Current Newsletter - July 2006

<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>July 2006</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></div> <bR> <div> No.47 July, 2006</div> <bR> <div> Editor: John Conroy</div> <bR> <bR> <div> <B>1. COMING EVENTS</B></div> <bR> <div> (Meetings are normally held (unless otherwise advertised) at 6.30 pm on the first Tuesday of each month in the Palliative Care Cottage, Mona Vale Hospital)</div> <bR> <div> Tuesday, 4 July</div> <bR> <div> Members' Open Forum - This will be a relaxed and informal evening when you will have the chance to share information and experiences with men in similar situations to your own. We shall break into small groups based on the nature of the treatments we have had or are currently having or are considering as an option. There will be an opportunity to discuss outcomes, any present problems you may have, or anxieties concerning you about the future, as well as to pass on details about what you have found helpful personally.</div> <bR> <div> Friday - Saturday, 28 - 29 July</div> <bR> <div> Pain Management Symposium: (Royal North Shore Hospital)</div> <bR> <div> Tuesday, 1 August</div> <bR> <div> Topic and speaker to be confirmed.</div> <bR> <bR> <div> <B>2. Report of the Meeting held on Tuesday, 6 June</B></div> <bR> <div> In place of our evening meeting for the month of June, we arranged an afternoon visit to the Pathology Laboratories at the Sydney Adventist Hospital, Wahroonga. Our thanks to Dr Bevan Hokin, Director of the Laboratories, and to his colleagues Greg Watts, Richard Shirley, and Richard Suggitt who kindly gave us their time to explain aspects of their work relating to Prostate Cancer.</div> <bR> <div> Richard Shirley gave us an account of how PSA assaying is carried out. As blood samples come into the laboratory, each one is given a bar code which records the identity of the sample and the test required. The blood, which is placed in a tube containing a small quantity of barrier gel, is allowed to clot. Clotting takes about 5 to 10 minutes. (The process occurs more quickly in glass than in plastic tubing.) The tubes are then placed in a rack which is inserted into the computerised analyser machine. The computer has a programmed work. It identifies from the bar code on the tubing to whom the blood sample belongs and what testing is required. The machine can perform up to 24 tests at any one time.</div> <bR> <div> The blood samples are then spun in order to separate the serum from the rest of the blood material. The gel provides a barrier between the two blood components so that the serum, where the PSA resides and which has the least density, rises to the top of the tube and can be easily accessed. The PSA in the serum remains active for 24 - 48 hours. The machine pours the serum into a small cup containing a bead coated with an antibody, and is rocked for about 35 minutes. This process causes the PSA to adhere to the antibody. The bead is then washed and a second reagent antibody is added and adheres to the bead, forming a kind of sandwich with the PSA as the filling. The bead is again washed. The analyser then measures the intensity of light glowing from the coated bead and this is converted by means of a graph into the PSA score. The whole procedure takes about one hour.</div> <bR> <div> There are about five or six methods for measuring PSA and for this reason it is wise to stay with one pathology provider, as different methods can give different readings. Also it is desirable not to have a blood sample taken immediately after having a digital rectal examination or performing an activity such as riding a bicycle, as the effect can be to raise the PSA level. (Incidentally, a man who has a PSA reading of less than 4 has a 10% risk of having Prostate Cancer; a man with a reading greater than 20 has an 80% risk.)</div> <bR> <div> The group then met Richard Suggitt who spent time explaining the nature of the Gleason Score. Gleason developed his classification of Prostate Cancer tissue in the 1960s. Tissue taken from a biopsy or collected during a TURP (Trans-Urethral Resection of the Prostate, -or 'rebore') procedure is examined under a microscope. The pattern of cells and glands in two parts of the tissue sample is carefully scrutinised. Each pattern is given a grade of 1 (where the cells are well differentiated) to 5 (where cells are poorly differentiated). These two grades are added to give a score between 2 and 10.