Active Surveillance for Low Risk Prostate Cancer BY Dr Jeremy Grummet Prostate cancer can be aggressive and lethal, or slow and non-threatening, or anything in between. The challenge for each man with prostate cancer is working out where along this spectrum their particular disease lies. To guide us, we can use the PSA level and how fast it is rising (PSA velocity), how the prostate feels on rectal examination (the clinical stage), and the Gleason score of the cancer on biopsy (how aggressive or otherwise the tissue looks under the microscope). Putting all this information together, we try to predict the natural course of the disease. If the cancer appears to be localised to the prostate and the patient’s life expectancy is greater than 10 years, he and his specialist together decide
whether radical treatment will be undertaken with the aim of curing the disease. The question is, does the cancer need to be cured? The mainstream treatments for localised cancer are surgery (radical prostatectomy), which can be performed using several techniques, and radiotherapy, which may also take different forms. Whichever treatment is chosen, by virtue of the prostate’s delicate anatomical position, there are potential side-effects involving urinary, sexual and bowel function which may have a serious impact on that man’s quality of life. Since the introduction of PSA testing, we are finding many more prostate cancers with low risk features. In other words, these cancers may never progress or cause the patient any harm. So should these men be subjected to treatment which may not be necessary, and which may even cause harm? CONTINUED PAGE 3
FROM THE CEO The Prostate Cancer Foundation of Australia is delighted to be convening another major international conference on prostate cancer in 2010. This meeting builds on the hugely successful conference of November 2008 and extends the research, clinical and consumer streams in light of recent exciting developments in this area. With the theme Advancing Quality of Life, it will bring together leading Australian and international speakers and showcase the latest developments in prostate cancer research, management, health promotion, treatment and support. The conference will have designated streams for scientific research, clinical developments, support group instruction and healthcare professional training. We are also very pleased to confirm that the combined meeting of the Australian Canadian Prostate Cancer Research Alliance and the Australian Prostate Cancer Research Centre, Queensland will be convened as a satellite to the main conference (see page 11). As the peak Australian body in prostate cancer, we feel very privileged to be in a position to facilitate a meeting among key stakeholders in research, healthcare professional education, support groups and health promotion. In 2008 we brought all these players together for the first time. In 2010 we will be using the meeting as an opportunity to map a way forward for dealing better with prostate cancer in the future. The conference represents a unique opportunity for those people concerned about prostate cancer to come together to set the agenda for the next few years. Our aim is to bring together the largest gathering of survivors, carers, researchers and healthcare professionals who all have one important thing in common – a profound interest in matters relating to prostate cancer and a determination to play a role in reducing its impact. There is much work to be done in awareness raising, support and research – this conference will be another major step and we urge you to unit in the fight and join us on the Gold Coast on 6 August. Full details are on our website at www.prostate.org.au. I hope to see you there!
National Board Chairman
David Sandoe OAM
Finance Director Chris Hall Research Chairman
Professor John Mills
Assoc. Professor Phil Stricker
Support and Advocacy Committee Chairman David Gregory Rotary
State Chairmen Tony Sonneveld OAM (NSW) Jim Freemantle (WA) Jim Hughes (QLD) Des Grogan (VIC/TAS) Independent Directors
Professor Dexter Dunphy AM, Anita Ziemer Patricia Watson Jim O’Ryan Steve Callister
Jim O'Ryan National Board Member National Board member Jim O’Ryan spent most of his career in banking, and he retired as a general manager with the Commonwealth Bank in the mid-1990s. After that he pursued a management consulting career with a Boston-based company, before taking up a role as a professional company director. Jim identifies personally with the impacts of prostate cancer, having undergone a radical prostatectomy in 1991. Since then he has been fortunate to enjoy life to the full, with his wife of 44 years, Sybil, and their two daughters and four grandchildren. In his spare time Jim enjoys hiking, and has ticked off many of the great walks in Australia and overseas. A keen golfer, Jim is president of his golf club on Sydney’s Northern Beaches and claims to have a handicap ‘heading in the same direction as his advancing years’. Since 1998 Jim has been a Director of PCFA, four years of which he served as Chairman. His particular interest remains the achievement of positive outcomes from the considerable medical research that is now being funded by PCFA.
find us on 2 PROSTATE NEWS
Jim said: ‘The most rewarding thing I get from working with PCFA is providing young talented postdoctoral fellows with grants to undertake leading-edge investigations into prostate cancer, with the hope that one day they might be able to ease the burden of the disease on Australian men and their families’.
CONTINUED FROM COVER
What if there was a way to keep a close eye on these cancers to make sure they behaved themselves? A way that could avoid treatment of those cancers that remain stable, but could still allow curative treatment in those that showed signs of becoming aggressive? Enter, ’active surveillance’.
What is active surveillance? Active surveillance is not unique to prostate cancer. It is also conducted in the settings of low risk kidney and testicle cancer. The important point here is low risk. It is not an appropriate management option for aggressive disease. Once the diagnosis of prostate cancer has been confirmed on biopsy and it is deemed low risk (e.g. a Gleason score 3+3=6), the man may then undertake an active surveillance regime. This involves regular PSA levels and rectal examinations (initially every 3–6 months). Of critical importance is the need for repeat biopsies over the years. Exactly when the first repeat biopsy should take place is controversial, but it should certainly be within 12 months of the initial biopsy for two reasons. Firstly, even if the PSA and rectal examination findings remain stable, they are not accurate enough to be solely relied upon as markers of local progression. Secondly, a biopsy is just a sample of the prostate and can be subject to sampling error. In other words, it is possible that the initial biopsy has missed a more aggressive tumour which requires treatment. If all of the man’s cancer parameters remain stable, he continues on surveillance indefinitely. If, on the other hand, there is evidence of disease progression, then treatment to try to cure it may begin. Strictly speaking, this is where active surveillance differs from ‘watchful waiting’. Watchful waiting is the term used when a patient and his PSA are observed over time with a view to starting palliative hormone therapy if signs of cancer progression appear. Watchful waiting is more appropriate for a man with limited life expectancy due to other serious health problems or age. Active surveillance, on the other hand, may be considered in any man with low risk disease, who is also a candidate for local curative treatment. Not only are we now diagnosing more low risk prostate cancers, we’re also diagnosing them in much younger men. These are men who may not yet have experienced the lower urinary tract symptoms (LUTS) or erectile dysfunction (ED) that often come with age. Active surveillance allows these men to continue to enjoy their normal urinary and sexual function. Even if, years down the track, active surveillance is no longer appropriate for a man and curative treatment is undertaken, that man has ‘bought’ himself an extra few years of normal function.
