PROSTATENEWS reducing the impact of prostate cancer
ISSUE 51/OCTOBER 2012
TEN YEARS OF PROGRESS IN PROSTATE CANCER
NATIONAL BOARD Chairman David Sandoe OAM Deputy Chairman Jim Hughes AM Finance & Operations Chris Hall (Chairman) Research Advisory Professor John Mills (Chairman) Awareness & Education Dr David Malouf (Chairman) Associate Professor Phillip Stricker (Education Sub-Committee Chairman) National Support Groups David Gregory (Chairman) Marketing & Fundraising Steve Callister (Chairman) Rotary John Palmer State Chairmen Tony Sonneveld OAM (NSW/ACT) Peter Gebert (VIC/ TAS) Roz Baker (WA) Professor Judith Clements (QLD) Professor Villis Marshall AC (SA/NT) Cover shot: David Sandoe OAM, The Hon. Melinda Pavey, Parliamentary Secretary for Regional Health and Dr Anthony Lowe at the launch of the 2012 Community Attitudes Survey at the State Library of NSW
> CEO Message I’m delighted to report the results of PCFA’s 10th anniversary Community Attitudes Survey which were recently published in a report entitled Research, Awareness, Support:Ten Years of Progress in Prostate Cancer. The launch of the survey is a significant milestone for PCFA as it shows the impact the organisation has had in driving awareness and understanding of prostate cancer in the community. It is also a measure of how things have changed over the last decade and where we need to focus our efforts going forward. The survey revealed that Australian men see prostate cancer as the single most important health issue they face and one of the top five health issues for the community at large. We were extremely pleased to see that PCFA’s efforts to raise awareness and knowledge of prostate cancer are paying off with a 12% increase in the percentage of men who feel informed about the disease over the past decade. Awareness and knowledge of the PSA test has also increased with more than
40% of men now being tested every year. However, we also found that almost 40% of men believe the advice they receive about testing is confusing. The need for clear and consistent advice about testing, supported by every medical college and all other interested parties, is evident. We found that almost one quarter of men who have been diagnosed with, or are undergoing further investigation for, prostate cancer contacted a support organisation and found it to be a very valuable source of information and support. Pleasingly, prostate cancer support groups were very highly rated by participants in the survey, with an average satisfaction score of 8 out of 10. However, we also found that men lack knowledge of support services and need health professionals to be more active in guiding them to appropriate information and support. Our thanks to Bayer who generously sponsored the report and launch. For more details of our findings, please visit www.pcfa.org.au to download a copy of the full report.
Dr Anthony Lowe, Chief Executive Officer, PCFA
Contents CEO MESSAGE
AROUND THE COUNTRY
tralia’s high Some of South Aus ing PCFA achievers promot
Around the country Shepparton Biggest Ever Blokes Lunch
Whitsundays fleet fundraiser INSERT HEADLINE HERE
Queensland: A fleet of more than 140 boats from all over the world descended on Gloucester Passage in the Whitsundays on 12th September to take part in Shag Islet Cruising Yacht Club’s (SICYC) annual fundraiser, raising an impressive $30,120 for PCFA. SICYC’s event organiser, Ken Thackeray, was blown away by the response which has grown rapidly over the past few years. “It’s like a phenomenon that’s got a life of its own,” he said.
SOUTH AUSTRALIA’S HIGH ACHIEVERS PROMOTE PCFA South Australia: PCFA has received almost $35,000 from a book featuring some of South Australia’s most notable high achievers in a unique publishing initiative that aims to conquer the Aussie tall poppy syndrome head-on. The brainchild of author and publisher Ashley KnooteParke, BBQ to Boardroom features profiles of 66 highly successful South Australian men and is the second of the Boardroom Series, launched when high achieving Australian Test cricketer, Wayne Phillips, did the honours as a representative of PCFA (Lounge to Boardroom, a collection of SA’s high achieving women, was the first book in the series).
Victoria: Over 650 men, from all walks of life, gathered together on Friday 31st August for Shepparton’s Biggest Ever Bloke’s Lunch, raising an astounding $102,000 for PCFA. Now in its fourth year, the sell-out event – initiated by Chris McPherson, Managing Director of McPherson media group (pictured below) – is generously supported by local businesses who provide auction and raffle prizes for fundraising. The event boasted a number of high profile speakers including Dr John Tickell, a former Hawthorn player, who spoke to the crowd about men’s health – in particular prostate checks – and the gang from The Footy Show, who had the guests in stitches over lunch at the Eastbank Centre as they shared tales from their footy days.
