Pccnottawa.ca2

NEWSLETTER OF PROSTATE CANCER CANADA NETWORK OTTAWA SEPTEMBER, 2014
P.O. Box 23122, Ottawa, ON K2A 4E2 • (613) 828-0762 • [email protected] Do You Really Need
a Biopsy? Two
and Sexual Issues
New Tests Help
after Prostate
You Decide
from johnshopkinshealthalerts.com
It's the holy grail – a prostate cancer these tests and their proper role in
test that can, with complete accuracy, the management of prostate cancer. distinguish men who have prostate Published studies are limited, and cancer from those who are cancer none of the tests has a long-term track free and, when prostate cancer is record in the real world where doctors diagnosed, determine whether it's an screen, counsel and treat patients. aggressive form that requires prompt It's also important to recognize that treatment or a slow-growing tumor prostate cancer tests can be marketed Presented by
that may only need close monitoring.
without proof of benefit and that PCCN Ottawa
While no such diagnostic tool is on the unsubstantiated claims abound for A FREE engaging session by near horizon, a number of companies have introduced new tests that could For now, the tests are intended to Andrea Simone, RN, BScN, CURN, push us closer to that goal. There's augment – not replace – a doctor's who will discuss successful still a great deal to be learned about clinical judgment and existing tests techniques and treatments related currently used to screen for and to erectile dysfunction following CRACKING OPEN THIS WALNUT
monitor prostate cancer. Whether the prostate cancer treatments in a fun Summer's been great. new tests add information that will and non-threatening environment. We've had such a time. significantly affect treatment decisions We've read and relaxed remains to be seen. Do you really need Partners and spouses are welcome! But my hamstring's not fine. a biopsy? An elevated prostate-specific Still, we forge on antigen (PSA) level can indicate that At 3:30 pm, Saturday,
a man has prostate cancer; however September 20th, 2014
The back of my front findings may also be elevated in men Where that muscle affixes. with other less serious conditions, At the Chateau Laurier
But here's some new stuff such as benign prostatic Our reporters have found Burgundy Room on level 2 enlargement (BPE). Yet most ‘Bout prostates and cancers, men with elevated PSA levels The news just abounds.
RSVP required as spaces are limited See Biopsy? on page 4 RSVP: JOHN at [email protected]
THE WALNUT • SEPTEMBER 2014
A Look at Updated
This latest iteration represents the third P.O. Box 23122, Ottawa, ON K2A 4E2 Prostate cancer experts at Johns
613-828-0762 (Voicemail) Hopkins have developed an update of the data.
Email: [email protected] • updated version of the Partin Tables, The newly revised Partin Tables show PCCN OTTAWA is a volunteer organization of prostate a tool to help men diagnosed with cancer survivors and caregivers. Our purpose is to prostate cancer and their physicians that certain categories of men who support newly-diagnosed, current, and continuing were previously not thought to have patients and their caregivers. PCCN Ottawa is a better assess their chance of a surgical a good prognosis actually could be member of the Prostate Cancer Canada Network.
cure. The refined tool, based on a study of more than 5,600 men treated at The cured with surgery. That's because the researchers now have a better John Arnold
Johns Hopkins Hospital from 2006 and Bill Dolan
understanding of intermediate risk to 2011, was published in the British and see that more men now fall into Journal of Urology International.
that category, instead of the higher- Jim Thomson
"The first thing most men want to John Temple
know when they learn they have For example, men with a biopsy prostate cancer is their prognosis and Gleason score of 8 and above Program Director Bill Dolan
whether they will be cured," says Alan previously were not thought to be good Mentoring Director W. Partin, M.D., Ph.D., Professor Outreach/Awareness John Arnold
and Director of the Brady Urological candidates for surgery because of the Volunteer Coordinator Bill Lee
Institute at Johns Hopkins and creator likelihood that the prostate cancer had Peer Support Director Knowlton Constance
spread. The new Partin Tables data of the Partin Tables.
show a higher probability of a cure The Partin Tables are a statistical with surgery even if a man's Gleason Shannon King
model to show the probability that the prostate cancer is confined to the prostate and therefore is likely to Gleason scores of 9 and 10 are still Distribution:
considered high risk, indicating that Andy Proulx,
be cured with surgery. The model is the prostate cancer likely has spread. Arland Benn
based on a patient's prostate specific antigen (PSA) level, Gleason score The researchers also found that having Members at Large David Brittain, Lionel Burns,
a PSA level of 10 and above was a John Dugan, Gerry Gilbert,
(a number from 2 to 10 that estimates better cut-off for predicting the spread Admin Support Team Mike Cassidy, Doug Payette,
the aggressiveness of tumors removed Martin de Leeuw, Fil Young
during a biopsy based on their of disease compared with lower levels.
