May 2004

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" height=120 BGCOLOR="#CCCC99" TEXT="#080000" bgproperties="fixed" background="03f8dfe1esnpes.jpg"> <div> <B>May 2004</B></div> <bR> <div> <A HREF="id3.htm" TARGET="_top" TITLE="Calendar"><U><B><U>Calendar</U></B></U></A><A HREF="id3.htm" TARGET="_top" TITLE="Calendar"><U><B> </B></U></A><B>  |   </B><A HREF="id60.htm" TARGET="_top" TITLE="Carers Group"><U><B><U>Carers Group</U></B></U></A><B>   |   </B><A HREF="id2.htm" TARGET="_top" TITLE="Group Guidelines"><U><B>Group Guidelines</B></U></A><B>   |  </B><A HREF="id61.htm" TARGET="_top" TITLE="Library"><U><B> </B></U></A><A HREF="id61.htm" TARGET="_top" TITLE="Library"><U><B><U>Library</U></B></U></A><B>   |   </B><A HREF="id4.htm" TARGET="_top" TITLE="Current Newsletters"><U><B><U>Current Newsletters</U></B></U></A><B>   |   </B><A HREF="id16.htm" TARGET="_top" TITLE="Archived Newsletters"><U><B><U>Archived Newsletters</U></B></U></A><B>   |   </B><B><U>Pamphlets</U></B><B>  |  </B><A HREF="index.htm" TARGET="_top" TITLE="Northern Beaches Prostate Cancer Support"><U><B><U>Hom</U></B></U></A><B><U>e</U></B></div> <div> </div> </td> </tr><tr> <td valign="top" height=360 BGCOLOR="#CCCC99" TEXT="#080000" bgproperties="fixed" background="03f8dfc3.jpg"> <div> <B><U>NEWSLETTER</U></B><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> <B>No. 23. May, 2004</B><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Editor: John Conroy<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> <B>WE ARE TWO YEARS OLD !</B><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> At our first meeting in May, 2002, there were 12 persons present. As we go to press, we now have 55 men, 16 carers of men with Prostate problems, and 25 medical and health professionals on our mailing list. Sincere thanks to the many people who have helped develop and expand the Program. Our objective is to reach more and more men in the Northern Beaches community to alert them to the risk of Prostate Cancer and to provide support for those who have Prostate problems.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> <B>1. REPORT OF THE MEETING HELD ON: Tuesday, 6 April</B><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> a. Apologies were received from John Gately, Jack and Merryl Godfrey, Bill and Joan Lamont, Bill Liney and Jim Rogan.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> b. We had as our speaker this month Dr Lisa Horvath one of the researchers into Prostate Cancer at the Garvan Institute for Medical Research, Sydney. Dr Horvath is a medical oncologist and exercises a dual role: as a specialist at the Royal Prince Alfred Hospital, and as a member of the Prostate Cancer Study Group at the Garvan Institute. She also works closely with the St Vincent¹s Clinic, with which she also worked during the four years of her PhD studies at the Garvan.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Dr Horvath has spoken on several occasions at Rotary Clubs, but this was her first appearance at a Prostate Cancer Support Group. What ensued at our meeting was an enthusiastic, highly entertaining and most informative survey of her research. While it was occasionally technical, it was also intensely absorbing, so much so that one sometimes forgot to take notes.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Dr Horvath took us on a rapid survey of some familiar statistics about Prostate Cancer, assuming that this would be familiar territory for us. Firstly, she reminded us that in NSW, Prostate Cancer accounts for 23% of all male cancers, and for 14% of all cancer related deaths in men. There has been a growing incidence of the disease since 1970, - with a big increase in the mid 1990s following the introduction of PSA testing. Numbers are now heading down again and may get back to normal. It's certain that less Prostate Cancer was being diagnosed in the early days, coronary heat disease being the biggest killer 25 years ago.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> The biggest risk of being diagnosed with Prostate Cancer is living beyond 60 years of age. The next is race, black Americans having the highest risk and Asian populations the lowest. There is an increased risk for Japanese men who follow a Western diet, but this is not as high as for Western men. The third risk factor is the presence of Prostate Cancer in a man's immediate family. Prostate Cancer mortality has not changed much over the past 30 years. The question is: can we reduce the number? This is a real challenge for cancer medicine.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> There are three outcomes of diagnosis affecting the nature of treatment: the serum PSA test result; the grade, given by the Gleason score (which says how nasty the cancer looks down a microscope); and the stage, that is whether the cancer is localised (confined to the Prostate capsule), or spread, either outside the capsule or to other organs. We have discussed treatments in other sessions.