ILLAWARRA reachES for the stars for prostate cancer New South Wales: The Illawarra community enjoyed a dazzling night of fun and entertainment recently at “Reach for the Stars”, an innovative event organised by Noel Cox, a former convenor of PCFA Batemans Bay. Not only did the event raise an impressive $33,311 for PCFA, it also delivered a very real message as Noel himself has advanced prostate cancer. His passion for the event is fuelled by his desire to see more services for men, like him, affected by prostate cancer. Keith James of the Wollongong PCFA Support Group agreed that the funds raised would certainly be of assistance to the work the support group does in the area. Picture: Noel Cox (2nd from left) and wife Jeanette with entertainers from Reach for the Stars
ROUND THE ROCK 2012 RIDERS Western Australia: WA’s Round the Rock 2012 riders, Libby Calabro, Jimmy Barber and Blair Richards have set off on a four month journey that will see them travel 33,000 kms, passing through every State and Territory, on two BMW motorcycles as they raise funds for PCFA and the Royal Flying Doctor Service. Also in WA, The Roughrider Rudling Golf Day was held on 3rd September at the Western Australian Golf Course in Yokine with over two hundred keen golfers braving the cold and windy weather, followed by an after function where Adrian Lester spoke about his personal experience with prostate cancer. The event is held in honour of Peter Rudling who passed away from prostate cancer.
Prostate cancer: six things men should know about tomatoes, fish oil, vitamin supplements, testosterone and PSA tests When it comes to prostate cancer, there’s a lot of confusion about how to prevent it, find it early and the best way – or even whether – to treat it. Below are six common prostate cancer myths along with research-based information from scientists at the Fred Hutchinson Cancer Research Center to help men separate fact from fiction*
Myth #1 Eating Myth #2 High tomato-based products such as testosterone levels increase the ketchup and red pasta sauce prevents prostate cancer.
“The vast majority of studies show no association,” said Dr Alan Kristal, Associate Director of the Hutchinson Center’s Cancer Prevention Program and a national expert in prostate cancer prevention. Dr Kristal and colleagues last year published results of the largest study to date that aimed to determine whether foods that contain lycopene – the nutrient that puts the red in tomatoes – actually protect against prostate cancer. After examining blood levels of lycopene in nearly 3,500 men nationwide they found no association. “Scientists and the public should understand that early studies supporting an association of dietary lycopene with reduced prostate cancer risk have not been replicated in studies using serum biomarkers of lycopene intake,” the authors reported in Cancer Epidemiology, Biomarkers & Prevention. “Recommendations of professional societies to the public should be modified to reflect the likelihood that increasing lycopene intake will not affect prostate cancer risk.”
risk of prostate cancer. “This is
a lovely hypothesis based on a very simplistic understanding of testosterone metabolism and its effect on prostate cancer. It is simply wrong,” Dr Kristal said. Unlike estrogen and breast cancer, where there is a very strong relationship, testosterone levels have no association with prostate cancer risk, he said. A study published in 2008 in the Journal of the National Cancer Institute, which combined data from 18 large studies, found no association between blood testosterone concentration and prostate cancer risk, and more recent studies have confirmed this conclusion.
Myth #3 Fish oil (omega-3 fatty acids) decreases prostate cancer risk. “This sounds
reasonable, based on an association of inflammation with prostate cancer and the anti-inflammatory effects of omega-3 fatty acids,” Dr Kristal said. However, two large, well-designed studies – including one led by Dr Kristal that was published last year in the American Journal of Epidemiology – have shown that high blood levels of omega-3 fatty acids increase the odds of developing high-risk prostate cancer. Analyzing data from a nationwide
study of nearly 3,500 men, they found that those with the highest blood percentages of docosahexaenoic acid, or DHA, an inflammation-lowering omega-3 fatty acid commonly found in fatty fish, have two-and-a-half times the risk of developing aggressive, highgrade prostate cancer compared to men with the lowest DHA levels. “This very sobering finding suggests that our understanding of the effects of omega-3 fatty acids is incomplete,” Dr Kristal said.
Myth #4 Dietary supplements can prevent prostate cancer. Several large,
randomized trials that have looked at the impact of dietary supplements on the risk of various cancers, including prostate, have shown either no effect or, much more troubling, they have shown significantly increased risk. “The more we look at the effects of taking supplements, the more hazardous they appear when it comes to cancer risk,” Dr Kristal said. For example, the Selenium and Vitamin E Cancer Prevention Trial (SELECT), the largest prostate cancer prevention study to date, was stopped early because it found neither selenium nor vitamin E supplements alone or combined reduced the risk of prostate cancer. A SELECT follow-up study published last year in JAMA found that vitamin E actually increased the risk of prostate
cancer among healthy men. The Hutchinson Center oversaw statistical analysis for the study, which involved nearly 35,000 men in the U.S., Canada and Puerto Rico.
Myth #5 We don’t know which prostate cancers
detected by PSA (prostatespecific antigen) screening need to be treated and which ones can be left alone. “Actually, we have
a very good sense of which cancers have a very low risk of progression and which ones are highly likely to spread if left untreated,” said biostatistician Ruth Etzioni, Ph.D., a member of the Hutchinson Center’s Public Health Sciences Division. In addition to blood levels of PSA, indicators of aggressive disease include tumor volume (the number of biopsy samples that contain cancer) and Gleason score (predicting the aggressiveness of cancer by how the biopsy samples look under a microscope). Gleason scores range from 2-5 (low risk) and 6-7 (medium risk) to 8-10 (high risk). “Men with a low PSA level, a biopsy Gleason score of 6 or lower and very few biopsy samples with cancer are generally considered to be very low risk,” Etzioni said. Such newly diagnosed men increasingly are being offered active surveillance – a watchful waiting approach – rather than therapy for their disease, particularly if they are older or have a short life expectancy. “The chance that these men will die of their disease if they are not treated is very low, around 3 percent,” she said. Similarly, such men who opt for treatment have a mortality rate of about 2 percent. “For the majority of newly diagnosed cases of prostate cancer, giving initial clinical and biopsy information, we can get a very good idea of who should be treated and who is likely to benefit from deferring treatment.”
