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The Manitoba Prostate Cancer Support Group
Vol. : 166 - April 2005
Thought For Today
Men are an ingenious assembly
of portable plumbing
-Christopher Morley
The Manitoba Prostate Cancer
Support Group encourages wives,
loved ones, and friends to attend
all meetings.
Feel free to ask basic or personal
questions without fear of
embarrassment. You need not
give out your name or other
personal information.
The Manitoba Prostate
Cancer Support Group does
not recommend treatment
modalities, medications, or
physicians. All information
is however freely shared.
___________________________
Want to reach us by email ?
___________________________________
J. Butler M.D.
Radiation Oncologist
In This Issue
Paul Daeninck M.D.
Pain Management
page 2
Graham Glezerson M.D.
Urologist
MOST MATERIALS LEAVE OUT DETAILS KEY
TO DECISION MAKING
Alan Katz M.D.
Family Practitioner
page 3
Len Leboldus M.D.
Urologist
FOCAL CRYOTHERAPY FOR PROSTATE CANCER MAY
OFFER BENEFITS OVER CURRENT TREATMENTS
Ross MacMahon M.D.
Urologist
page 4
John Milner M.D.
Urologist
SEX, CANCER AND ALL THAT JAZZ
Gary Schroeder M.D.
Radiation Oncologist
page 5
POWELL URGES MEN TO
DETECT PROSTATE CANCER EARLY
Thanks!
___________________________
Cancer Information
Service
page 6
NEW URINE TEST MAY IMPROVE
PROSTATE CANCER SCREENING
IMPOTENCE FROM PROSTATE RADIATION
MAY BE AVOIDABLE
page 7
[email protected]
Medical Advisors to
The Manitoba
Prostate Cancer
Support Group
EXPERTS CALL FOR TEAM APPROACH
TO PROSTATE CANCER
Call toll free: 1-888-939-3333
or 1-905-387-1153
When you call the toll free
number of the Cancer
Information Service, your
questions will be answered by
someone who understands
how confusing the subject of
cancer can be. All calls are
kept confidential
NEXT MEETING:
TOPIC: Prostate Health & Naturopathic Medicine
Drs. Sims and Schrader Naturopathic Physicians
April 21, 2005
7-9 P.M.
Location: AUDITORIUM of the Seven Oaks General Hospital - Leila & McPhillips
Lots of Free Parking on the street.
www.manpros.org
The Manitoba Prostate Cancer Support Group Newsletter
Most materials leave out details key to
decision making
Ann Arbor - When a man is diagnosed with early-stage
prostate cancer, he must decide among four different
treatment methods, each of which carries its own set of
benefits and risks. The specialists disagree which
method is most effective and the research to date is
inconclusive.
But when men turn to widely available patient education
materials, they're likely to find minimal information on the
likelihood of side effects and a bias toward active
treatment, according to a new study published by
University of Michigan Health System researchers in the
May issue of Annals of Internal Medicine.
Patients should not rely on only one source of information
before making a decision about prostate cancer treatment.
We found no single health pamphlet or Web site presented
all the information needed to make an informed decision.
Prostate cancer patients say they want to learn about the
side effects of treatment before making their decision, but
our study found many educational materials actually
avoided talking about these side effects, says lead study
author Angela Fagerlin, Ph.D., a research investigator in
the Department of Internal Medicine at UMHS.
Early-stage prostate cancer is usually treated with watchful
waiting, radical prostatectomy, radiation therapy or
hormone therapy. No clinical trials have shown a difference
in 10- to 15-year mortality among these treatments, so men
must weigh the importance of a variety of side effects when
deciding what treatment to pursue.
The researchers sought out publicly available materials
produced by patient advocacy groups, government
organizations, pharmaceutical companies, insurance
companies, universities and comprehensive cancer
centers. Web sites were identified by reviewing national
organizations, pharmaceutical companies and an
open-ended Web search.
