajiv Singal, a Toronto Urological Surgeon, gives us a rundown of what Movember is all about. Last year, his fund raising team ranked in the worldwide top 7 for money raised for Movember.


Rajiv, when did you first become involved with Movember?

I first became involved with Movember in 2009. It was actually a resident on my service at the time, Dr Dean Elterman that brought this to my attention. I had no inclination to participate but was very quickly impressed by Dean's enthusiasm as well as the maturity that he brought at a relatively junior stage to the importance of being visible advocates for our patients.


I understand that you and your team ranked highly in the world in 2012 for the amount of money raised for prostate cancer. Where does this money go and how does it help prostate cancer patients?

We had a very successful 2012 campaign. Personally I was #1 briefly worldwide on November 20 and then faded to #7. There was tremendous interest in the message that was promoted around men's health. The money both in Canada and around the world goes to a number of different ventures, ranging from basic science and educational initiatives to survivorship and support programs. In 2012 a number of Mental Health initiatives were also supported. A full report card of Movember disbursements is available for people to review.


Can you outline the role that Prostate Cancer Canada plays in the current landscape of prostate cancer?

Prostate Cancer Canada is a large foundation that has plays an important role in Canada to support men during all aspects of the prostate cancer journey. This includes hosting regular support groups across the country, funding research and a variety of survivorship initiatives. It's biggest role in my view this year has been to try and address the vacuum that has been created by a variety of different screening guidelines around the world. There is much confusion around who to screen and when. With the USPTF recommendations the genuine fear is that many men with potentially significant disease will never be found. We have reduced mortality in the PSA era but have also over-treated many men, causing unacceptable consequences. Prostate Cancer Canada’s terrific #knowyournumber campaign this past September during prostate cancer awareness month attempted to try and address this need for assessing individual risk. We don’t want to throw the baby out with the bathwater


What does your wife think of the 'mo?

My wife, as you might imagine from the picture, is not very fond of the look but has generally been very supportive albeit somewhat resigned as she has seen my efforts take off over the years. She knows it is for a good cause but usually cannot wait for November 30 to arrive. I am hoping my oldest son, who just went off to university this year will join the effort this year. We will see.



Rajiv Singal currently leads the Surgical Robotics Program jointly run by Toronto East General Hospital and Sunnybrook Health Sciences Centre. He was Head, Division of Urology, Department of Surgery at the Toronto East General Hospital from July 2001 until October 2012 and is an Assistant Professor within the Department of Surgery at the University of Toronto. He supervises the Clinical Endourology Fellowship program at TEGH under the umbrella of the University of Toronto and also teaches undergraduate and postgraduate medical trainees. His clinical interests include the surgical management of urinary stones, minimally invasive urological surgery and the surgical treatment of genitourinary malignancies including prostate and kidney cancer.

A detailed item on this topic can be found at the BJUI blog site

You can follow Rajiv on LinkedIn and on Twitter

Categories: Prostate Cancer

30
October
2013

Australian Prostate Cancer Research

Australian Prostate Cancer Research

This week’s Guest Post is by James Garland, CEO of Australian Prostate Cancer Research - a relatively new organisation that is breaking new ground in clinical and translational research.

"Australian Prostate Cancer Research (APCR) was founded two years ago as there was no organisation drawing together researchers and resources to run large-scale, multi-partner research projects targeting improved clinical impact for men with prostate cancer. Everything we do at APCR has a measurable outcome and a direct line-of-sight to a tangible impact for patients. It has been a busy past twelve months for us and here are some of the reasons why:


2013 Prostate Cancer World Conference

We hosted the first ever Prostate Cancer World Congress this year attracting over 1,000 attendees, including clinicians and researchers from over 35 countries. Melbourne Convention and Exhibition Centre hosted the event and we were fortunate to have record support from industry partners and from the Victorian Government. The event is critical in bringing world leaders to Australia to share their knowledge and skills with our local clinicians and healthcare providers. We couldn’t have been happier with the result, it was an unprecedented success, attracting hundreds of submissions of which 170 were short listed for presentation.


Pelvic Floor Exercise Programme

At the 2013 World Congress, we also launched a fantastic new animated educational video providing information about the pelvic floor muscles and how to correctly perform pelvic floor exercises. These exercises are important in helping men regain continence after treatment for prostate cancer. The DVD also allows men to both learn and try the exercises in the privacy of their own home.

