Current Newsletter - October 2005

<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>October 2005</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> </td> </tr><tr> <td valign="top" height=360 BGCOLOR="#CCCC99" TEXT="#080000" bgproperties="fixed" background="03f8dfc3.jpg"> <div> <B><U>NEWSLETTER</U></B></div> <bR> <div> No.39.  October, 2005</div> <bR> <div> Editor: John Conroy</div> <bR> <div> <B>1.   COMING  EVENTS</B></div> <div> 6.30 pm,  Tuesday, 4 October Ms Catherine McGrath, [Centre for Values, Ethics and Law in Medicine, University of Sydney]</div> <div> Cancer and the emotions - life after diagnosis and treatment</div> <div> Catherine is a former lawyer and historian, and was diagnosed with breast cancer three years ago. She now works as a researcher and presenter in cancer survivorship related areas, and has recently been running a series of workshops on Survivorship.</div> <div> The Centre for Values Ethics and the Law in Medicine has been researching the psychosocial aspects of cancer survival for nearly 10 years and has published various papers and a book, and featured in an ABC 4 Corners program in 2000.  Professor Miles Little and Ms Emma-Jane Sayers from the Centre have spoken to our Group in previous years.</div> <div> Catherine will talk briefly about some of the emotions people go through from diagnosis to post treatment.  She will then focus on the issues that can come up for people after treatment. Although the work at the Centre has been on people who have finished treatment and are cancer free (i.e., people who do not have advanced disease) it has been finding that people with advanced disease relate to these issues as much, if not more than, survivors.</div> <div> 6.30 pm,  Tuesday, 1 November</div> <div> Associate Professor Phillip Stricker [St Vincent's Hospital, Darlinghurst]: Recent Advances in Diagnosis and Treatment of Prostate Cancer</div> <div> 6.30 pm,  Tuesday, 6 December</div> <div> CHRISTMAS  GET-TOGETHER</div> <bR> <div> <B>2.    Report of the Meeting Held on Tuesday, 6 September:</B></div> <div> Apologies were received from: Una Conroy, Richard Darmopil, Geoff Emanuel, Freda and Ernie Treloar.</div> <div> Dr Michael Izard, who is a radiation oncologist from the Mater Hospital, North Sydney, last spoke to our Group in 2003, and we were delighted to welcome him back.  He was again talking on the subject of Brachytherapy.</div> <div> Brachytherapy is not new. It is a refinement of radiotherapy to make that process more accurate.  Hormone and chemotherapies aim at the whole body but radiotherapy is a localised treatment which aims at the precise place where the disease is.  Brachytherapy is more localised still than External Beam Radiotherapy [EBRT]. The prefix tele- means 'long distance' [tele-phone, tele-vision, tele-therapy], whereas brachy- means 'close' or 'near'.</div> <div> Radiation therapy [RT] came from the studies of Madame Marie Curie and, in the 1890s, was soon applied to skin therapy, especially to treating hairy moles. It was then applied to tumours to dry them. Its first application to Prostate Cancer was in 1910, when radium was put against the tumour to stop bleeding. This was brachytherapy. In 1914 it was found that radiation causes sterility. The method was tried for the sterilization of sheep but it caused ulceration of the sheep's scrotum. Around this time, fractionation [short bursts of radiation] was found to be a more effective method of treatment.</div> <div> Researchers continued to build on these experiments.  We know that the heat from a candle or a light bulb or a fire drops with the distance we are from it.  A law of physics states that the amount of heat varies according to the inverse of the square of the distance from the heat source. In fact, 96% of heat is lost in the first 5 units of distance.  Brachytherapy uses this notion in focusing treatment on the affected site. Incidentally, the linear accelerator used in radiation therapy emerged from the technology of atom bomb research after World War II.</div> <div> As a tumour on the Prostate Gland gets bigger, the PSA level rises. If the cancer gets beyond the capsule, PSA climbs. Generally, if the PSA is low, there is a low chance that the cancer has gone through the capsule; the higher the level, the more chance there is that the cancer has spread. The following figures give a general indication:</div> <div> for a PSA less than 20 ng/ml, there is a less than 5% chance of escape;</div> <div> for a PSA greater than 100, there is a 95% chance of escape, and so you can see that the risk rises as the PSA rises.</div> <div> Radiation therapy treats the Prostate and a margin around it. In EBRT, five fields of radiation are aimed at the Prostate Gland, but these also hit other nearby healthy tissue;  for example, the rectum.  Hence, the rectum, which is less resistant to radiation than the Prostate, is the dose-limiting organ in this region of the body.  Brachytherapy puts the dose in and around the Prostate and not on the rectum. This dose can be up to 12-20% bigger than with EBRT.  RT is like turning on a hotplate:  it takes time to heat up, and also to cool down, so the effect continues for some time after the initial treatment.  Hence PSA will fall over time but not immediately treatment starts. It takes time to kill the cancer.  Likewise, the appearance of side effects may be delayed. The size of the radiation dose has to balance the percentage success rate of the treatment against the percentage side effects. Adding hormones helps keep the PSA down; it suppresses the cancer dramatically. The use of thalidomide enhances the effect of radiation and chemotherapy;  it is mostly done on brain tumours. Also, after surgery, RT can be used to catch any of the cancer that my have been left over inadvertently.</div> <div> The Brachytherapy procedure inserts needles, about 25 cm long, into the Prostate via the perineum, - the area between the scrotum and the anus, - under an epidural anaesthetic. There are 17 needles, which may be open or closed, inserted into an area of about 5cm by 4cm.  There are treatment points every 5 mm along the needles so as to allow the radiation oncologist to choose where to put the dose.  It is a once only treatment and is used on other cancers besides Prostate Cancer.