Guest Speaker Report.
Dr Craig Gedye, Research Scientist, Medical Oncologist and supporter of the appointment of a Prostate Cancer Specialist Nurse for our region was our guest on the 12th. of December.
We appreciated the fact that Dr Gedye was able to reschedule his patient appointments to spend time with us today, arriving at 2pm but having to leave at 3pm sharp. Rather than talking through a slideshow Dr Gedye started by asking questions about our perception of the value of having a dedicated Prostate Cancer Specialist Nurse. This soon developed into a general question and answer session and was much more interactive than a slideshow. By the end of the session, it was apparent that the nurse would be able to fill in any gaps between the treating physician and the patient by correcting any misconceptions and explaining in simple terms exactly what was happening.
Specialist appointments can be quite stressful in that we have to try to remember not only what the specialist said but also to remember the questions we wanted to ask. A specialist nurse would be able to help us through this in a more casual atmosphere.
The Nurse will not be attached to any particular Doctor or Specialist but will report to the Director of Nursing Services at the Mater Hospital
Now that funding for the nurse has been approved it is expected that an appointment will be made in early 2018 and hopefully, by March or April, we can expect a visit to our group.
January 2018 No meeting in January
Professor Jim Denham is well known to most if not all of us for his work in cancer research focussing on clinical trials and radiation delivery. In 2016 he was awarded the Order of Australia Medal for Services to Medicine and Medical Research.
Today he will talk about the TROG 03 04 RADAR TRIAL which began in 2007 and concluded in 2017. The medical part of this trial involved 2 levels of Androgen Deprivation therapy prior to Radiation therapy with and without the addition of a bone-strengthening drug.
As well as the medical outcomes after 10 years, Professor Denham paid particular attention to the general well being and resilience
of the participants and their partners by documenting their health status compared to the general population.This is a self-assessment system to measure such things as energy levels, fatigue, emotional well being, quality of life etc. This is known as the “Life 10 years after the prostate cancer treatment project”. Both men and their partners have responded to questionnaire booklets given to them.
I understand from Terry the results will be presented in a clever and amusing way to be enjoyed by all. !
Social Event 2018
Lunch Cruise on Newcastle Harbour
Sunday March 18th is the date set for the Newcastle Harbour Lunch Cruise with Nova Cruises. This is a 2.5 hours Harbour Cruise with Morning Tea and Lunch.
The cruise departs at 12 noon from the Lee Wharf pontoon, Honeysuckle Drive. To quote from their brochure: Enjoy all the sights Newcastle Harbour has to offer as we cruise the working port and picturesque foreshore. See the harbours coal loading facilities, tugboats and big ships up-close. Indulge in our freshly prepared buffet lunch consisting of seasoned roasted chicken, double smoked leg ham hand carved off the bone, fresh local prawns, and a selection of salads to compliment. Enjoy a selection of petit fours for dessert with complimentary tea & coffee or select from a full range of drinks available from our fully licensed bar.
The Cost is $54 or $49 Concession and we need full payment by the February meeting. If you are unable to attend the February meeting but would like to join the cruise please contact a committee member.
Mike Seddon On behalf of Guest Speakers Mob : 0419 599 230
email : [email protected]
Surgery for early-stage prostate cancer is invasive and doesn’t save lives The Conversation
By Dr Ian Haines, Monash University
Posted 20 Jul 2017, 8:40 am
From the 1980s, when prostate screening became available, many men over 40 were diagnosed with early-stage prostate cancer even though they may not have had any symptoms.
The word cancer understandably strikes fear into the hearts of many, and most would assume the best course of action would be to have the cancer removed, whatever the side-effects may be. But impotence and incontinence are no small side-effects, especially when you consider, as two new studies have done, removing the cancer is not necessarily the best option, and the cancer may not in fact require treatment at all.
Most prostate cancers take decades to exit the prostate, and most men will usually die with, but not from, prostate cancer.
Two recent clinical trials undermine the categorisation of prostate cancer as a death sentence.
They are unambiguous in their findings and seismic in their implications.
Both found men with early-stage abnormalities of the prostate who do not undergo surgery or radiation treatment, but whose condition is monitored for any progression of the cancer, live just as long as men who opted for complete removal of the prostate and now live with its immediate consequences, including incontinence, intimacy issues, bowel problems and intervention regret.