</div> <bR> <div> The Gleason score is a way of estimating the degree of malignancy of the tumour. While the procedure of identifying tissue patterns is subjective, the technicians doing the classifying are highly skilled. Grades 1 and 2 are not always so easy to recognise, but grade 3 is quite distinct, as are grades 4 and 5. Richard Suggitt showed us diagrammatic representations and also photographs of the five types of cancerous Prostate tissue.</div> <bR> <div> We completed the visit with a tour of Jacaranda Lodge at the Hospital and were impressed by the wide range of printed and audio-visual resources on Prostate Cancer (and other cancers) available from the centre's library.</div> <bR> <bR> <div> <B>3. Report of the Public Seminar on Prostate Cancer held at the Garvan Institute on Thursday, 8 June</B></div> <bR> <div> This seminar on Pancreatic and Prostate Cancer was held under the auspices of the Garvan Institute of Medical Research. Only the content on Prostate Cancer is reported here.</div> <bR> <div> Dr Lisa Horvath, who has spoken to the Northern Beaches Group on a previous occasion, is a medical oncologist who combines clinical practice with a research program. She spoke first on 'Treatment and Outcomes of Prostate Cancer'. Her topic dealt with current treatment strategies.</div> <bR> <div> Dr Horvath described the location of the Prostate Gland in the abdomen and referred to its function; namely, of secreting components of semen.</div> <bR> <div> Prostate Cancer constitutes (as of the year 2000) 23% of all male cancers and 14% of all cancer deaths in men in NSW. Most men will develop Prostate Cancer during their lives, but for many it will remain sub-clinical. The peak period for diagnosis is in men around 60 years of age. Medical professionals are better at diagnosing the disease now than in the 1970s. Incidence reached a peak in the 1990s when PSA testing was introduced in Australia.. However, mortality rates have barely changed over the years, probably due to earlier detection and better treatments. Risk factors for developing this form of cancer are age, race, and family history. The early onset of the cancer suggests a genetic mutation, whereas if it is found in men in their 70s this is regarded as normal for all.</div> <bR> <div> In identifying the presence of cancer in the Prostate gland, a digital rectal examination is carried out because most cancers occur on that part of the gland closest to the wall of the rectum. It has few symptoms. It can be detected as the result of a blood test, of an ultrasound through the rectum, or of a biopsy. What effects the outcomes are:</div> <bR> <div> stage whether it is confined locally, has spread outside the capsule to the lymph glands, or has spread to other parts of the body; or grade as determined by the Gleason Score.</div> <bR> <div> Prostate Cancer is slow growing. From the time of first treatment of a localised tumour, a period of about 5 years will elapse before the PSA level rises to equal or go beyond 0.4. On average, it takes another 8 years for the cancer to metastasise, and approximately 5 more years before death will occur.</div> <bR> <div> Treatment may be by: surgery, either open or assisted (either laparoscopic or robotic; the chief benefit of the two latter being that men leave hospital sooner; but these are new treatments and their effects are not certain); radiotherapy, either external beam radiation or brachytherapy; or watch and wait, most suitable for men with a low grade tumour; they may stay that way for many years, whereas undergoing treatment can bring various side effects.</div> <bR> <div> Adjuvant treatment. After surgery, further treatment may be necessary when PSA begins to rise again, and may take the form of radiotherapy, or hormone therapy, - often in conjunction with radiotherapy.</div> <bR> <div> If metastasis has occurred (spreading to other parts of the body) hormone therapy may be used (to switch off the production of testosterone); chemotherapy (Docetaxol or Metoxantrone), given in three-week schedules; monthly injections of Zometa for bone-specific therapy; or radiotherapy in the form of external beam radiation or radio-active strontium.</div> <bR> <div> In conclusion, Dr Horvath emphasised that treatment was a significant clinical problem. There are a number of treatment options but there is limited evidence for what is best in any given situation. New markers of outcomes and responses to treatment are needed to improve clinical practice.</div> <bR> <div> Additional points were made in responses to questions from the audience:</div> <bR> <div> * We don't know if the Gleason Score moves over time; there is simply no evidence. For example, if a man¹s Gleason score is low at the age of 40 years, will it increase over time? However, if it is low at 70 it is not likely to get worse.