Any materials that did not cover the four standard prostate
cancer treatments, looked at cancer in general or focused on
prostate cancer screenings was excluded. The final list
included 44 print materials, Web sites, videos and CDROMs.
Publications Agreement #40037332
Return Undeliverable Canadian Addresses to:
Manitoba Prostate Cancer Support Group
#705 - 776 Corydon Ave
Winnipeg, Manitoba
R3M 0Y1
April 2005
2
Each item was scored based on whether it contained
information on specific topics, from a basic overview of
prostate cancer to the side effects of each treatment option.
While most materials covered basic information on prostate
anatomy and prostate cancer staging, fewer materials
addressed negative topics such as potential side effects,
emotional discomfort or death.
There was a disturbing lack of discussion about the
likelihood of experiencing the side effects of these
treatments, as well as a lack of discussion about what it
would be like to undergo these types of treatments, says
Fagerlin, who is also with the Ann Arbor VA Health
Services Research and Development Center for Practice
Management and Outcomes Research.
Specifically, half the materials did not discuss the need for
hospitalization after radical prostatectomy and only 53
percent of print materials talked about catheterization.
Incontinence and impotence were frequently listed as side
effects of treatment, but bowel disorders and the risk of
death were seldom acknowledged.
In addition to content, the materials were evaluated for
accuracy, balance and readability. The information
was found to be accurate for the most part and only one
item showed significant imbalance in describing
treatment options. In general, though, the materials were
biased toward active treatment over watchful waiting and
the impact of side effects was minimized.
The researchers also found the average reading level for the
materials was above the ninth-grade level typical for health
information but above the average reading ability of
American adults. Materials were also written in passive,
third-person, clinical language and contained dense pages
full of text with no graphics, photos or other visual
elements to engage readers.
The study authors recommend that organizations producing
patient education materials offer complete information on
how the treatment is provided, including its risks and
benefits. The material should speak from a patient's point of
view and should use a clear and engaging writing style and
presentation.
To help patients obtain thorough, balanced information on
treatment options, the study authors developed a set of
patient education materials, available in booklet form, on
CD and audiotape, and on the Internet at
www.prostatecancerdecision.org.
www.manpros.org
(Continued on page 3)
The Manitoba Prostate Cancer Support Group Newsletter
(Continued from page 2)
In addition, Fagerlin suggests patients seek out educational
materials from organizations that have established
credibility, such as the National Institutes of Health, the
Centers for Disease Control and Prevention, the National
Cancer Institute or the American Cancer Society.
Funding for the study came from the Michigan Department
of Community Health and the Michigan Public Health
Institute.
In addition to Fagerlin, study authors are John Wei, M.D.,
from the UMHS Department of Urology; David
Rovner, M.D., Christophir Jentoft, and Margaret HolmesRovner, Ph.D., from Michigan State University; and
Sue Stableford from the Maine Area Health Education
Center Health Literacy Center at the University of New
England.
Soucre: University of Michigan Comprehensive Cancer Center
...
Videos, We Have Videos!
More than 100 video tapes are
available for loan or purchase.
We have “videographed” almost every speaker
for the last six years, and there are others from
outside sources on particular topics.
A detailed listing with indexes
is available on our website www.manpros.org
Contact Eleanor or
Lorne Strick
(204) 667 9367
if you are interested.
April 2005
3
Focal cryotherapy for prostate cancer may
offer benefits over current treatments
NewsRx.com - July 29, 2004
Physicians are adopting a new cryosurgical procedure for
prostate cancer using focal, freezing technologies, which
early evidence suggests causes fewer side effects than the
current surgical treatments for the disease.
Clinical results of this new focal procedure called the
"male lumpectomy" were presented by Gary Onik at the
recent annual meeting of the Society of Uroradiology.
Onik's study examined 21 patients aged 58 to 70 with
prostate cancer who underwent focal cryosurgery, and 20
had no evidence of cancer in follow-up examinations
between 2 and 8 years later.
