Download CVPCSG newsletter 11.11 - Prostate Cancer Canada

November/December 2011
NEWSLETTER
These smiling
faces make up the
initial 1:2:1 mentoring
group who are prepared
to meet members to
discuss individual
concerns.
NEXT MEETING:
Dr. Mark Woldnik from Cumberland will be presenting a family physicianʼs perspective on the
detection and treatment of prostate cancer with personal anecdotes and experience.
!
!
7:30; Monday evening, November, 2011
Annual Christmas Pot Luck 4:30 pm on November 28
See page 2 for more information
Ramblings: Our Takla Lake rep, Merry
Kissmoose, seen here
practicing the latest in
moose carols, reports from
the Great White North that
he last saw Doug hip
hopping into a very large
bog where some hungry
horse flies were waiting. He
went on to state that his
other friends were doing
their best to avoid Doug in
hopes that he would soon
return to the Island.
[1]
News Flashes:.
Monday, October 17, 2011: Harvest Auction: The evening of active
bidding succeeded in raising $420 to support the annual Christmas
Dinner.
Monday, November 14, 2011: Dr. Mark Woldnik: Dr. Woldnik will
discuss prostate cancer from a family doctorʼs point of view.
2011
Steering Committee
Monday, November 28, 2011: We hope to have a good
turnout for our annual Christmas Pot Luck which begins
at 4:30 in the Evergreen Lounge at the Florence Filberg
Centre, 411 Anderton Avenue in Courtenay.
Space is limited to 72 seats so please call:
Don at 250.334.2807 or Bob at 250.338.2313
to reserve your seat(s).
For the Pot Luck bring your favourite salad, veggie or
dessert. Everything else will be provided.
Monday, January 9, 2012: Gordon Hearing Services: Jason
Gordon will be explaining how hearing losses are detected and dealt
with.
Ongoing: If you have a Thriftyʼs Smile Card, please be sure to use it. The
returns that help us so much are drifting downwards and every bit helps.
Chair:
Doug McPherson
250 336-8526
Vice Chair:
Harry Whitfield
250 339-0221
Secretary/Treasurer:
Brian Lunn
250 338-8235
Programs:
Doug McPherson
Paul Ryniak
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What is Celibacy?
Celibacy can be a choice in life, or a condition imposed by
circumstances.
While attending a “Marriage Weekend”, Frank and his wife
Nancy listened to the instructor declare,
"It is essential that husbands and wives know the things that are
important to each other."
He then addressed the men: "Can you name and describe your
wife's favorite flower?"
Frank leaned over, touched Nancy 's arm gently, and whispered,
"Gold Medal-All-Purpose, isn't it?"
And thus began Frank's life of celibacy..
Lessons Taught by Life
Make peace with your past so it wonʼt screw up the present.
Get rid of anything that isnʼt useful, beautiful or joyful.
Time heals almost everything...Give time, time.
Life isnʼt tied with a bow, but itʼs still a gift.
[2]
Hospital Outreach:
Russ Engelmyer
250 339--4986
Social:
Bob OʼBlenis
250 338-2313
Website:
Don Waddell
250 338-6748
Newsletter:
Brian Lunn
250 338-8235
Home Visits:
Don Lanyon
250 334-2807
Brochures:"
Norm Lundie
250 339-6474
Important Changes in BC Representation
Legislation Now In Effect
On September 1, 2011, B.C.ʼs new personal planning laws came into effect.
Read the government press release announcing these changes here:
http://www2.news.gov.bc.ca/
news_releases_2009-2013/2011HLTH0060-001118.pdf
Itʼs difficult to think of a time when you or a loved one might be unable to
express your wishes to a health care provider due to illness or injury.
However, planning in advance for this possibility is extremely important.
Thanks to new health care consent laws and other personal planning
options that came into effect on September 1, 2011, capable adults may
now make an Advance Directive and/or name a Representative to make
their health care decisions, without having to visit a lawyer.
New resources and optional legal forms are available through the Ministry
of Health website http://www.health.gov.bc.ca/hcc/advance-careplanning.html where you will find comprehensive information, including links
to the new legislation, forms, and health authority resources. The provincial
advance care planning guide will be available Fall 2011.
Name a Representative in a Representation Agreement
http://www.ag.gov.bc.ca/incapacity-planning/
Nidus and Personal Planning - http://www.nidus.ca/ A valuable source
of information and support in planning for a time when you will be unable to
express your wishes. Nidus will also provide assistance in preparing for
your future.
Prostate Cancer Canada
Network - Comox Valley
website:
www.cvprostatecancer.org
e-mail:
[email protected]
Mailing Address:
5976 Aldergrove Drive,
Courtenay, BC, V9J 1W3
Meetings:
Comox Valley Health Centre,
961a England Avenue,
Courtenay, BC
Next Meeting:
Monday, 7:30 pm, November 14,
2011.
Member of the month:
Ray Lindsay
Nidus & Personal Planning
The Nidus Personal Planning
Resource Centre is a non-profit,
charitable organization. Nidus
provides information to British
Columbians about personal
planning. They also operate a
centralized Registry for personal
planning documents. Personal
planning is about making legal
arrangements in the event you
need assistance managing your
affairs due to illness, injury or
disability. Personal planning can
address a variety of situations
and needs. Amendments to
personal planning legislation in
BC started September 1, 2011.