ABOUT THE AUTHOR Dr Jeremy Grummet is a urologist and the principal investigator of the Prostate cancer Research International: Active Surveillance (PRIAS) study for the Alfred Hospital study site. He is also a member of Australian Urology Associates private practice.
Active surveillance is a mainstream management option for low risk prostate cancer, in men with a life expectancy greater than 10 years. It may avoid radical curative treatment and its potential side-effects either indefinitely, or for several years. The risk of prostate cancer becoming incurable during the period of observation appears to be very small. There needs to be ongoing research into active surveillance.
The risks The biggest fear in any active surveillance program is of missing the window of opportunity when the cancer may be at a curable stage. The risk of this occurring is real. Fortunately, it also appears to be very small due to the tight follow-up that active surveillance requires. International collaborative research, such as the Prostate cancer Research International: Active Surveillance (PRIAS) study and Surveillance Therapy Against Radical Treatment (START) trial, is being conducted to further assess the safety of active surveillance. However, as highlighted in the policies of the American Urology Association and Urological Society of Australia and New Zealand, and more recently in the National Comprehensive Cancer Network guidelines, active surveillance is already considered a mainstream management option for low risk prostate cancer and is being promoted by these authorities to prevent overtreatment of this disease. Another issue that needs to be addressed is the psychological impact of active surveillance: a man is diagnosed with cancer, but the cancer is then not treated. Unless the reasoning behind this is fully explained from the outset, it is easy to see why many men become anxious. In fact, the anxiety itself may interfere with a man’s quality of life to such an extent that he abandons active surveillance and opts for curative treatment, even if there are no signs of cancer progression. The onus is therefore squarely on the specialist to ensure that the man fully understands the reasons for active surveillance and what its follow-up program entails. ■
For more information, visit: www.auanet.org www.nccn.org www.usanz.org.au www.prias-project.org
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Dr Lisa Butler and Associate Professor Susan Henshall were two of PCFAâ€™s first research grant recipients. Here they provide updates on their research and insights into the importance of PCFAâ€™s research funding program.
Dr Lisa M Butler PCFA Fellow 2002-2004
WHERE ARE THEY NOW?
The aim of my Postdoctoral Fellowship, funded by PCFA from 2002-2004, was to develop new, more specific strategies for treatment of advanced prostate cancers. Growth of prostate cancer cells is initially dependent upon hormones called androgens. Androgen ablation therapy is used to reduce androgen levels in patients with advanced prostate cancer in order to arrest tumour growth. Unfortunately, despite an initial response, resistance to androgen ablation inevitably occurs and there is an urgent need for better treatments for advanced prostate cancer. My Fellowship project focused on developing new ways of blocking androgen action in prostate cancer cells. I utilised a series of inhibitors developed in our laboratory, which specifically blocked the function of the androgen receptor. I showed that these inhibitors were effective regardless of the level of expression, function or activity of the androgen receptor in the cancer cell. Importantly, inhibition of the androgen receptor using these new agents, in turn, effectively suppressed the growth of prostate cancer cells.These studies provided strong evidence that specific targeting of the androgen receptor would be an effective approach to the management of metastatic prostate cancer. Since completing the PCFA Fellowship, I extended this concept further to investigate a panel of clinical agents that also target the androgen receptor. I have demonstrated that combining low doses of different agents results in markedly more effective killing of prostate cancer cells than higher doses of the agents used alone. In addition to the potential for an increased clinical response in men with advanced prostate cancer, this approach, using considerably lower drug concentrations could result in fewer side effects. Ongoing studies will investigate the biological mechanism of this enhanced effectiveness using combinations of androgen receptor-targeted agents. I am also currently developing protocols to test these drug combinations in preclinical and clinical trials for patients with advanced prostate cancer. The PCFA Fellowship has been invaluable for the development of my research career.The scientific outcomes from the research project provided a strong basis for establishing my research program in prostate cancer and led to the subsequent award of Florey and Cancer Council Research Fellowships, and funding for the project by the Cancer Council and NHMRC. In 2009, I was awarded a three-year research grant from Cancer Australia/Prostate Cancer Foundation of Australia Priority- Driven Research scheme to further develop the combinatorial therapeutic approach.The research that has come out of this Fellowship has significantly increased our understanding of the role of androgen signalling in prostate cancer, and has strong potential for translation into clinical studies in the short term. Dr Butler is at the Dame Roma Mitchell Cancer Research Laboratories, University of Adelaide and the Hanson Institute.
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Associate Professor Susan Henshall PCFA Fellow 2002-2004 In 2002, I was awarded the inaugural Prostate Cancer Foundation of Australia Research Fellowship. This provided essential funding to pursue the discovery of biological markers that indicate poor outcome in prostate cancer patients. As a result, the Prostate Cancer Group at Garvan undertook a genome-wide study to identify genes that are associated with aggressive prostate cancer. This study discovered that men who have low levels of a gene called AZGP1 in the prostate at the time of surgery (radical prostatectomy) have a greatly increased risk of developing metastatic cancer. This means that these men could benefit from more aggressive treatment such as radiotherapy or chemotherapy around the time of surgery when they still have potentially curable cancer. Conversely, patients with a low risk of developing metastatic disease could have the option of deferring treatments that have a negative impact on quality of life. At the completion of the PCFA Research Fellowship in 2004, I received funding from the Cancer Institute NSW and the E.J. Whitten Foundation. This allowed me to build on my earlier research to confirm the accuracy of AZGP1 as a tissue biomarker for prostate cancer outcome in a prospective trial. This trial is currently underway in four hospitals in Sydney. If successful, the adoption of an AZGP1 test into clinical practice will represent a major advance in the treatment of prostate cancer patients. In addition, my group’s research into the underlying biology of aggressive prostate cancer has identified another gene, GATA-2, that might cooperate with AZGP1 to drive the progression of this cancer. The work originally funded by PCFA highlighted to me the importance of providing effective tailored treatment for cancer patients. In my current role at the Garvan Institute of Medical Research, Sydney, as part of the Garvan St Vincent’s Cancer Centre Project Team, we are establishing a dedicated space for cancer researchers to work alongside cancer clinicians with facilities and infrastructure designed specifically to support patient focused research outcomes. I am also a member of PCFA’s Research Committee, supporting PCFA’s Research Program. This program provides key funding for innovative prostate cancer research in Australia and continues to encourage young investigators to undertake research into prostate cancer.