Chris Brown
appearance under a microscope) and To access the updated Partin Tables, Hal Floysvik
clinical stage, which is the extent to which a tumor can be felt during a PCCN Ottawa does not assume responsibility or digital rectal exam.
By inputting your PSA, the Gleason liability for the contents or opinions expressed in this newsletter. The views or opinions expressed are solely Data for the Partin Tables, first score, and the clinical stage results for the information of our members and are not intended published in 1993, have been and clicking on "find results," you for self-diagnosis or as an alternative to medical advice and care.
based on the outcomes for more can see the percentage chance that the than 20,000 men who underwent cancer is confined to the prostate, has PCCN Ottawa Mission Statement
prostate removal (known as radical migrated to the edge of the gland, has We provide information on prostate cancer to
prostatectomy surgery) at Johns invaded the seminal vesicles, or has those in need, gathered from a variety of sources.
Hopkins over the past three decades. spread to the lymph nodes. We participate in events that provide a venue
for promoting awareness of prostate cancer
through our informed member interaction at public
gatherings or as speakers. We collaborate with local
organizations such as The Ottawa Hospital, the
Ottawa Regional Cancer Foundation, the Canadian
Cancer Society, urologists and oncologists for
Our Steering Committee did not steer itself into oblivion. Instead, it took a much-deserved information and support.
summer break. A summary of the September meeting will be published in the October issue.
THE WALNUT • SEPTEMBER 2014
A Question About Kegel Exercises from johnshopkinshealthalerts.com
Here's an important question
post-prostatectomy incontinence. continence, initially in women, from a recent issue of the
Although men can be considered and later, when the era of radical Prostate Cancer Bulletin. "I am
good candidates for surgery up to prostatectomy began, for men. After 68 years old and am scheduled for
the age of 70 and even beyond, radical prostatectomy, patients can prostate cancer surgery next month.
urinary continence is an important exercise the pelvic floor muscles as In a conversation with my urologist
consideration in my practice.
a means of interrupting the urinary today, he told me that he wanted
stream. Kegel exercise is commonly me to begin Kegel exercises daily to
The Kegel exercises were derived recommended, although the ability to strengthen my pelvic floor muscles.
from the work of Dr. Arnold Kegel, interrupt the urinary stream doesn't He said that these special exercises
a Los Angeles gynecologist who, in guarantee that total urinary continence would help speed up the return of
the 1940s, developed a method for will be preserved.
urinary continence following the
rehabilitating the strength of the vaginal surgery. I had never heard of these
muscles after childbirth. Dr. Kegel Your urologist is correct in suggesting exercises before and was even more
created these exercises to strengthen that doing Kegel exercises before surprised to hear that I may have
the muscles that travel from the front of surgery will familiarize you with problems with urination after the
the pelvis around the rectum. Actively the kind of muscle contractions surgery. What are your thoughts on
contracting these muscles shortens, necessary to interrupt the urinary the value of Kegel exercises before
tightens and rehabilitates the vaginal stream. However, there's very little and after prostate surgery?"
muscles. In men, they have the same data to suggest that you will actually effect on the muscles that control the strengthen the sphincter muscle in any Dr. Mostwin replies. At age 68, you
urinary stream.
meaningful way. So start doing the should definitely be concerned about Kegel exercises now in preparation for urinary continence after prostate Kegel exercises have been utilizing them after the operation, but cancer surgery. Increased age is one adopted over the years as part of a understand that there are other factors of the risk factors in developing rehabilitation program for urinary in regaining continence post-surgery. NEXT MONTHLY MEETING
Thursday, Sept. 18
6:30 – 7:30 p.m.: Mentoring for newly diagnosed in the Shalom Room
7:00 p.m.: PCCN Ottawa business
7:30 p.m.: Melina Ladouceur, the Lead Cancer Coach at the Maplesoft Centre, will discuss
what the Centre can do for cancer patients. Ms. Ladouceur is a registered social worker with a passion for health and wellness and a background in health system navigation. She has received additional training in health coaching through Health Change Australia and the National Association of Professional Cancer Coaches.
She also runs the Work and Cancer Survivorship group coaching program as well as a program for children and teens who are coping with cancer in the family.
We meet the third Thursday of each month at St. Stephen's Anglican Church,
930 Watson Street. Follow the Queensway to the Pinecrest exit and proceed north, past
the traffic lights, to St. Stephen's Street on the left. Parking is at the rear of the church.
Please remember your contribution for the St. Stephen's food bank.
WARRIORS SUPPORT GROUP
Tuesday, Sept. 16
1:00 – 3:00 p.m.: Regularly scheduled meeting
Warriors meetings are held the Tuesday BEFORE the regular monthly meeting
at the Maplesoft Centre for Cancer Survivorship Care 1500 Alta Vista Drive
(at Industrial in Cancer Survivors Park, across from Canada Post)
THE WALNUT • SEPTEMBER 2014

Biopsy? from page 1 Prostate Cancer Detection Method
end up having an anxiety-provoking biopsy to rule out prostate cancer. Can Save Men Painful Examination
Two new tests appear to be able to more accurately identify appropriate biopsy candidates.