Prostate Cancer: Key Facts
19,000 Australian men are diagnosed with prostate cancer each year.
3,000 men die from the disease each year (more than 9 in 10 men with prostate cancer will still be alive 5 years after diagnosis).
In the early stages, there are often no symptoms of prostate cancer.
More than half of the men with prostate cancer are over 65 years of age when diagnosed. Risk factors for prostate cancer include age, family history, carrying the BRCA1 or BRCA2 gene mutation.
It is rare in men aged under 50.
For more: ABC Health & Wellbeing prostate cancer fact file
How to live long enough to see the end of illness
Take statins if you’re over 50, and baby Aspirin, too. Drop the vitamin supplements like they were a lit cigarette. Junk the juicer. If the vegetables at the supermarket aren’t today-fresh, opt for fresh frozen. Wear sensible shoes. Eat lunch and go to bed at the same time every day. Get your flu shot. Move around a lot, even when you aren’t exercising. Digitize your medical records, family history and genetic profile, and store this information on a USB stick. Carry it with you always. Share it, anonymously, with the world.
Think of yourself as a system: cancer is not something the body gets and health is not something it has—both are states, dynamic processes really, that the body undergoes. And your system is not the same as anyone else’s: the daily glass of red wine that does wonders for your friend may be killing you. Take note of the specific, unchanging details of your system. Is your ring finger longer than your index finger? That ups the risk of prostate cancer for a man, and of osteoarthritis for a woman. (No one knows quite why, but the marker is well -established.) Keep an eye on your more changeable fine points. Check your nails: yellowish hue bad (go for a diabetes check); white crescent at the base good (iron levels are sufficient). Check your ankles: indentation marks from your socks or loss of hair could mean circulatory problems and increased risk of blood clot.
Do all these things, which essentially add up to two commandments—cut down on daily sources of life-threatening inflammation and take an active part in your own health care—and you stand a very good chance of living to see the end of illness.
Genetic Testing and the Future of Prostate Cancer Treatment
Dr Mark Scholz MD
“Uncontrolled cancer cell growth results from misbehaving genes. An intriguing approach to cancer therapy is to identify the mutated genes and target treatment to specifically counteract the damaging effects of that gene. ”
Recently, five new life-extending treatments have become available: Provenge, Zytiga, Xtandi, Xofigo, and Jevtana. Older treatments like radiation, Lupron, and Taxotere are also still effective. Thankfully, mortality can be postponed for a long period of time.
Still, roughly 28,000 men die of prostate cancer each year in the United States. Mortality results when all treatment options have been exhausted due to the prostate cancer becoming resistant. When resistance develops, it is reasonable to consider off-label treatments, usually treatment that is FDA-approved for other types of cancer. The question is, with so many treatment options, where does one begin?
I had a patient, who we will call Paul, who was successful in finding a very effective “off-label” treatment. He was diagnosed in 2010 and initially, things looked pretty optimistic. His Gleason score was 3+4=7 and PSA was 4.2. Paul had a prostatectomy, but the cancer was outside his prostate and PSA never dropped to zero. He had radiation and Lupron but the PSA only remained low for a brief period of time. Over the following 3 years, Paul tried almost every possible treatment. By summer 2014, he developed progressive bone marrow failure, a common development in men with uncontrolled prostate cancer. His production of red blood cells was so impaired he could only be kept alive with monthly blood transfusions. The PSA was above 120 and he had a less than 10% chance of living 6 months.
At this point, Paul switched his medical care to my office. But just before he switched, his doctor started him on an off-label medication called Mekinist, a pill that is FDA-approved for metastatic melanoma. Within months, his PSA dropped to 18.96 and his bone marrow improved dramatically. Paul’s health improved to the point he was able to return to work full time and travel internationally with his family. He tolerated the drug very well, but after two years the cancer became resistant again, leading to his passing in 2016.
Paul and his doctor were very fortunate in picking Mekinist as a treatment. Men have a better chance nowadays at prolonging life with advanced prostate cancer due to the achievements in the medical field and the growing number of available options. But that’s where the issue of choosing the right treatment comes in.