The work originally funded by PCFA highlighted to me the importance of providing effective tailored treatment for cancer patients.
PROSTATE NEWS 5
Like many men in their 70s, John Ewan from northwest Sydney was diagnosed with prostate cancer just over three years ago. Since then John has opted for active surveillance of the disease. He has been ably assisted on his cancer journey by his wife Niela. ‘I had been getting regular PSA tests for several years and a test in late 2006 indicated that I had an enlarged prostate,’ John said. ‘I was referred to a specialist, Associate Professor Woo, and he detected a small cancer less than 0.5mm in diameter. It’s a tribute to medical science that they can find something so small!’
& CARERS A PARTNERSHIP
Although John didn’t need surgery, it was vital that the cancer was monitored regularly to ensure it didn’t spread. John has continued to have regular PSA tests every few months, and Associate Professor Woo has implemented an active surveillance program that involves monitoring John’s PSAs for any variations. In 1987 John’s wife Niela was diagnosed with breast cancer at the age of 49, and they both feel that sharing this experience made them more prepared when John was faced with his prostate cancer. ‘When I was diagnosed it came as a complete shock, but these days there’s a lot more information available on cancer and cancer treatment, said Niela. ‘Although John was quite distressed when he was diagnosed, the specialist explained things very clearly to us, which made us more confident that things were going to be okay.’ For John and Niela, an important part of the process has been to discuss John’s medical results so they’re both aware of his progress. Niela also supports John in helping to maintain a healthy lifestyle. ‘I’ve put him on a good diet, replacing white bread with wholemeal and getting him to cut down on sugar in his tea – all the things he enjoys!’ Niela said. With the support of his wife and doctors, John is confident that his cancer will be kept in check for the rest of his life. ‘There’s no question of surgery at this point while my free-to-total ratio is stable,’ said John. ‘As long as I continue having regular PSA tests, I’m not worried. I feel comfortable that I’m in expert care and the right course of action has been put in place, which is actively monitored.’ Something John has learned from the experience is that a cancer diagnosis isn’t always as frightening as it may seem. ‘It’s important that all men over 60 have regular PSA tests, because this thing can creep up on you, he said. ‘I would encourage anyone who gets diagnosed with cancer to read and learn from all the literature available to get a better understanding of the problem and the treatment options. And most importantly, don’t be afraid to ask your doctor questions.’ ■
6 PROSTATE NEWS
BOOK REVIEW David Sandoe OAM AND Pam Sandoe OAM*
Left to right: David Sandoe OAM (PCFA Deputy Chairman), Dr David Malouf (President USANZ), General Peter Cosgrove AC MC (retd), Associate Professor Prem Rashid, Graeme Johnson (PCFA Chairman).
PROSTATE CANCER: YOUR GUIDE TO THE DISEASE, TREATMENT OPTIONS AND OUTCOMES This third edition of Prostate Cancer – your guide to the disease, treatment options and outcomes, by Associate Professor Prem Rashid, is one of the most informative books we’ve had the privilege to read. The information is as pertinent for the newlydiagnosed as it is for the man and his wife/partner and family who are well into the prostate cancer journey. It is very easy to read and can also be used as a clear reference guide. The clinical information is presented in such a way that it can be readily understood with excellent illustrations and graphics. Unanticipated events and sometimes the uncertainty of this disease can be trying. The diagnosis of prostate cancer can also be significant threat to the relationship between the patient and his partner. We have long said it’s a partnership disease that requires lots of understanding and interpretation of complex information. Just deciding on a treatment option is bewildering, as the right treatment varies for each man. However, this book can help determine the best plan for you, with the guidance of your medical professional.
By the time you have read this book, you’ll better understand how the many risk factors, such as diet, environment and fitness level impacted your life. You will know the way to better heart health, with the lifestyle changes required to manage your well being. We are delighted that Associate Professor Rashid included more on the value of support groups and added chapters on sexual and psychological health and well-being. The section on Case Studies is invaluable as the patient can better connect with other men’s experiences and learn that he is not alone. We are sure patients will find this book reinforces points discussed with their medical professional. It also gives easily understood explanations to a lot of confusing information that is discussed with the patient and his wife/partner during consultations. The book also moves away from the purely medical opinions of professionals who treat prostate cancer and involves consumers and partners who give the other side of the journey. ■
*David Sandoe, OAM, is National Deputy Chairman of PCFA & Co-Leader of Sydney Adventist Hospital (SAH) Prostate Cancer Support Group (PCSG), and Pam Sandoe, OAM, is Co-Leader of SAH-PCSG.
PROSTATE NEWS 7
Named in honour of former PCFA Chairman, Max Gardner, who died from prostate cancer in 2004, the Max Gardner Award for Distinguished Service is given by PCFA to an individual or organisation that has made an outstanding and significant contribution to the cause of prostate cancer in Australia. Above: Bill McHugh and Peter Dornan accept their awards in Brisbane.