</div> <bR> <div> * PSA is an imperfect screening tool. We get a feel of what is happening to PSA over time: if it creeps up faster than age allows, it becomes a worry. It is important to look at trends in PSA level rather than absolute values.</div> <bR> <div> * There is no evidence of a link between BPH (enlargement of the Prostate) and Prostate Cancer.</div> <bR> <div> * Having Prostate Cancer at a young age doesn't affect sexual performance, but treatment will.</div> <bR> <div> * HIFU is currently used for patients getting a recurrence of Cance after a radical prostatectomy or radiation therapy, or who are unable to undergo other treatments.</div> <bR> <div> Associate Professor Sue Henshall, Head of Prostate Cancer at the Garvan Institute, spoke on Prostate Cancer Research in the Genomics Era. The story begins in 1953 with the discovery of the molecular structure of DNA by Watson and Crick. This is bearing fruits today: Contemporary issues include such questions as the genetic basis of disease progression and the distinguishing of 'good' from 'bad' cancers; determining biological markers of response to therapy to enable decisions to be made as to which treatment best suits each patient; and new therapy strategies.</div> <bR> <div> The genome project was finished in 2003. It identified what amounts to 1 billion words of description, - enough to fill 800 Bibles. One of the big changes resulting from the subsequent work of the biotech industry has been that instead of examining one gene at a time, the use of gene chips has enabledf all '800 Bibles' to be checked at once.</div> <bR> <div> Nomograms are now used in diagnosis which combine averaged information about pre-operative PSA, the Gleason score, the location of the cancer within the Prostate capsule, in the seminal vesicals, the lymph nodes, and outside the Prostate, to give an overall score which tells the probability of how bad the cancer is. That is, it is a 'probability' and not an 'actual' score.</div> <bR> <div> Molecular prognostics is an area which looks at the molecular significance of the individual patient's cancer.</div> <bR> <div> Another area of research is looking for genes that predict Prostate Cancer.</div> <bR> <div> The St Vincent's Campus Prostate Cancer Group Tissue Bank and Clinical Data Base now has information from more than 6 000 Prostate Cancer cases and an extensive patient database.</div> <bR> <div> In conclusion, Dr Henshall said that genome technology would provide for the individual tailoring of treatment, and would lead to the design of more effective drugs with fewer side effects. It would provide clinicians with better indicators. There are many people involved in this work, including laboratory scientists, nurses, data entry clerks, medical oncologists, urologists, pathologists, statisticians and patients.</div> <bR> <div> An additional point made in response to a question from the audience was that the link between testosterone and Prostate Cancer is a complicated one.</div> <bR> <div> <B>4. VALE: JACK GODFREY</B></div> <bR> <div> Jack Godfrey passed away on 19 April from an illness unrelated to his Prostate Cancer. He and his wife Merryl were initially members of the Royal North Shore Support Group, and came to us in the early days of our own Group. We shall miss them from our meetings and extend our sincere condolences to Merryl and her family.</div> <bR> <bR> <div> <B>5. ANDROLOGY AUSTRALIA</B></div> <bR> <div> New website helps men's health</div> <bR> <div> The Andrology Australia website <FONT SIZE="3" COLOR="#0000FF" FACE="Tahoma" ><A HREF="http://www.andrologyaustralia.org" TARGET="_top" TITLE="http://www.andrologyaustralia.org"><U><U>www.andrologyaustralia.org</U></U></A></FONT> has been revamped and updated so that quality information is more easily accessible and men can make better decisions about their health.</div> <bR> <div> New sections in the website include links to support groups, frequently asked questions, an A to Z of health topics, and the ability to order resources online.</div> <bR> <div> The website provides the most comprehensive information on male reproductive health disorders in Australia.</div> <bR> <div> Andrology Australia, administered by Monash Institute of MedicalResearch, is  an Australian Government initiative and aims to enhance community and health professional knowledge in targeted areas of male reproductive health.