Prostate Health Index. Commonly
known as the phi test, this assay measures blood levels of PSA, free PSA and a precursor (or early form) of PSA, known as pro-PSA or p2PSA. Research suggests that pro-PSA levels are a better indicator of prostate cancer than total or free PSA levels and that men with elevated pro-PSA levels are at high risk for having an aggressive form of prostate cancer. Using a mathematical equation, the phi test combines all three variants to better determine whether prostate cancer is present. The test is indicated for use in men age 50 and older whose A new technique developed
of the PSA (prostate specific antigen) at Eindhoven University of value in the blood. If this is high, Technology in the Netherlands can physicians will usually remove digital rectal exam showed no signs of potentially show tumors with much samples of prostate tissue through cancer and who have a total PSA value greater precision.
the anus at six to sixteen points for between 4 ng/mL and 10 ng/mL – a gray zone that could indicate prostate Each year prostate tissue samples pathological examination. cancer or a less serious condition such are taken from over a million men However, 70% of the subjects show no as BPE. The phi test doesn't deliver a around the world - in most cases using signs of cancer. So does this mean the definitive answer about whether or not 12 large biopsy needles - to check high PSA level is a false alarm? Not to have a biopsy. Instead, the phi test's whether they have prostate cancer. always: the biopsies may have been results, which are scored from 0 to 55 This medical procedure, which was taken at just the wrong places. Cancer and above, reflect the probability that a recently described by an American is later found in 30% of the patients biopsy will detect cancer. For example, urology professor as ‘barbaric', with negative results (no cancer). a phi test score below 27 is associated shows that 70% of the subjects do Among the positive results (patients with a 9.8 percent probability that not have cancer. The examination is with signs of cancer), doctors do not prostate cancer is present, while unnecessarily painful and involves know the exact sizes of the tumor. a score of 55 or more suggests a risk for these patients, and it is also In many cases, operations show that likelihood of greater than 50 percent. costly to carry out. A patient-friendly the tumors are so small that surgery Phi test results must be considered in examination, which drastically reduces was unnecessary. As well as that, the light of a man's other risk factors.
the need for biopsies, and may even examination leads to inflammations in eliminate them altogether, has been up to 5% of patients. Plus the fact that 4Kscore. This blood test measures
developed at Eindhoven University each examination costs around USD levels of three PSA variants (total of Technology (TU/e), together 2500 to carry out.
PSA, free PSA and intact PSA), plus with Academic Medical Center an enzyme called human kallikrein (AMC) Amsterdam. Research team leader Dr. Massimo 2 (hK2), which is elevated in men Mischi at TU/e has developed a with prostate cancer. Some scientists According to statistics collected method to investigate whether and believe hK2 may promote the growth and analyzed by Cancer Research where men have prostate cancer using and spread of prostate cancer. The UK, an estimated 258,000 men died existing ultrasound scanners, together 4Kscore also uses a mathematical from prostate cancer (worldwide) with the AMC Amsterdam. These algorithm to calculate the risk of in 2008. The standard procedure devices create images of organs in the prostate cancer in a man with an used worldwide for prostate cancer elevated PSA level. examinations starts with measurement See Detection Method on page 5 THE WALNUT • SEPTEMBER 2014

Detection Method from page 4 major comparative study will be held New Guidance
in these hospitals next year between body using sound waves, in the same the old and new methods, to proof that way as prenatal ultrasound scans. But the new method is better. This will these systems are usually unable to involve the use of both methods on show the difference between healthy at least 250 men. If all goes well the Prostatectomy and tumor tissue.
method will also be made available from 2016 for other patients, a large To make this visible, Dr. Mischi used part of which will then no longer have the fact that tumor tissue produces to undergo the old and painful form large numbers of small blood of examination. The new method can vessels to allow it to grow, with a be introduced quite simply because characteristic pattern. Patients are no new equipment is required; the given a single injection of a contrast When is radiation the right choice
for men who have had a radical existing ultrasound scanners which the medium containing tiny bubbles, prostatectomy? A panel of doctors hospitals already have can continue which are shown by the ultrasound representing the American Urological scanner right down to the smallest Association (AUA) and the American blood vessels. Using advanced image- Society for Radiation Oncology analysis techniques that can recognize (ASTRO) have collaborated to answer the characteristic blood vessel pattern that question.
in tumors, the computer then generates The resulting guidance, published an image showing where the tumor The Walnut Laureate
in 2013, is intended to help doctors is. The examination only takes one and their patients decide whether minute, and the results are available they should have adjuvant radiation no more than a few minutes later. (which is performed in conjunction These examinations also save money, with radical prostatectomy) or salvage because costly biopsy analysis is no radiation (which is administered in longer necessary.
response to evidence that cancer The researchers were able to compare has recurred).
the ‘tumor images' from 24 patients at According to the panel, consideration three hospitals in the Netherlands with of adjuvant radiation should be the the actual prostates after removal by RESTAURANT OF
standard of care for any man who operation. The images were found to PROSTATE WORDS
displays evidence of lingering cancer give a good indication of the locations by Glenn Kletke following radical prostatectomy, such and sizes of the tumors.