MAX GARDNER AWARD WINNERS
The 2008 Inaugural Winners were Con Casey, Gary Bowes, Bob Collard, Trevor Hunt, Don Baumber, John Goodall, John Conroy OAM and Spence Broughton. This year’s most recent Max Gardner Awards winners are:
Bob Slade Some 12 years ago following a diagnosis of prostate cancer, Bob Slade vowed to do all in his power to promote awareness of the disease. Bob motivated his Bathurst Rotary Club and others to organise a very successful public meeting about the nature and management of prostate cancer, which led to the formation of the Bathurst District Prostate Cancer Support Group. Bob has been secretary and has held other executive positions since and has worked to promote awareness in central west and then, with other local groups, the entire north west of NSW. In February 2009, he worked with Bathurst Council and the community to achieve a world record by connecting 13,000 neckties around Mount Panorama to raise awareness of prostate cancer.
John Allen The Dubbo Prostate Cancer Support Group was formed in 1996 after both John Allen and Fred Opprecht were diagnosed with prostate cancer within weeks of each other. Following a radical prostatectomy soon after, John, along with his wife Elizabeth, worked for the formation of the group, consisting of men and their partners, that continues to this day. John and Elizabeth have also guided the formation of many new groups, notably Broken Hill, and have been invaluable in awareness raising activities in rural and regional NSW. John is a member of the National Support & Advocacy Committee and a councillor on the State Chapter, and is valued for his long standing contribution to the fight against prostate cancer.
Jayne Matthews For almost 20 years Jayne Matthews has worked at St Vincent’s Hospital with Associate Professor Phillip Stricker, supporting men with prostate cancer from diagnosis to death. Jayne was instrumental in establishing Australia’s first support group at 8 PROSTATE NEWS
St Vincent’s with Max Gardner and numerous others, and has run the group over than time. She is the coordinator of the St Vincent’s Prostate Cancer Centre, under the directorship of Associate Professor Stricker, and publishes the Life Boy magazine. She organises support groups, provides educational material, and has been a research coordinator. She has also served on the PCFA NSW Board and continues to advise the NSW section. She has been an enormous support for tens of thousands of men with prostate cancer and in an excellent role model for prostate cancer nurses in Australia
Ron Schmarr Ron Schmarr was an early member of the Support Group movement in Australia and was elected to the first Support and Advocacy Committee in 2001. He had special interest in prostate cancer awareness and he coordinated very successful public meetings in several rural areas, notably in Taree. His efforts have helped develop a blueprint of arrangements for public awareness meetings Australia-wide. He followed Con Casey as leader of the group at North Shore Hospital, focusing on a warm welcome, and he developed the Group’s newsletter. He has been a volunteer counsellor for the Cancer Council of NSW.
Peter Dornan Peter Dornan was diagnosed with prostate cancer in 1996 and a subsequent prostatectomy left him depressed, incontinent and impotent. Peter’s search for answers to deal with the debilitating side-effects of his treatment led to the establishment of the Brisbane Prostate Cancer Support Network, Australia’s largest support group, of which Peter is Convenor. As part of Peter’s rehabilitation therapy, he developed an aggressive exercise regime to treat incontinence in both men and women, published in the book Conquering Incontinence. The book and exercise program are widely used by men, both prior to, and post-prostatectomy, and by others suffering from incontinence problems. His exercise regime has been ratified internationally and Peter has given many presentations at national and international conferences, as well as at support group meetings. He has always been available to assist others through their prostate cancer journeys.
Bill McHugh Bill McHugh was diagnosed with prostate cancer in 1999 and had radiotherapy. He became an active member of the Brisbane Prostate Cancer Support Network and focused on working with men who were newly diagnosed. He became a trained volunteer for the Queensland Cancer Fund (now Cancer Council Queensland) and worked in a variety of cancer support activities. Bill retired in 2005 and became a Queensland representative on PCFA’s Support & Advocacy Committee (SAC). As SAC Chairman he co-authored the PCFA policy statement on ‘PSA Testing for Early Detection of Prostate Cancer’. Recently Bill has been a driving force behind the new book Advanced Prostate Cancer – A guide for Men and their Families. As a consumer representative on various state and national committees and in liaison with the Commonwealth Health Forum Australia, Bill has been able to progress the prostate cancer message with politicians and health professionals. He is a Director of the newly formed Australian Prostate Cancer Research Centre – Queensland.
Robert Phillips In 2004 a prostate cancer awareness campaign in the Eltham area of Victoria led to Robert Phillips playing an integral part in the establishment of the Diamond Valley Prostate Cancer Awareness Group, which also provides information and support to prostate cancer sufferers and their families. As President of the group, Robert has actively engaged the wider community, including sporting groups, in prostate cancer awareness and fundraising events including archery tournament, art shows, concerts, bowling and basketball competitions, men’s health walks and charity golf days. From the early days, when Robert single-handedly took on all administrative tasks involved in establishing the group, he has been a committed campaigner whose single motivation is to save local men from this disease. ■
From left: John Allen, Con Casey, Ron Schmarr, Robert Slade and Jayne Matthews accept their awards at Kirribilli House in Sydney.
Above: Max Gardner Award winner, Robert Phillips.
PROSTATE NEWS 9
SUPPORT GROUPS CANBERRA
In January, a man contacted Peter Daley, the ACT Support Group Coordinator, following which he and his wife attended the January meeting. The couple were ‘grey nomads’ travelling around Australia by caravan, but were near Canberra when his recent health problems developed. He had had a radical prostatectomy six years ago, followed by salvage radiation therapy two years ago. His PSA level was currently increasing and he was contemplating the options of hormone therapy or orchidectomy, which had been recommended by his doctor.
Following a prostate cancer diagnosis in 2006, Bryan Hearn found that the information available to him was confusing. ‘Initially I opted for a radical prostatectomy, but later changed to brachytherapy treatment which proved very successful,’ he said. ‘I became aware of the existence of prostate cancer support groups, but the nearest to McLaren Vale was at Noarlunga. I attended there once to see how the group operated and with the help of their organisers and other cancer groups, launched a Prostate Cancer Support Group in McLaren Vale during early September 2007.