</div> <bR> <div> For more information:</div> <bR> <div> Phone: 03 9594 7200</div> <div> 0400 144 728</div> <div> e-mail: <FONT SIZE="3" COLOR="#0000FF" FACE="Tahoma" ><A HREF="mailto:cassy.bezeruk@med.monash.edu.au" TARGET="_top" TITLE="mailto:cassy.bezeruk@med.monash.edu.au"><U><U>cassy.bezeruk@med.monash.edu.au</U></U></A></FONT></div> <bR> <bR> <div> <B>6. PCFA</B></div> <bR> <div> Inaugural PCFA Men's Health Promotion Conference: Saturday, 12 August Victoria University Conference Centre, Level 12, 300 Flinders Street, Melbourne, Vic.</div> <div> Sessions include:</div> <bR> <div> * Recent Advances in Prostate Cancer Management</div> <div> * Exercise and Positive Health Outcomes for People with Cancer</div> <div> * Coping with Cancer: The Power of Shared Experience</div> <div> * Below the Belt: Men's Health, Masculinity and Prostate Cancer</div> <div> * Conquering Incontinence - An Assertive Approach</div> <div> * Men's Sexual Health</div> <div> * Testicular Cancer</div> <div> * Engaging with Men - A Rural Perspective</div> <div> * PSA Testing - Under the Microscope</div> <bR> <div> Cost: $50 for delegates with a chronic medical condition, and for carers and family members.</div> <bR> <div> Further Information: Phone: 03 9419 6222</div> <div> E-mail: <FONT SIZE="3" COLOR="#0000FF" FACE="Tahoma" ><A HREF="mailto:melbourneoffice@prostate.org.au" TARGET="_top" TITLE="mailto:melbourneoffice@prostate.org.au"><U><U>melbourneoffice@prostate.org.au</U></U></A></FONT></div> <bR> <bR> <div> <B>7. PAIN MANAGEMENT SYMPOSIUM</B></div> <bR> <div> Two day Symposium to be held at the Centenary Lecture Theatre, Royal North Shore Hospital on 28-29 July.</div> <bR> <div> Day 1. The Problem of Cancer Pain</div> <div> Day 2. Complementary and Alternative Therapies in Pain Management</div> <bR> <div> Cost: $198 per day or $341 for both days (GST incl.)</div> <bR> <div> For further information:</div> <bR> <div> Phone: Ms Ros Wylie: 9926 7386</div> <div> Fax: 9926 6780</div> <div> Email: <FONT SIZE="3" COLOR="#0000FF" FACE="Tahoma" ><A HREF="mailto:rwylie@med.usyd.edu.au" TARGET="_top" TITLE="mailto:rwylie@med.usyd.edu.au"><U><U>rwylie@med.usyd.edu.au</U></U></A></FONT></div> <bR> <bR> <div> <B>8. BIRTHDAY HONOURS</B></div> <bR> <div> Hearty congratulations to David and Pam Sandoe who both received an OAM in this year's Queen's Birthday Honours. David is (among other things) a director of the PCFA and Co-Chair of its Support and Advocacy Committee. He and Pam head the Prostate Cancer Support Group at the Sydney Adventist Hospital and both have travelled far and wide talking on husband and wife relations after treatment for Prostate Cancer. They have been visitors to our Northern Beaches Group on several occasions.</div> <bR> <bR> <div> <B>9. NEW WEBSITE</B></div> <bR> <div> A new website has gone on-line (this month) named 'Cancer Survivors Foundation of Australia'. Its temporary address is:</div> <bR> <div> <A HREF="http://www.jarrahbark.com/cancersurvivors/index.html" TARGET="_top" TITLE="http://www.jarrahbark.com/cancersurvivor"><U><U>www.jarrahbark.com/cancersurvivors/index.html</U></U></A></div> <bR> <div> This will become:</div> <bR> <div> <A HREF="http://www.CancerSurvivors.org.au" TARGET="_top" TITLE="http://www.CancerSurvivors.org.au"><U><U>www.CancerSurvivors.org.au</U></U></A></div> <bR> <div> 'A major function of the site is to focus all cancer resources and groups in the one place'. It argues that currently it is 'nearly as hard to find reliable information on the Web as it is to contact a support group when the need is urgent'.</div> <bR> <div> The group 'will shortly be releasing a Cancer Survivors lapel badge and broach based on the Wollemi Pine', ... 'with all profits going to cancer support'.</div> <bR> <bR> <div> <B>10. INFORMATION UPDATE</B></div> <bR> <div> Publications Received Copies of all of the following are available for borrowing from the Lending Library.</div> <bR> <div> (i) Prostate News, Issue 26, May 2006. Prostate Cancer Foundation of Australia.</div> <bR> <div> This issue includes items on Diet and Dietary Supplements, and on Incontinence.</div> <bR> <div> (ii) The Healthy Male. Newsletter of Andrology Australia, Issue 18, Autumn, 2006.</div> <bR> <div> The focus of this issue is on problems of the testicles. Other items cover: wearing underwear, male infertility, and the ineffectiveness of saw palmetto in treating Prostate enlargement.</div> <bR> <div> (iii) Prostate Cancer fact sheet. Andrology Australia. January, 2006</div> <bR> <div> (iv) Erectile Dysfunction (impotence) fact sheet. Andrology Australia. October, 2005.</div> <bR> <div> (v) Testosterone Deficiency fact sheet. Andrology Australia. October, 2005.</div> <bR> <div> (vi) Understanding Vasectomy fact sheet. Andrology Australia. October, 2005.</div> <bR> <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>