The project was led by Specialist Nurse Practitioner Helen Crowe, who has 20 years’ experience in prostate cancer care, and brought together a number of other practitioners and industry partners to deliver this high quality program, free to clinicians.

The project was funded by Hospira Pty Ltd. To order a copy of the educational DVD, you can contact: Lynette McIntosh on Ph 03 8744 5017.


PROSTMATE – Online Clinical Support Model

We’re really excited about this project. PROSTMATE is a ground breaking personalised support system for men and their families dealing with prostate cancer. It will provide access to the latest information, personalised support, specialised programs and consultations with experienced prostate cancer specialist nurses and allied health practitioners.

PROSTMATE has being developed in partnership with leading cancer agencies, researchers and clinicians. It will be free to join, easy to use and a valuable resource to help make informed choices. The site is expected to be released to the general public in November, 2013. So not long to go now! Keep an eye on www.prostmate.org.au


Expanding the Collection of Rare Tissue Samples

We continued our funding and coordinating role for the Urological Biorepository Project; a long-standing, unique and critical research resource. We have expanded our staffing footprint in the area of blood and tissue collection as we develop new partnerships in the area of genomics. This year saw plans for expansion in collection to bone and blood samples from new groups of men with prostate cancer.

The increase in scope adds significant value to the resource, which is now one of the leading contributors to the largest global genomics study – The Cancer Genome Atlas (TCGA). We have also collected one of the most accurate, rare sample banks that is actively being studied in the development of new gene tests and targets for treatment.


New Specilaised Prostate Cancer Clinic Model – Coming Soon!

Australian Prostate Cancer Research is supporting three new cancer clinic models this coming year, predominantly for high risk and advanced cancer patients; but one new Clinic in Melbourne will provide a complete service to men with prostate cancer at all stages – the first of its kind in Australia.

Clinicians and patients alike have alerted Australian Prostate Cancer Research to gaps in patient care, stating they need more tailored and focused treatment options at the later stages of the disease and help in avoiding the ‘drop-off’ in support some patients experience following treatment. Australian Prostate Cancer Research is developing partnerships and funding-streams to implement and sustain new holistic clinic models that will research improved protocols and treatment pathways for patients".


James Garland is Chief Executive Officer of Australian Prostate Cancer Research. Research into prostate cancer is not a new phenomenon; but James and the team are focusing on projects that deliver direct impacts for men with the disease and the healthcare sector that supports them. James has been working in the non-profit sector in Australia and the UK for over 10 years and has worked across a range of other areas in the sector including disability, community development, child protection and education. James received a Bachelor of Commerce from the University of Melbourne, is currently studying an MBA at Swinburne University and has held CFRE credential since 2008. James Chairs the biannual CEO Forum for non-profit leaders.

For more information you can contact APCR via email at This email address is being protected from spambots. You need JavaScript enabled to view it.

You can follow this link to the APCR website APCR

Categories: Prostate Cancer

14
September
2013

Urology Cancer Surgery - Present and Future

Urology Cancer Surgery - Present and Future

Continuing the series of Guest Posts by highly regarded Urologists, Benjamin Davies from UPMC answers questions on Urologic Cancer Surgery

Dr. Benjamin Davies is a Urological Surgeon specialising in cancer management. He is an Assistant Professor in Urology at the University of Pittsburgh Medical Centre and the Director of the Urologic Oncology Fellowship. He is a respected clinician scientist and is considered a pioneer for urologists in social media, particularly Twitter.

In this post, Ben Davies answers questions on the current practice and future development of urological cancer surgery


Ben, what was your motivation to concentrate on urology cancers?

I think I was frankly attracted to tumour biology first and then I was introduced to the actual surgery. Once I started being a surgeon I quickly forgot about the basic science biology and become engrossed in large cancer surgeries and robotically enhanced ones as well. I like the direct impactful role that surgery offers to the patient right then and there. No waiting for medication to work or waiting for lab work….it’s operate and hopefully cure. Concrete work.


What is the hardest part of your job?

Sick patients are the absolutely most challenging. It’s simply not a 9-5 job. When I have a patient that is struggling I tend to really take it personally (which of course you shouldn’t) and you can easily become very stressed. Learning to manage the stress is part of becoming a successful physician but is definitely the most challenging.


Female urological system

What have been the biggest developments in urologic cancer in the past few years?