However, he was also the sole carer for his severely disabled wife, and on that basis it seemed that he had decided that he would not pursue further treatment as there would be no-one to care for her. At the meeting, SG members told of their personal experiences involving similar treatment situations and suggested possible solutions to his wife's need for 24-hour care if his treatment meant that he couldn’t provide this.
‘This group continues to run very successfully. We meet on a monthly basis and enjoy presentations from a wide variety of speakers covering topics ranging from acupuncture to funerals, chiropractors to nutritionists and almost every thing in between. I also became involved with the Fleurieu Cancer Network at a local level and PCFA. I now know there is plenty of help and support available out there in the community and nobody needs face this journey on their own.’
Since then, the SG Coordinator reported that our visitor had moved himself and his wife back closer to family and friends and had commenced treatment which was going well. He has also found that he was able to cope with that, plus his caring responsibilities. He wrote a letter of thanks to our SG members for giving him the hope and encouragement to undertake further treatment.
New members are welcome and should contact Bryan Hearn on 08 8323 7924.
Tasmania Support Groups have been operating in Tasmania for around 10 years. Groups meet monthly in Ulverstone on the North West Coast, as well as in Launceston and Hobart. Tasmanian Support Groups are active supporters of the Man Van project (see p15) and publicise this and other awareness raising activities in the community. As a direct result of a Community Awareness Evening in Launceston in February 2010, over 60 requests for further information were received, and the Launceston Support Group is busily looking for a new meeting venue to accommodate the expected influx of new members! The Hobart Support Group now conducts two monthly meetings, a second one in the evenings for those who can’t attend the original daytime meetings. John Dowsett from the Hobart Group has now also established the Eastern Shore Prostate Cancer Support Group to cater for people from that side of the River Derwent to eliminate the drive to Hobart for meetings. All sectors are performing above expectations at this time!
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Australian-Canadian Prostate Cancer Research Alliance at Gold Coast Conference The Australian-Canadian Prostate Cancer Research Alliance (AC-PCRA) is a collaborative network of Australian and Canadian clinicians, scientists, specialists and other professionals working in prostate cancer research and care. An initiative of the Queensland Government Smart State National-International Research Alliance Program, the AC-PCRA aims to facilitate research and collaborative opportunities. The Australian hub for the AC-PCRA is at the Australian Prostate Cancer Research Centre – Queensland, a multidisciplinary research centre hosted by Queensland University of Technology at Princess Alexandra Hospital. Membership to the AC-PCRA is free, and is open to anyone working in a prostate cancer-related field. The AC-PCRA Symposium will be held in conjunction with the 2010 PCFA National Conference. These two events will bring together clinicians, academics, General Practitioners, scientists, allied health workers and a variety of professionals in a dynamic and informative environment. AC-PCRA sessions will focus toward stimulating collaborations and will cover such topics as Targeted Therapeutics, Genomics, Biomarkers and Endocrinology. While the AC-PCRA Symposium is scientifically-focused, some consumers and members of the general public may be interested in sessions being presented about the new Multidisciplinary Clinical Trials Unit for Advanced Prostate Cancer, being run at Brisbane’s Australian Prostate Cancer Research Centre – Queensland. Leading scientists and clinicians will act as moderators for AC-PCRA sessions, presenting topics in a variety of formats, including think tanks, workshops, moderated panels and joint plenaries with PCFA. The AC-PCRA Symposium is an excellent opportunity for strengthening existing collaborations, as well as forging new bonds with other delegates from around the world. ■ For information about the AC-PCRA, including membership and the upcoming Symposium, contact Ally Tutkaluk, Australian AC-PCRA Coordinator on 07 3176 7446 or email firstname.lastname@example.org or visit www.aus-canprostatealliance.org
PROSTATE NEWS 11
NSW Gonads Ride
Tony Sonneveld OAM (Chairman PCFA NSW Board) with members of The Table4Ten Committee.
The call went out for the Gonad riders to come to Temora on 26 March for a new bike ride fundraiser. The event looks to raise in excess of $12,000 in its first year and attracted more than 100 motor bike riders, many looking quite unusual after riding through a locust plague, with bikes and riders emerging splattered and smeared. The event, supported by Men’s Sheds, the Temora Men's Cancer Support Group and funding from the local Masons, is set to become a permanent fixture on the PCFA bike ride calendar.
From left: Andrew Giles (CEO PCFA), Steve Dutton (Pirtek) and Tony Sonneveld OAM (Chairman PCFA NSW Board).
Kirribilli House Thank You On 18 March, PCFA were privileged to have use of the Prime Minister’s residence at Kirribilli House to celebrate our achievements over the last year and to acknowledge our many corporate, community and individual supporters in NSW.
Ord Minnett Sydney Harbour Swim Classic
9th Ord Minnett Sydney Harbour Swim Classic, 14 March 2010.
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On Sunday 14 March 2010 Sydney turned on one of its classic summer days for a unique community swimming event, with Sydney Harbour Bridge, Sydney Opera House, the Royal Botanic Gardens and Sydney Harbour as beautiful backdrops. With two races open to the public, it was a chance to challenge the body with a 1km Mini Swim Classic and/or the 2km Swim Classic. Attended by more than 5000 people, this event, sponsored by the first time by Ord Minnett continues to grow and provided a great opportunity for raising prostate cancer awareness. The PCFA marquee was visited by more than 750 people – many keen to purchase the new PCFA tattoos. The highlight of the day was the Ord Minnett Charity Run, with Guy Leech and Don Boland swimming for PCFA, with Don Boland coming first.
NSW FROM DREAMS TO REALITY
From Dreams to Reality Art Exhibition, 7 April 2010. Photo Liz Ham, Vogue, December 2009.
PIRTEK FISHING CHALLENGE
NSW Whiting Junior Winner.
On Sunday 11 April, 2500 anglers around Australia participated in the Pirtek Fishing Challenge. The challenge was a catch and release tournament, chasing over 17 species from around the country, and the event brought together families and friends to raise money for PCFA. With most of Australia having perfect conditions, South Australia and Victoria battled through strong winds, while Tasmania braved a lightning storm. However, mother nature could not hold back the generous public support or the outstanding commitment of the Pirtek team and this year’s event has been one of our most successful.