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Dr Horvath reported a study of patients in the USA carried out by Pound. All of the men in the study had had radical prostatectomies. Pound found that 30% of the men relapsed within a median time span of five years; the median time span beyond this for the development of metastasis (spread to other organs) was eight years; and the median time span beyond this for ensuing death was five years. That is, there was a median life span expectancy after prostatectomy, according to this study, of 18 years.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Prostate Cancer is unique in the slow way it grows. For this reason it is fascinating to research and treat. The fact that there can be a rise in PSA after a Radical Prostatectomy is accounted for by the presence of a micro-metastatic disease in the body which secretes the PSA which originally came from the Prostate. The challenges for research are:<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> * How does Prostate Cancer start and progress?<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> * Why doesn't it start at the same age in all individuals?<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> * How do we predict the outcome of Prostate Cancer?<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> * How can we better tailor treatment to the individual patient?<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> The work at the Garvan Institute is concerned with a research technique called gene chip transcript profiling. With this process, a gene chip is taken from each man in the research study. Conventional classification is by microscopic examination. But it happens that similar profiles may have different outcomes. There are different molecular profiles. It was found that looking at DNA had some limitations; it was a static technique. Instead, the researchers broke it down into RNA to find what is being expressed by each molecule. With a sample of prostates taken from 74 men, each producing about 46 000 genes, this gave about 3.5 million pieces of data to work with.The process used was a screening, not a diagnostic process.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Dr Horvath works on the expression of a particular molecule identified as being present in Prostate Cancer. Her work searches for genes that are drug targets for the treatment of Prostate Cancer, - drugs that will not target the rest of the body. She also searches for genes that predict Prostate Cancer outcomes.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> The stages of the research process are:<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Discovery<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Pre-clinical testing<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Clinical trials<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Phase 1<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Phase 2<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Phase 3<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Approval for and manufacture of drugs.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> This process takes about 16 years. The question is: Can we reduce this time?<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> In summary, Dr Horvath made the following points about Prostate Cancer research:<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> How can research help patients?<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> How can treatment be tailored to the individual patient?<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> The aim is to get a molecular profile of the cancer and to design more drugs for more effective treatment. The nature of cancer research is to move from basic science research activity to translation into treatment of specific cancers.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> During question and discussion time, the following points were made:<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> The process that Dr Horvath described does not take the place of conventional treatment but to augment it. Gene manipulation in the treatment of Prostate Cancer has a doubtful place. Dr Horvath's concern is to improve what happens after the Prostate is removed.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Research funding in Australia is falling. On the other hand, researchers in the USA are resource rich. Interestingly, large amounts of funding for Prostate Cancer research come from the US Army.