Onik said, "Essentially 95% of the patients had stable
prostate specific antigens (PSA) at an average of 4 years.
This demonstrates that patients are responding to the
procedure."
Impotency and incontinence are the two most common
complications associated with any prostate surgery, but
Onik and colleagues found about 80% of men receiving
focal cryosurgery remained potent and none became
incontinent.
Endocare Inc., the manufacturer of the Cryocare system
used for the procedure estimates that the number of focal
procedures has doubled each year in recent years. A
recent survey cited in Physicians Weekly said
approximately 60% of the 150 centers that perform
cryosurgery in the U.S. now offer some form of focal
cryotherapy.
Additionally, targeted cryosurgery is the most effective
treatment for men with recurrent prostate cancer (after
failed radiation treatment) whose PSA levels again rise.
Aaron Katz of Columbia Presbyterian presented
compelling 6-year clinical data at the national AUA
conference where he showed 71% of failed patients still
had undetectable PSA values 5 years after undergoing
targeted cryosurgery. This article was prepared by Biotech
Law Weekly editors from staff and other reports.
Copyright 2004, Biotech Law Weekly via LawRx.com
...
www.manpros.org
BRIAN RICHARDSON
BILL BACKMAN
TUSIA KOZUB
CHRIS SIGURDSON
SOFIA COSTANTINI
PETE SZEKELY
The Manitoba Prostate Cancer Support Group Newsletter
April 2005
5
Powell Urges Men to
Detect Prostate Cancer Early
The Milwaukee Journal Sentinel - July 8, 2004
Thursday, July 8, 2004
Sex, Cancer and All That Jazz, was conceived by
our member, Norm Oman, who collected stories told
by cancer survivors: some funny, others not funny,
but all are perplexing.
The musical has been written, performed and
produced by a group of talented artists, many of
whose lives have been touched by cancer.
Help throw some light on the issues of sexuality
confronting cancer patients by treating yourself to an
hour of entertainment!
Friday, Aprill 22
7:00 PM
School For The Deaf
285 Pembina Hwy
Washington -- Looking fit after traveling some 2,900 miles
on diplomatic business in four countries over eight days,
Secretary of State Colin Powell still looks back on his
successful prostate cancer surgery as carrying an important
message for all men.
"Detect prostate cancer early," Powell says. Otherwise, if
you don't, "it will kill you."
And the younger you are, the more aggressively the cancer
will grow, Powell said this week in an interview on PBS'
Tavis Smiley show.
African-Americans have to be more careful, and have more
examinations on a regular basis to detect the disease as
early as possible, Powell said. "That's just a fact of life."
"We are at a higher risk to prostate cancer than our white
brothers," Powell said. "It's well-known. It's documented."
Forrest Nickerson Theatre
But, he said, all men are at risk.
...
Powell's experience bears out how elusive prostate cancer
can be.
Referring to a test given routinely to men at about 50 and
usually to African-Americans a few years earlier, Powell
said that a test about six years ago showed that his PSA
(Prostate Specific Antigen) level was high.
He had two biopsies in the late 1990s that did not detect
cancer, he said. Last August, with the PSA level still
elevated, he had a "very intrusive biopsy" at Walter Reed
Army Medical Center and the tumor was found.
Out of 13 samples, only one had shown the cancer.
Powell elected surgery over radiation and other options.
"Nobody likes to have surgery," he said. "And, believe it or
not, even though I am 67 years old, until that operation last
December I had never spent one day or night in a hospital.
I've been in remarkably good health."
Suddenly, to hear you have cancer and it's got to be
removed "is a little unnerving," Powell said. "But you have
got to face it."
(C) 2004 The Milwaukee Journal Sentinel. via ProQuest Information
and Learning Company; All Rights Reserved
Stitches
February 1998
www.manpros.org
...
The Manitoba Prostate Cancer Support Group Newsletter
New Urine Test May Improve
Prostate Cancer Screening
The following information was obtained from the
Cancerfacts.com website.