Being a loser has never been of more benefit to the fight against prostate cancer when it results in donations to PCFA of more than $8,000. Through the competitive weight loss and fitness program, the Burn That Belly Away (BTBA) Challenge, members of the Bridge to Bay Alliance team, including the RTA, Baulderstone Pty Ltd, Hyder Consulting Pty Ltd and Manidis Roberts Pty Ltd, decided to raise money in support of a men’s health initiative. Staff were weighed over a 6-week timeframe, the winner being the one to lose the most percentage of their body mass. Congratulations to Dean Hackett, Stuart Spencer and Steve Enoch who came first, second and third respectively, losing a combined total weight of 31.7kg! This was a great effort by the BTBA team for prostate cancer and for men’s health.
Featuring 25 works from 20 of Australia’s leading and emerging fashion photographers the From Dreams to Reality art exhibition was launched on 7 April at the MLC Centre. The images are diverse, colorful and captivating. Shot from coast to coast from Palm Beach to Perth, there’s everything from buffed bodies including surfing champion Kelly Slater in all his toned glory, to actor Aden Young in cocktail mode, to Miranda Kerr on the beach in Rio adorned with peacock feathers. All the limited editions were snapped up within minutes, with donations from the profits going to PCFA and NBCF. PCFA would like to thank Hush Communications for arranging this great event and the photographers, models and stylists, all of whom donated their work for such a great cause.
CITY 2 SURF CALL FOR ENTRIES! Calling all runners, walkers, rollers and crawlers – we need you to join us on 8 August 2010 for this now world famous event to help us raise funds and awareness for prostate cancer. It’s also a great chance to be an everyday hero in the fight against prostate cancer, so register now at http://city2surf.sunherald.com.au
BURN THE BELLY AWAY CHALLENGE
PCFA NSW Manager, Wendy Farrow with the BTBA Challenge team.
PROSTATE NEWS 13
From left: PCFA Men’s Health Ambassador, Steve Hood, Ann Zonneveld (TJH), PCFA Queensland Manager, Graeme Higgs, Michael Cole (TJH) and Alastair Wilkie (TJH).
Hugh’s OZ Blue Ribbon Charity Ride Hugh Gilroy is a 79-year-old who embarked on a charity ride around Australia on his Honda Goldwing motorcycle to raise awareness of prostate cancer and funds towards research. He left Childers on 22 March 2010 and toured Australia anticlockwise, returning to to Childers on 11 May 2010. See his route and schedule at the website below. Elite Camper Trailers of Maryborough donated a camper trailer towed by Hugh’s bike for the trip, which was raffled at the conclusion of the trip. See Hugh's blogs at www.micr.com.au/ozcharityride/Hughs_OZ_ Blue_Ribbon_Charity_Ride/Front_Page.html
Thiess John Holland staff raise funds for research During 2009, the Thiess John Holland Airport Link Project raised in excess of $35,000 for charity. One of the last initiatives undertaken by the airport Link Team was the Thiess John Holland Men’s Health Awareness campaign. On 20 January 2010 Thiess John Holland staff presented a cheque to the amount of $18,758.30 to PCFA for prostate cancer research. Fundraising events were held across the Project throughout November. Three Queensland Ambassadors also delivered educational presentations to 13 sites with a total of 600 men and women in attendance. Thank you to everyone who participated, donating funds and time, ensuring the enormous success of the campaign, with special acknowledgement to Alastair Wilkie who organised sponsors and T-shirts.
Cheque presentation from the CBRE annual Rugby Tens competition. From left: PCFA Queensland Manager, Graeme Higgs, Ryan Molloy and John Slater.
Rugby Tens do more than keep you fit
Representatives of the Southport Sharks with a welcome cheque for PCFA.
Southport Sharks and a bright idea PCFA is one of the three charities supported by the Southport Sharks in its ongoing community program. This program supports causes which closely align with the club’s own visions and values, as well as the values of their members. As part of this support, $1 is donated from every club membership to the chosen charities and more than $25,000 has been raised to date. The first quarter donation for 2010 is $5,308. The Southport Sharks will also support PCFA at its annual Sportsman’s lunch on 25 June. 14 PROSTATE NEWS
CB Richard Ellis is a global corporate leasing company and staff members John Slater (Associate Director - Industrial & Logistics Services) and Ryan Molloy (Negotiator Metropolitan Investment Properties), have been the key drivers behind the initiative for the annual Rugby Tens game that also raises important funds for PCFA. Originally their aim was to have fun and raise money for a male-based charity in what is the traditionally male-dominated field of global corporate leasing. But the annual Rugby Tens game has grown each year from four teams at its inception in 2008, when a few keen rugby buffs banded together to set up what was initially a touch game between competing companies. The idea has evolved to full contact, competition rugby, and in the third year of the event 12 teams will be participating in Brisbane at Ballymore in September, and a further four to six teams are keen to participate interstate. Other corporate participants include Jones Lang LaSalle, Knight Frank, Savills, Macquarie Bank and McCullough Robertson. For more information, visit www.prostate.org.au
Better Access to Mental Health Care Guy Carey with the Man Van.
Man from the Van Down the MinE In July 2009 PCFA and the Cancer Council Tasmania (CCT) began trialling a joint operation in Tasmania to put a Mobile Awareness Network scheme (MAN) into place to complement the Prostate TAS fundraising initiative started by CCT in mid-2008. The Man Van now regularly travels the state, attending functions, giving information and answering questions on prostate health and other men’s health issues. The essence of the Man Van project is to get ‘the message to the blokes’, but not all eventualities can be anticipated in a job description as Guy Carey discovered recently in Tasmania. Guy, project officer for the PCFA and CCT’s Men’s Health and Cancers project was invited to talk to the workforce at the Beaconsfield Gold mine. The office staff and treatment plant presentations went as anticipated. However, the mining crews have a ‘tool box’ briefing before commencing their shift in their crib room…underground. Guy was fitted out with boots, overalls, hard hat, light and emergency breathing kit. He grabbed his laptop and data projector, clipped his tag on the board, stepped into the cage and dropped 375 metres underground. He then sloshed through 100 metres of slurry to the crib room, a steel room set into the side of the tunnel where he delivered his presentation to 25 very attentive men. As Guy said, "We need to take the message to where the blokes are".