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> <B>2. INFORMATION UPDATE</B><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> a.) Andrology Australia is a nationwide organisation based at Monash University Medical Centre, and dedicated to undertake those measures that will enhance the reproductive health of males, including community and professional education strategies and support of national research programs. It has just produced its Annual Report. A summary can be viewed at: <FONT SIZE="3" COLOR="#0000FF" FACE="Tahoma" ><A HREF="http://www.andrologyaustralia.org" TARGET="_top" TITLE="http://www.andrologyaustralia.org"><U><B><U>www.andrologyaustralia.org</U></B></U></A></FONT><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> To obtain your individual copy:<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> phone 1300 303 878<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> or fax 03 95994 7111<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> or e-mail <FONT SIZE="3" COLOR="#0000FF" FACE="Tahoma" ><A HREF="mailto:info@andrologyaustralia.org" TARGET="_top" TITLE="mailto:info@andrologyaustralia.org"><U><U>info@andrologyaustralia.org</U></U></A></FONT><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> b.) Jim Rogan stays in the news. He spent a busy time at the Easter Show, riding each night at 7.00pm and taking every opportunity to spread the message about Prostate Cancer.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> c.) The Cancer Council NSW is running a series of interesting training programs during May (contact the Cancer Council for further information):<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> 5 May: Sydney Metropolitan Volunteers Seminar to engage the people of NSW to reduce the impact of cancer on communities. This will be of interest particularly to people who would like to do volunteer work with the Cancer Council.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> 17 May: Community Speakers Program to raise community awareness about the importance of early detection and prevention of skin, breast, bowel, prostate and cervical cancers. (This is an information meeting prior to setting up training seminars; the date could change.)<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> 29 May: Support Group Facilitator Training. Sessions for new and experienced facilitators. This is an important session and we ought to have a representative from the Northern Beaches. Geoff Emanuel has volunteered to go along.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> d.) A group of six Members met at the Pittwater RSL on Wednesday, 21 April to discuss the future directions of the Group: John Conroy, Geoff Emanuel, Ron Faulkner, John Reid, Jo-Ann Steeves and Phillip West (apologies, Jim Rogan). We covered a range of issues about the working of the Group and many positive ideas were discussed. Some of these will be raised at the May meeting. Be there!<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> e.) Website. We are almost up and running. All that remains is to get a permanent address. In the meantime, if you would like a preview, go to: <FONT SIZE="3" COLOR="#0000FF" FACE="Tahoma" ><B><U>http://members.optusnet.com.au/raylee/index.htm</U></B></FONT><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> It's looking good. Thanks again to Lee Purser for all her hard work in setting up the site. Let me know (phone or e-mail) if you have any suggestions or comments.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> <B>3. REMINDER: DATES OF NEXT MEETINGS: </B>(6.30 pm on the first Tuesday of each month in the Palliative Care Cottage, Mona Vale Hospital) All friends, partners, carers, and family members are welcome. Refreshments will be served.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> 4 May Dr Michael Lowy (Sydney Centre for Men's Health) Sex and Intimacy after Prostate Cancer: Recovering the Thrill. Dr Lowy gave a very informative talk to the Group on a previous occasion (in 2002). His topic tonight is one that he is particularly interested in.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> 1 June Dr Carolyn Mountford (Institute of Magnetic Resonance Research, Royal North Shore Hospital): Magnetic Resonance Technology and Prostate Cancer.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <bR> <div> <B>YOUR CONTACT NUMBERS</B></div> <bR> <div> <TABLE BORDER="0" CELLPADDING="2" CELLSPACING="1" WIDTH="664" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 116 WIDTH="357"><div> <U>Program Co-ordinator</U> </div> <bR> <div> Dr Peter Moore </div> <div> Northern Beaches Palliative Care<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <div> 9997 3555 </div> </tD> <tD VALIGN=TOP WIDTH="296"><div> <U>Group Leader</U></div> <bR> <div> John Conroy<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <div> 9918 9358<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <div> <A HREF="mailto:conroyjs@bigpond.com" TARGET="_top" TITLE="mailto:conroyjs@bigpond.com"><U><U>conroyjs@bigpond.com</U></U></A></div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 89 ><NOBR><div> <U>NSW Cancer Council Cancer Support Helpline</U></div> <bR> <div> 13 11 20<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> </NOBR></tD> <tD VALIGN=TOP><NOBR><div> <U>Prostate Cancer Foundation of Australia</U></div> <bR> <div> 1800 220 099</div> </NOBR></tD> </tR> </TABLE></div> <bR> <bR> </td> </tr></table></body>