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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 ⸭ ⸬⸬⸪⸪⸫⸫⸬⸬⸭ 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. # 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. # 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.# # # # # # # 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.## # # # # # # # # 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.# # # # # # # # # # # # # # 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.# # # # “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. # # # # # # # 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.# # # # # # # 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]