It is difficult to know which agents to select with so many new agents being approved for all the different types of cancer. We put several other patients on Mekinist after seeing Paul’s success, but they showed no benefit. But prostate cancer is not a single disease, it is multiple diseases; it looks different for each man. So it is not surprising when one man shows anti-cancer benefit while many others show none with the same treatment. This is where genetic testing has the potential to make a big difference.
METHODS OF GENETIC TESTING
We actually attempted a scan directed bone biopsy on Paul, in hope of obtaining cancer cells for genetic testing. Unfortunately, the biopsy was unsuccessful because no viable tumor cells were obtained. Our experience in doing bone biopsies in prostate cancer patients to obtain tumor cells for genetic testing has only been successful in about half of the patients in whom we have attempted to perform a biopsy. Until recently, bone biopsy was the only way to access the genetic material in tumor cells. But technological advancements in the medical field are growing quickly. The latest breakthrough is the discovery that tumor DNA released into the blood from dying cancer cells can be obtained with a blood test.
There are still many challenges to overcome in our attempts to use a genetically-guided approach. While we now have the ready ability to identify malfunctioning genes by name, we don’t always know the gene’s actual function. Also, in most cases, medicines to counteract the mutations we detect don’t yet exist.
However, the fact that targeted therapy for specific mutations can be successful was most notably validated by the discovery that Olaparib, an FDA-approved drug for ovarian cancer, may also be beneficial in men with prostate cancer who have a specific mutation in the BRCA gene. It turns out that this BRCA mutation (or other related types of mutation related to DNA repair) occur fairly frequently in men with advanced metastatic prostate cancer. A study testing Olaparib for treatment of prostate cancer patients was published in the New England Journal of Medicine.
It showed that Olaparib was very effective in 15 out of 16 men who had this type of mutation in their cancer cells. In men without this specific type of mutation, the response rate to Olaparib was less than 10 percent. Hopefully, genetic testing will lead to further such discoveries.
Because we were unable to obtain genetic information from Paul, we don’t know if his excellent response to Mekanist occurred due a malfunction of a specific gene called GNAS (which can predict that Mekanist will work), or to some other yet unknown gene. However, now with the easy access of genetic information through blood testing with blood-derived genetic tests, we should be able to learn which treatments are likely to induce a cancer response based on each patient’s specific genetic profile.
‘Play for Purpose’ Charity Lottery
Play For Purpose is a not-for-profit game. We guarantee that $15 from every $25 ticket you buy goes directly to the charity of your choice. You also get the chance to share in $1,000,000 worth of prizes. Now that’s a win-win!
Every Day 54 men are diagnosed with prostate cancer. No other cancer affects more Australian men and yet in far too many cases, men live with long-lasting impacts on physical and mental well-being and often fail to seek or find help or support. Tragically every day 9 men don’t survive. $15 from each ticket will help us fund life-saving research and provide vital support to the 200,000 men and their families currently affected by prostate cancer. Too many men are at risk. Your support for Play For Purpose will make an amazing difference. Breakthroughs and improvements in the treatment of prostate cancer are possible with the support of people like you.
- Gold Bullion valued at $500k
- Luxury Car Package Valued at $150k
- Travel prizes worth over $40k, and
- over 11,000 minor prizes
With at least a 1 in 19 chance of a prize, tickets purchased on-line only due to cost efficiency
NOTE: HPCSG Editor is not a health professional and bears no responsibility to any claims held within any publications and articles mentioned. Please discuss and seek advice from your own preferred health professional regarding any information or interest found in any article or publication listed in this newsletter.
HPCSG NEWCASTLE HARBOUR LUNCH CRUISE
WHEN – Sunday, 18th March 2018
WHERE – Lee Wharf, Honeysuckle Dr, Newcastle
COST – $54/$49 – further details in Newsletter
Balmain Sports Medicine 7th Annual Charity Golf Day
WHEN – 16th Feb, 2018 WHERE -Moore Park Golf Club
Registrations now open
02 9818 1004
Outback 4WD Adventure
WHEN – 22 – 29 Sep 2018
WHERE – Cobar to Broken Hill via the Big Red outback of NSW/SA/QLD