Researchers have developed a simple urine test for a
protein reduced exclusively by prostate cancer cells that
may improve the accuracy of screening.
A research team led by Dr. Bruce Zetter, from Children's
Hospital Boston, discovered a protein, called thymosin
beta-15, unlike prostate specific antigen (PSA), is produced
almost exclusively by cancer cells and is detectable in
urine. The protein stimulates cell migration and promotes
the spread, or metastasis of prostate cancer. The study
results first appeared in the January 21st, 2005 issue of the
online edition of the journal The Prostate.
The authors reported, "thymosin beta-15 (T beta-15) is a
urinary biomarker for prostate cancer, and suggested that T
beta- 1 5, in combination with PSA, can be used to improve
both sensitivity and specificity of prostate cancer
diagnosis.”
In the study, Zetter and colleagues compared thymosin
beta-15 levels in urine samples from 121 men with prostate
cancer, 15 men with kidney or bladder cancer, 81 men with
non-malignant prostate disease such as prostatitis, 73 men
with other non- malignant urologic diseases such as urinary
tract infections, and 52 healthy men without prostate cancer
who served as a comparison, or control group. T beta- 1 5
were elevated in men with aggressive or untreated prostate
cancer but near normal in healthy men and other
genitourinary diseases. Men with aggressive prostate cancer
were 12 times more likely than the healthy controls to have
elevated thymosin beta- 1 5.
Men with aggressive prostate cancer were 12 times more
likely than the men that were used as the control subjects to
have elevated thymosin beta- 15. T beta-15 levels were
found to be normal or near normal in healthy men as well
as those men with other genitourinary diseases.
Notably, nearly half of cancer patients whose PSA levels
were considered normal tested positive for thymosin beta- 1
5. Conversely, many men with other genitourinary diseases
had elevated PSA'S, but normal thymosin beta-15 values.
When PSA and thymosin beta15 were combined, the
combination detected prostate
cancer more often than PSA
testing alone, with far fewer
false- positives.
April 2005
6
Impotence from Prostate
Radiation
May be Avoidable
The following information was obtainedfrom the Google Alerts website - and
came from ASCO (American Society of
Clinical Oncology)
Radiation therapy is effective for prostate
cancer, but up to 90 percent of men will
develop impotence after the treatment.
New research indicates that this
frustrating side effect may be avoided if
MRI and CT, rather "than just CT, are
used to plan exactly how and where
radiation will be delivered.
Previous reports have suggested that
prostate radiation causes impotence by
damaging the structures that control
blood supply in the penis. Therefore,
radiotherapy that avoids these structures
could potentially preserve sexual
function. This is where treatment
planning comes on.
Dr. Patrick W McLaughlin, from the University- of
Michigan in Ann Arbor, said that with standard CT
planning, it is often assumed that the distance between the
prostate and these key structures is 1.5cm, however, Dr.
McLaughlin and colleagues found that when they used
combination of MR[ and CT scans in 25 men who had
prostate cancer in order to determine the exact distance
from the prostate to the blood-containing structures it was
found that the average distance - 1.45 cm - was close to that
used with CT-based planning, however, the actual values
varied from 0.7 to 2.1 cm.
The exact determination of the distance allowed the team to
target radiotherapy more precisely, and dramatically reduce
the dose to the critical erection structures.
The new findings were published in the International
Journal of Radiation Oncology Biology Physics.
The authors of this study reported that further studies would
be needed in order to determine if MRI plus CT planning of
the radiation therapy actually prevents impotence.
...
www.manpros.org
...
The Manitoba Prostate Cancer Support Group Newsletter
Experts Call for Team Approach
to Prostate Cancer
22 September 2004
WASHINGTON (Reuters) - Doctors need to develop a
more organized team approach to prostate cancer, with a
clear outline of how to screen for and treat the disease, a
panel of cancer experts said on Wednesday.
Doctors still do not agree on the best way to screen for
prostate cancer, let alone how to treat it, the panel of 24
doctors and researchers said.