</div> <div> Brachytherapy is no use as a treatment for cancer that has spread beyond the Prostate capsule.  Also, it is used cautiously if the patient has continence problems or has had a Trans-Urethral Resection of the Prostate [TURP] which enlarges the hole through the Prostate Gland. Likewise, care has to be taken not to cause a fistula [leakage] between the Prostate and the rectum by piercing through where the connecting walls are thin.</div> <div> Seed implants will treat the prostate cancer that is confined to the prostate, and a small margin around it;  if the cancer is more than a few millimetres away from the edge of the gland, it will not be within the treated volume.  If the placement of the seeds within the gland is less than ideal, there may be areas of the gland (which may contain some cancer cells) that may not receive an adequate dose.  Permanent (seed) brachytherapy is no use as a treatment for cancer that has spread beyond the prostate capsule.</div> <div> The permanent implant of iodine seeds into the Prostate is not suitable if the patient's PSA is high.  Also, seed implants may not reach all sites of the cancer, whereas the temporary implant under brachytherapy can be more accurate.</div> <div> Radiation therapy and erections don't go together;  recovery of normal erections is slower than after surgery.  If a man has normal erectile function prior to radiotherapy, then 50% of men (whose average age is greater than 65) will still have erections 2 years later, but about 10% per year will drop off after that.</div> <div> Currently, Brachytherapy treatment at the Mater Hospital would start at 7.30am;  a CAT scan would be taken at around 10.00am;  and the first dose of radiation would occur at 3.00pm. The new machines that are being installed speed up the process considerably.  They improve the ultrasound imaging to enable more accurate placing of needles and adjusting the dose according to placement.</div> <div> Dr Izard concluded by reviewing some of the current areas of research interest regarding Prostate Cancer.  These include:</div> <div> The merits of PSA screening. The financial arguments in favour of ignoring testing, - although the natural history of the cancer can be either slow or aggressive. Cryotherapy [freezing, - using liquid nitrogen] as a treatment method. This is at the stage of development where brachytherapy was 20 years ago.  It has a future, but the problem is how to control the ice ball.</div> <div> Similarly with heat therapy.</div> <div> Hormone therapy.</div> <div> Chemotherapy and the development of new drugs.</div> <bR> <div> <B>3.    SEPTEMBER WAS  -  NATIONAL PROSTATE CANCER AWARENESS MONTH!</B></div> <div> It was a busy month but the activity was worth while.  Due to the efforts of a number of Members of our Group, many more men [and their partners and families] in this area are aware of the risks of Prostate Cancer, and of the existence of our Support Group.  Many thanks to all those Members who made our Public Awareness Campaign for the month such a success.</div> <div> Samples of the bookmarks that were placed in local libraries and of the coasters that were put on the tables of the Master Builders' Club and the Pittwater RSL are included with this Newsletter.</div> <div> Thanks, also, to the various organisations who so kindly assisted by giving space for our information displays, by assisting with financial support, or by providing publicity:</div> <div> Dee Why Village Plaza,  Forestway Shopping Centre,  Manly Council,</div> <div> Manly-Warringah Division of the Master Builders' Association,  Pittwater</div> <div> Council,  Pittwater Life, Radio Northern Beaches, The Manly Daily,  Uptin</div> <div> Print,  Warriewood Centro, Warringah Council,  and  Warringah Mall.</div> <div> THANKS!</div> <bR> <div> <B>4.    INFORMATION  UPDATE</B></div> <div> a.    Publications Received</div> <div> Probe, [Vol.1, Issue 3, Winter, 2005]. A biannual newsletter of the Australian Prostate Cancer Collaboration.</div> <div> Campbell, H.S. et al.:  Cancer peer support programs - do they work? in Patient Education and Counselling, 55 [2004].</div> <div> Kash, K.M. et al.:  Psychosocial Oncology:  Supportive Care for the Cancer Patient, in Seminars in Oncology [2005].</div> <div> Tilkeridis, J. et al.:  Peer support for cancer patients, in Australian Family  Physician, Vol. 34, No. 4, April, 2005.</div> <div> Lifestyle Factors Impacting on Medical Conditions, APS Psychologists: 'Good Thinking'. The Australian Psychological Society Ltd.</div> <bR> <div> Copies of these publications are now available in the Library.</div> <bR> <div> b.    Report</div> <div> The 7th Annual Meeting of the Australian Prostate Cancer Collaboration was held at the Garvan Institute, Darlinghurst on Wednesday and Thursday, 21 and 22 September.  It was attended by medical professionals, researchers and consumers from Australia and overseas. The program was divided into nine sessions 'covering education, decision making, epidemiology. the biology of prostate cancer and new therapeutic strategies, at both scientific and clinical levels ... [and] new models for studying prostate cancer and on the latest clinical interventions'.</div> <div> Many of the papers were beyond the layman.  However, it was interesting to hear what directions research is taking, to make contact with people in the forefront of current research and clinical practice, and to learn about some of the latest trends in diagnosis and treatment.</div> <div> One interesting feature was the increasing dissatisfaction with PSA testing because of its unreliability, and because of the lack of good scientific information about the efficacy of screening, the effects of treatments, and about Prostate Cancer itself.</div> <div> We hope to have some of the papers available in our Library and to have some of the people who were present speaking to our Members at next year's meetings.</div> <bR> <div> c.    Courses</div> <div> Surviving cancer</div> <div> 4 Meetings:  6.30pm - 8.30pm Thursdays from 13 October to 3 November,</div> <div> Centre for Continuing Education, University of Sydney.</div> <div> Phone:  9036 4771 [Anne Goodfellow]</div> <div> Cost $195.00</div> <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> <bR> </td> </tr></table></body>