Prostate cancer can take its toll on a man’s body, as well as his mind, and it’s natural to feel a range of emotions after being diagnosed, including sadness, anger and confusion. For some, these feelings are more intense and longer lasting, leading to depression and anxiety which can extend beyond the issue of cancer into other areas of their life. However, with the right advice and help, men and their partners can overcome depression and anxiety. Many services are available to people experiencing depression under the Australian Government’s Better Access to Mental Health Care program. A person’s GP can help develop a plan for the treatment of their particular mental health problems and refer them to a mental health professional. Medicare rebates are available for consultations with psychologists, social workers and occupational therapists in mental health when the person has been referred by a GP or a psychiatrist. The Better Access program covers treatments (up to 12 individual consultations and 12 group sessions a year) which may include psychological therapy, relaxation strategies and skills training for anger management or stress management. For more details, talk to your GP or find one at www.beyondblue.org.au. See beyondblue Fact Sheet 24 – Help for depression, anxiety and related disorders under Medicare, Fact Sheet 34 – Prostate Cancer and depression/anxiety, the booklet Maintaining your wellbeing: information on depression and anxiety for men with prostate cancer and their partners or call the beyondblue info line on 1300 22 4636.
PROSTATE NEWS 15
COMMUNITY PARTNERSHIP NEW SONG GETS The first Australian ‘bloke’s anthem’ Talk About It was launched by PCFA on World Health Day on 7 April as a new tactic to get Australian men talking about their health. Talk About It was composed and recorded by musician and radio personality Mike Brady of Up There Calazy fame. The press, TV and radio loved it! ‘Music is a powerful way to get a strong message out there with emotion,’ Mike Brady said. “If hearing this song encourages 5 or 10 men to talk with someone about a health issue that is worrying them, it will be worthwhile. Physical health, mental health, isolation, loneliness and stress are some issues many men are facing alone. If they ‘talk about it’ – it is an important first step.’ Ian Murray with his Outstanding Volunteer Achievement Award.
WA MAN WITH A MESSAGE FOR HIS MATES If it’s true the average Australian bloke does not like to talk about health, then Ian Murray must be no average bloke. He has just clocked up his 100th presentation on prostate health and continence health to corporations, workplaces, men’s groups, Rotary Clubs and other local service clubs as part of his role in PCFA’s National Men’s Health Ambassador Speaker Program. Ian has been a PCFA volunteer since 2006 when he assisted in pioneering the PCFA Pilot Ambassador Speaker Program. He then continued into the PCFA National Men’s Health Ambassador Speaker Program in 2008, sponsored by the Australian Government Department of Health and Ageing, National Men’s Continence Awareness Project. Ian is a passionate advocate for men’s health. He is a prostate cancer survivor and the first Ambassador Speaker in Australia across both programs to reach 100 presentations. “I survived prostate cancer and I would like to think that I am doing a little bit to help others survive too,” said Ian. The key themes in his talk are early detection and the importance of regular health checks for men – and how important it is to talk about men’s health. “I try to make the message relevant to the audience,” said Ian. “For example, when I present to automobile clubs I talk to them about an ‘annual service’ and they get the message.” Ian was honoured for his work at a special PCFA function at Government House in Perth. National Men’s Health Ambassador Speakers are available anywhere in Australia, any day, any time at no cost. Call 1800 206 700 Email email@example.com 16 PROSTATE NEWS
PCFA invited Mike Brady, who is a member of the Victorian PCFA board, to write the song and as a result of his generosity, have the license for Talk About It for five years. All income from sales goes to PCFA for Prostate Cancer Awareness in the Australian community. ‘Talk About It is a great song with a broad message,’ said Jo Fairbairn, National Community Partnerships and Health Promotion Manager. ‘It is a song about men and what ever ‘health’ means to them, when they hear it.’ ‘It’s a call to action – maybe talking to a GP about your blood pressure and cholesterol, checking for diabetes, having a health check for bowel cancer and prostate cancer and knowing your family history.’ Men’s health events are held nationally every week, particularly in International Men’s Health Week, 14–20 June 2010. Talk About It is now available to play at community and workplace men’s health events. Purchase it from PCFA online at www.prostate.org.au for $10, with $5 as a tax deductible donation or contact 1800 206 700 or firstname.lastname@example.org to order a copy. Or download it directly from www.ausindie.com where $1.50 from every sale goes directly to PCFA Prostate Cancer Awareness.
F49 and PCFA Men’s Health Community GrantS
PS & HEALTH PROMOTION MEN TO 'TALK ABOUT IT' Talk Abo by Mike B
rady Some thing s especially are hard to talk abo for a man ut, –w and do the best we ca e just keep it all insi n. de But some th ings are so won’t go a important, wa talk to them y – so tell someone they just about it, today. Funny how a his mind, b man would usually sa u we’ve been t I’ll tell you in this d y what’s on ay and ag left behind e . There’s no good sayin g later on should’ve d just o think of nu ne – it’s really no big what we mber one. deal just Chorus: Talk abou t it – tell th em we’re bullet proof and how you feel. Even th we think w e’re made ough Talk abou of steel. t it – your part pays to get in early an ner, friend, your wif d it just m ight save y e – it our life. Talk abou t it – talk a bout it – ta There’re th lk in often walk gs in life from which about it away – bu t it’s a diffe a bloke would live in toda rent world y. we all Life is wha t you make can do. If it – and th th er it’s really u ere’s a problem tell so e’s lots a man p to you. meone, Chorus an
Mike Brady, getting men to ‘Talk about it’. Photo: William Hewett.