Every few months, you have a reservation. as positive surgical margins. The panel Figure it's time to eat at the old place again.
The use of the new method, which also recommended that men with a has been patented by TU/e, can avoid The doctor's in the kitchen, he may pop out. biochemical or local recurrence after the need for biopsies to be taken from Waiters walk efficiently around the room.
prostatectomy be offered salvage millions of men around the world. The No use looking at the menu. Not a hope in hell radiation therapy if there is no procedure will no longer be necessary that you get to pick what you will be receiving.
evidence of distant metastatic disease. for a large part of the 70% of men Smiling men around you get served great plates However, they stopped short of from whom biopsies are currently of undetectable, delectable dish you never tasted.
considering this the standard of care.
taken unnecessarily. And far fewer For you it will be the usual salad of uncertainty. They also recommended that biopsies will need to be taken from the The same stale overcooked PSA on your plate.
biochemical recurrence be defined remaining 30% because the location Main course of rising or almost-the-same or as a detectable or rising PSA value of the tumor is already clear. Once a big heap of something's going on in there.
of 0.2 ng/mL or higher after surgery the new method has been sufficiently The bill. Relax. Your health card will cover it. and that it be confirmed by a second proven in clinical practice, the need to Don't forget to make your next reservation.
measurement showing a rise of 0.2 ng/ do biopsies may even be eliminated mL or higher.
almost entirely.
Glenn Kletke's poetry has most recently appeared in "Whistle for Jellyfish" published The complete guideline is available at The research is being carried out by Booklands Press together with the AMC Amsterdam and two other Dutch hospitals. A THE WALNUT • SEPTEMBER 2014

HEAR YE! HEAR YE! HEAR YE!
Viagra To Have Generic Name
and Available in Liquid Form
All drugs have two names, a trade name and generic name.
For example, the trade name is Tylenol and it's generic
PROSTATE CANCER
name is Acetaminophen. Aleve is also called Naproxen. Amoxil is also called Amoxicillin and Advil is also called Ibuprofen. The FDA has been looking for a generic name for Viagra. After careful consideration by a team of government experts, it recently announced that it has settled on the generic WHEREAS, prostate cancer is the most common
name of Mycoxafloppin. Also considered were Mycoxafailin, cancer to affect Canadian men; and Mydixadrupin, Mydixarizin, Dixafix, and of course, Ibepokin.
WHEREAS, 1 in 7 Canadian men will be diagnosed with
As well, Pfizer Corp. recently announced that Viagra will the disease in his lifetime; and soon be available in liquid form and will be marketed by Pepsi Cola as a power beverage suitable for use as a mixer. WHEREAS, an estimated 23,600 Canadian men will be
It will now be possible for a man to literally pour himself diagnosed with prostate cancer this year; and WHEREAS, 90% of prostate cancer cases are curable if
Obviously we can no longer call this a soft drink and it gives detected and treated in their earliest stages; and new meaning to the names of ‘cocktails', ‘highballs' and just a good old-fashioned ‘stiff drink'. Pepsi will market the new WHEREAS, Prostate Cancer Canada encourages men
concoction by the name of: MOUNT & DO.
over the age of 40, as part of their annual checkup, to initiate a conversation with their doctor about early detection of prostate cancer, which may include prostate-specific antigen (PSA) testing and a digital rectal exam;
THEREFORE, I, Jim Watson, Mayor of the City of
Ottawa do hereby proclaim September 2014 Prostate
Cancer Awareness Month in Ottawa.
Here are some of the PCCN Ottawa participants in the Father's Day Ultimate Run for Men's Cancers last June 15. Our organization sponsors Team Don Hampton (in blue). Don, who died of prostate cancer, was a member. Each year his extended family takes part in the event. Also in the photo, wearing the distinctive yellow Prostate Gurus shirts, are Wilf Gilchrist (#88 - NOT his age!), Ron Marsden beside him and team captain Fred Nadeau ((#89) on the far right. Not in the photo, because he was still slogging through the 15 k event, is Richard Bercuson.
THE WALNUT • SEPTEMBER 2014

Source: http://www.pccnottawa.ca/sites/default/files/thewalnut/136nlsept14.pdf