I think two things are the biggest developments:

1. Robotic surgery has significantly aided our surgical approach to prostate cancer care. It has without a doubt decreased the side effect profile of a rather morbid procedure.

2. Genomic testing is finally coming online. We have all been waiting for real genomic testing to help us with our care and the new prostate cancer tests (while still at the beginning of their testing) are promising.



What is the most important preventative measure in urological cancer?

Do not smoke. It is an absolute tragedy to smoke. Just stop it.


Ten years ago, an old boss of mine said to me …”Brook, in years to come you will look back on a holocaust of radical prostatectomies.” Is there is any truth in this?

Of course he was right!! We have done a major disservice in over-treating prostate cancer patients. And as a result our large US screening studies are flawed and we now have to deal with the consequences of bad data. The PSA screening debate has turned against us because we over-treated low volume, low risk prostate cancer without any pause and many times just for money. Hopefully the new generation of urologists has been sufficiently educated to stop the nonsense.


In ten years time, what will prostate cancer treatment look like?

Easy. After your MRI-guided biopsy you will get a genomic profile and risk stratification of your disease. If you are healthy man, then you will be offered a robotic prostatectomy at a centre of excellence.


Male urological system

Prostate cancer receives a huge amount of publicity and funding. Which urology cancer gets a rough deal, and what can be done to improve this?

The absolute worst is bladder cancer! The patient population that is affected is older, sicker, and has lower socioeconomic means. What to do?? The Bladder Cancer Advocacy Network is beginning to generate better lobbying efforts and academics certainly need to bring this issue to the fore more often.


You can read more about Ben Davies on the UPMC site, and follow him at @daviesbj on Twitter


Categories: Updates

06
September
2013

Blue September in Australia

Blue September in Australia

Continuing the series of Guest Posts by highly regarded Urologists, Brian Stork discusses Blue September

Australia has the highest rate of prostate cancer in the developed world. Fortunately, there are a number of ways individuals can raise awareness and funds for prostate cancer research. This month marks the beginning of “Blue September” in Australia and around the world.

Blue September in Australia

Blue September is a campaign to raise awareness and funding for all types of cancer in men and boys. Beginning in infancy, blue is a color associated with boys. The color blue, however, also symbolizes the loss of fathers, brothers, sons, and friends from the many types of cancer that affect men, including prostate cancer. The Blue September campaign not only raises money for cancer research, but also encourages men to take better care of their health in partnership with their healthcare providers. Prostate cancer research, however, has traditionally been one of the main beneficiaries of the Blue September campaign.

Going Blue

Blue September Wristband

There are many ways you can get involved and show your support for the Blue September movement:

2013 Beneficiaries

In Australia, this year’s beneficiaries from the Blue September Campaign include the Australian Cancer Research Foundation and Australian Prostate Cancer Research. Australian Prostate Cancer Research has created some outstanding educational resources for prostate cancer patients, and, thanks in part to support from Blue September Australia, is about to launch Prostmate – the world’s first online support program for men with prostate cancer.

Beyond Australia

Blue September appears to be thriving in New Zealand, the United Kingdom and Ireland. Proceeds from Blue September in New Zealand go to the Prostate Cancer Foundation. In the United Kingdom, procedes will go to the Urology Foundation. In Ireland, the benefits will go to the Mater Foundation, Cancer Care West, and the Mercy Hospital Cancer Appeal Fund.

Last year, the Blue September Community was very active in the United States, particularly in California. Unfortunately, this year, the community appears to be significantly less active. Participants in the United States are encouraged to support the Prostate Cancer Foundation, The Conquer Cancer Foundation of the American Society of Clinical Oncology, Think Cure or the cancer organiztion of their choice.

Leisel Jones

Support a Serious Cause and Have Fun

Having cancer is tough. Raising awareness and fundraising should be fun. Blue September offers a fun opportunity to raise awareness and support men with prostate cancer.

Australian Swimming Champion – Leisel Jones



Dr. Brian Stork, Urologist, MichiganGuest post by Dr. Brian Stork. Dr. Stork is a urologist from the U.S. in private practice at West Shore Urology, in Muskegon, Michigan. Dr. Stork has a passion for patient education, healthcare technology and healthcare social media. You can read more from Dr. Stork on his blog, and follow him at @storkbrian on Twitter and Google .

Categories: Prostate Cancer

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