Applications are now open for the 2010 Foundation 49 and PCFA Men’s Health Community Grants. These grants are about partnering with local communities to deliver men’s health awareness activities and initiatives in September 2010 – International Prostate Cancer Awareness Month. Following the principles of partnership, the Foundation 49 grants have been very successful in the past in locations across Australia, with each community deciding how to best reach the men in their unique setting. Foundation 49 and PCFA will support all applicants in accessing men’s health information that is relevant to them. Applications for funding must focus on activities aimed at raising men’s health awareness and include prostate cancer as a part of the activity. Individual grants up to $2,000 will be available across Australia. You can apply online at www.49.com.au. Please read the guidelines carefully to make sure you are eligible before applying. Applications close 25 June 2010. For further information email email@example.com PROSTATE NEWS 17
DR JOHN CONROY: A TRIBUTE We have been greatly saddened by the loss of Dr John Conroy, OAM who passed away on 28 February, just over a week after his 84th birthday. John was well known to members of Sydney’s Northern Beaches Prostate Cancer Support Group (NBPCSG), which he established in 2002 after being treated for prostate cancer. Born in Northam, Western Australia, on 19 February 1926, John was an active serviceman with the Australian Air Force towards the end of World War II. After the war, he received scholarships to attend the University of Western Australia and then the University of California, Berkeley, where he completed a master’s degree in economics. John’s academic career then took him to Cambridge, England, as a teacher of mathematics. He developed a lifelong passion for education, particularly the ways in which maths is taught to children. In Cambridge John met his wife Una, and they had their son, Crispin. In 1969 John was offered a lectureship at Sydney’s Macquarie University, where he trained teachers in mathematics education. He also did consulting work in Tonga, and eventually retired as a Senior Lecturer of the university. John continued to be active after retirement, working as an advisor in Indonesia on the development of a mathematics curriculum and teaching indigenous trainee teachers at the University of Western Sydney. In 2007 John was honoured with the Medal of the Order of Australia for his service to education and the community. 18 PROSTATE NEWS
From left: Her Excellency Professor Marie Bashir AC CVO, Governor of NSW and NSW PCFA Patron, Dr John Conroy OAM with his Max Gardner award and Graeme Johnson PCFA National Chairman at Government House.
As part of his community work, John was the driving force behind NBPCSG from 2002, and also a volunteer with the Northern Beaches Palliative Care Unit from 1996. His commitment to the prostate cancer cause continued for the rest of his life, and he held a number of key roles in his final years. In 2007 he was a Cancer Voices representative on the Trans Tasman Radiation Oncology Group and represented PCFA on the NSW Oncology Group. In 2008 he was a member of the Cancer Council NSW North Sydney Planning Group, and part of the working party that drew up the council procedures for PCFA’s NSW Chapter Council. He received a Max Gardner Award for Distinguished Service to PCFA that year, and was elected to the NSW Chapter Council in 2009. John worked tirelessly with NBPCSG, which included writing the newsletter and sourcing guest speakers. He was enthusiastic about providing the best possible information and education for its members and promoting ‘care for the carers’. At his funeral on 3 March, Crispin Conroy spoke of his father’s ‘inquiring and original mind that he used to help others’ and described him as kind, humble, compassionate and tenacious, as well as a dynamic leader and visionary. NBPCSG is committed to keeping John’s dream alive and maintaining his legacy of support and care within the PCFA community. ■
SIMON BUCKLEY A LIFE LESS ORDINARY BY WENDY FARROW Simon Buckley had planned a dream adventure – to travel the world on a motorbike to raise funds and awareness for prostate cancer. And he achieved his dream – until his tragic accident in the final stages of the Ride Right Round event in Argentina in March this year.
Simon’s thirst for adventure from an early age led him into a career in tourism, which served to fuel his interest in people and travel, but ultimately he asked himself, ‘What you are doing for society? When should you start? What is your legacy? Who are you in it for?’. Simon’s great adventure, the Ride Right Round, brought him into close contact with many PCFA staff who worked with him, and his friend Todd Barry, on the Australian stages of the trip. Jo Fairbairn (PCFA Community Partnerships) recalls a Men’s Health event in rural Victoria: ‘Simon and Todd drove into the hall on their huge motorcycles with lights blazing. The audience was blown away that these boys were creating awareness of prostate cancer on a big world trip. There must have been at least 300 people at Federation Square to wish the boys well as they set off.’ Their Sydney send-off was threatening to look like a small affair, but then a quiet phone call resulted a few minutes later in the roar of bikes as a local bike gang rode in to show their support. PCFA NSW Manager Wendy Farrow said, “Simon just had friends everywhere!” PCFA Queensland Manager, Graeme Higgs, met Simon and Todd on the last leg of the Australian run of Ride Right Round in 2009. He recalls: ‘PCFA Champions Tex, Jen and Bundy, as well as few others, had met Simon and Todd before. However, for most of us a warm Territory evening would be the first inkling that we had found some new firm friends. Sadly the unthinkable has happened and Simon, who we all still expect to come striding through the door with his big cheeky grin, is no longer with us.’ It was beyond tragic that while preparing his welcome home – when he was less than 60kms from the end of his journey in Argentina – we received news that Simon had a blow-out and, falling from his bike, was killed.. In his short 32 years of life, Simon packed in more than most would, or could even dream of. He meant so much to so many and leaves with us the legacy of what can be achieved when one reaches for dreams with enthusiasm, focus and passion. As he would say:
The problem with life You can do anything You just can’t do everything. PROSTATE NEWS 19
Rotary Club of Terrey Hills Annual Golf Day
Kool Kruisers Annual Car Show
Men’s Health Week
Work, Life, Family and Good Health Getting the Balance Right Breakfast - Mornington
SternFIRST Charity Golf Day
Ray White Moorefield 2 Bowls Triples
Women of V8s – Ladies Longest Lunch
Australian Bream Challenge
Bligh Park Tavern Rod and Custom Show
Men’s Breakfast for Prostate Cancer Research – St Laurence’s Anglican Church Caboolture
PRO/CAN Ride Around Australia
14 - 20
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