Our Mission Statement:
Prostate Cancer Information
“We aim to help those who have
Prostate Cancer Canada:
www.prostatecancer.ca
Prostate Cancer Canada
Network:
www.prostatecancernetwork.ca
Canadian Cancer Society:
Information LIne:
1 888 939-3333
Comox Valley Unit:
102 1509 Cliffe Avenue
Courtenay, BC, V9N 2K6
250 338-5454
Prostate Cancer Foundation BC
www.prostatecancerbc.ca
been diagnosed with prostate
cancer by providing opportunities for
learning more about the disease
through group discussions and
personal support. We work to
increase public awareness of
prostate cancer through advocacy,
presentations to interested groups,
free prostate cancer screening and
publicity.”
Medical Advisors:
Dr. Aaron Clark
Dr. James Chartrand
Dr. Will Tinmouth
[3]
A made-in-Canada view of PSA testing from PCC
Prostate Cancer Canada 10/25/2011
A“tizzy” is perhaps the best way to describe the effects of the recommendation released earlier this month by the United
States Preventive Services Task Force, a panel of medical professionals that provides guidance on preventive health
measures. The recommendation concerned the prostate-specific antigen (PSA) test, which is conducted on men to screen for
cancer of the prostate gland, the most common form of cancer experienced by Canadian men. While no one disputes the PSA
test helps to detect cancer, the task force decided on the basis of five large clinical trials that the risks of prostate cancer
treatment outweighed the risks of prostate cancer itself. In other words, the task force was telling healthy men they were better
off not knowing whether they had prostate cancer.
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I disagree, as do many other doctors like myself, who specialize in preventive medicine. The PSA test is by no means
perfect. However, it does form an important component in an ongoing and developing series of algorithms designed to predict
whether a given male will develop prostate cancer, and whether that cancer will be a dangerously aggressive form of the
disease. Early detection of the aggressive forms of prostate cancer in younger males (aged 65 or less) saves lives. However,
the medical community would benefit from a standardized approach for the treatment of low-risk prostate cancer — guidelines
on when to wait and monitor, for example, vs. actually treating the prostate cancer. Few people with prostate cancer ever
choose to wait and monitor. The CaPSURE study, a U.S. survey of 14,000 prostate cancer patients, found that only 9% of men
in the very low-risk category chose surveillance. If anything, the PSA test hubbub shows how important it is to develop new
studies that can detect earlier whether a person will develop prostate cancer — and methods that can accurately predict
whether the person will develop the aggressive or slow-growing form of the disease.
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Along with my co-worker, the genetic counsellor Jill Davies, and doctors from the University of Toronto and Toronto East
General Hospital, Iʼve been working on a study that works to improve our ability to screen for prostate cancer. The study uses
genomic testing to examine probable risk of disease in conjunction with procedures like the PSA test. Our team presented the
study last week in Montreal at the International Congress of Human Genetics.# #
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The study involves something called a “nomogram,” which is a number that evaluates a manʼs risk for developing
prostate cancer. Several ways to arrive at such a number exist; our study used a respected version developed at Torontoʼs
Sunnybrook Hospital, which takes into account not only conventional factors, such as PSA testing and a digital rectal exam, but
also factors such as family history, ethnicity, age and urination habits and behaviour. Better yet, the Sunnybrook rating system
provides two values — one which assesses risk of developing any type of prostate cancer, and the second which assesses risk
of developing the aggressive form of the cancer.##
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Hereʼs what we did: We selected 183 of Medcanʼs male patients and provided them with our Menʼs Health Screening
assessment (which leads to the Sunnybrook nomogram) as well as Medcanʼs Personal Genome Testing, which examines a
personʼs DNA to establish risk of developing many types of disease, including prostate cancer. (Mean age of male subjects
was 52.6 years.) Then we compared both results. The idea was to determine whether the genetic testing was independent of
the nomogram value. Did those with high nomogram values also have genomic scores that indicated increased risk of
developing prostate cancer? If yes, and the two values were in some way related, then genomic testing would not complement
the nomogram. If the two values demonstrated no relation, then perhaps genomic testing should be incorporated into the
nomogram algorithm.# #
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Our study indicated the two values were independent of one another. Two roads exist from this point. Weʼll look to
verify the results by increasing the studyʼs sample size. Weʼll also begin working to determine the efficacy of incorporating
genomic testing into the nomogram, with a view toward increasing the nomogramʼs predictive accuracy.# #
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“We wonʼt ever be able to tell you with complete certainty whether youʼll develop prostate cancer,” Jill Davies says.
Instead, the idea is to find, early on, those who have a high probability of developing the aggressive form of the cancer, she
says. Then, once we find those people, we can work to change their lifestyles in a manner that substantially decreases their
risk — for example, by avoiding obesity, smoking and a high-fat diet. Studies suggest it helps to eat lots of folate-rich foods,
including green vegetables, beans and orange juice. Also associated with a reduced risk of prostate cancer is a diet rich in
cruciferous vegetables, such as broccoli, cabbage, cauliflower, kale, collard and mustard greens, horseradish, kohlrabi,
brussels sprouts, broccoli rabe, radishes, turnips, rutabagas and watercress. # #
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The results of our genetic prostate cancer study are only one reason I disagree with the U.S. Preventive Services Task
Force recommendation. The PSA test is not perfect, but it is important because it forms a crucial part of the algorithm that can
predict risk of developing prostate cancer, such as the Sunnybrook nomogram.# #
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In future, thanks to Canadian studies such as the one Davies is leading, genomic testing may be one way to improve
and complement the nomogram risk-rating system, to give us an improved understanding of which men develop the aggressive
form of prostate cancer.
Dr. James Aw is the medical director of the Medcan Clinic, a leading private health clinic in Toronto. For more information, visit
medcan.com
[4]