April 2005
7
Because prostate cancer is often a slow-growing disease,
doctors and patients alike often do not take it seriously until
it has spread, said Dr. Anthony D'Amico of Brigham and
Women's Hospital and Harvard Medical School in Boston.
About a third of all cases of prostate cancer are dangerously
aggressive, D'Amico, a member of the panel, said in a
telephone interview.
"A three-month delay in the management of this type of
prostate cancer may actually lead to lower control rates," he
added -- meaning these patients will be more likely to
relapse and perhaps even to die of their disease.
"This is a third of all the guys coming in, out of 230,000
prostate cancer cases a year. It is not a small number."
"The coordination of care among urologists, radiation
oncologists and medical oncologists is crucial to the wellbeing of patients and to the proper management of prostate
cancer, but many patients are not made aware of a
multidisciplinary team approach until their cancer has
progressed to a late stage," the report from the
philanthropic Prostate Cancer Foundation reads.
In June doctors reported that prostate cancer patients can
also be helped by Taxotere, a breast cancer drug made by
Aventis SA.
Standard advice currently is for men to choose their
preferred treatment, in consultation with their urologist,
who may or may not be a cancer specialist. The usual
choices are surgical removal of the prostate, radiation
treatment or a hormone-based treatment.
D'Amico has also pressed for new ways to analyze the
standard screening test for prostate cancer, a measurement
of PSA or prostate specific androgen.
In contrast, when a woman is diagnosed with breast cancer,
she usually meets immediately with a surgeon, a radiation
specialist, and a medical oncologist who can talk to her
about chemotherapy.
His team has found that how quickly PSA levels rise, rather
than the absolute numbers, are the best indication of how
dangerous a patient's prostate cancer is. The panel said this
theory needs to be validated with more tests and put into
practice.
Men should have clearer choices, and their doctors should
have clearer guidelines on what to recommend, said the
report.
"This opens the door now to the testing of chemotherapy in
earlier stages of prostate cancer," D'Amico said.
http://www.prostate-cancer.org.uk/news/fullStory.asp?id=1440
"The need for innovation is more urgent than ever, as the
baby-boomer men reach the target age for prostate cancer
beginning at age 50," said Leslie Michelson, chief
executive officer of the Santa Monica, California-based
group.
"The number of new prostate cancer cases in the United
States is anticipated to increase by 50 percent to more than
300,000 new cases per year by 2012."
Prostate cancer now kills 29,000 Americans a year.
The report calls for better research and efforts to get men
with prostate cancer to take part in trials that can help
answer questions.
www.manpros.org
...
Manitoba Prostate Cancer Support Group
# 705 - 776 Corydon Ave.,
Winnipeg
R3M OY1
Publications Agreement
# 40037332
FUTURE MEETINGS:
M.P.C.S.G.
2005
Manitoba
April 21, 2005
7-9 P.M.
Topic Prostate Health &
Naturopathic Medicine
Dr. Sims / Dr. Schrader
May 19, 2005
7-9 P.M.
Topic Dealing With Incontinence
After Prostate Cancer Treatment
Fran Rosenberg RN
Nurse Advisor Continence Control
Executive Committee:
(204)
Marv Brodsky, Secretary
Jack M. Chapman, Honorary Lawyer
Ted Chivers, Special Projects
Joseph Courchaine, Treasurer
Michael Doob, Newsletter Editor
Herold Driedger, Political Action
Michael Iwasienko, Phone Committee
Jim Jannetta, Prostate Cancer Awareness
Dan Joss, Volunteer Coordinator
Ken Kirk, New Member Chairman
Larry Lakey, Member at large
Sol Masarsky, Hospital Visitation
Norm Oman, Chairman, Events Coordinator
Lorne Strick, Videographer
Pete Szekely, Newsletter Layout / Webmaster
Arthur Wortzman, Speaker Chairman
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632-6210
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487-4418
667-9367
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287-8621
989-3433
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