Myth #6 Only one in 50 men diagnosed with PSA screening benefits from treatment. “This number, which was
released as a preliminary result from the European Randomized Study of
FACT: Fruits and vegetables are prime sources of antioxidants, nutrients that neutralize harmful molecules that may cause permanent damage in your body and lead to cancer.
Prostate Cancer Screening, is simply incorrect,” Etzioni said. “It suggests a very unfavourable harm-benefit ratio for PSA screening. It implies that for every man whose life is saved by PSA screening, almost 50 are overdiagnosed and overtreated.” “Overdiagnosis” is diagnosing a disease that will never cause symptoms or death in the patient’s lifetime. “Overtreatment” is treating a disease that will never progress to become symptomatic or life-threatening. The 50-to-one ratio is based on short-term follow-up and “grossly underestimates” the lives likely to be saved by screening over the long term and overestimates the number who are overdiagnosed. “The correct ratio of men diagnosed with PSA testing who are overdiagnosed and overtreated versus men whose lives are saved by treatment long term is more likely to be 10 to one,” she said.
The Fred Hutchinson Cancer Research Center (FHCRC) is a world leader in research to prevent, detect and treat cancer and other life-threatening diseases.The above article was first published by the FHCRC’s publication team on the 22nd August 2012 and was immediately promoted by Science Daily: https://www.fhcrc.org; http://www.sciencedaily.com/ releases/2012/08/120822181238.htm Disclaimer:This article is not intended to provide individual advice on the prevention, diagnosis and treatment of prostate cancer.
PCFA would like to recognise the Movember Foundation as a key funder of its National Research Program
Journey: Experiences with Prostate Cancer A small Melbourne publishing house, Busybird, is planning a book of stories about people’s experience of prostate cancer, with a portion of book sales to be donated to PCFA. Men and their families and friends are encouraged to share their experience in prose or poetry. Instructions for submissions and details of the free writing workshops being offered (primarily in Victoria) to help people write their story can be found at www.busybird.com.au. The book will be launched in November 2013, to coincide with the ten year anniversary of Movember.
Tomorrow Counts launch after hours gp helpline Have an urgent health concern after hours? The after hours GP helpline can give you reassurance and practical medical advice. Phone number: 1800 022 222 For operating times and details visit www.yourhealth.gov.au/ gphelpline
The Tomorrow Counts website – developed in partnership with PCFA – is to be formally launched in Parliament House Canberra on 30th October, 2012. Once the website is live, men and their families and friends will be able to tell their story of prostate cancer and why tomorrow counts for them. www.tomorrowcounts.com.au
A joint initiative of the Australian Government and state and territory governments
Tawainese delegation visits PCFA PCFA recently welcomed a delegation from Taiwan, a country with a similar population to Australia, where cases of prostate cancer are advanced by the time people seek treatment The delegation, from Janssen-Cilag Taiwan (a division of Johnson & Johnson Taiwan Ltd), connected with PCFA via their company’s Australian arm after expressing interest in gaining an understanding of the role of a communitybased prostate cancer organisation.
Discussions, held with PCFA’s National Manager of Awareness and Education, Margaret Bennett, included the extensive role PCFA has in research, awareness and support; PCFA’s multisectoral approaches through support group activities; and the manner in which the nursing service enhances PCFA’s reach to affected men and their families. Of special interest was the communitybased research PCFA conducts to enhance community and government knowledge around prostate cancer and the group was impressed by the comprehensive nature of PCFA’s activities and the ways we work with the pharmaceutical sector to increase community awareness. The visit, arranged by Ms Kris Ashpole – Corporate and Government Affairs at Janssen-Cilag, Australia – was attended by Janssen-Cilag Taiwan employees Phiona Tsai (Pricing and Health Economics Manager); Betty Yang (Medical Adviser) and Jessie Chian (Senior Product Manager).
Help at hand: key ways you can obtain support PCFA’s National Manager of Awareness and Education, Margaret Bennett, shares some of the key ways you can seek support after diagnosis of prostate cancer We know from the men and women we see at PCFA that there is a great deal of confusion about how and where to obtain additional support for the wide range of issues after prostate cancer. It appears to me that many people see their cancer news as a crisis and indeed it is. However, for many people it is closer to an ongoing trauma that threatens their life and at times relationships. According to the free online dictionary, trauma is defined as: 1. A serious injury or shock to the body, as from violence or an accident 2. An emotional wound or shock that creates substantial, lasting damage to the psychological development of a person 3. An event or situation that causes great distress and disruption Rarely is someone unchanged after a cancer diagnosis. So it is fitting to talk about some of the psychological supports required either for one’s self or other family members. A lot of research is being done broadly in the cancer space incorporating what has been known as the ‘third wave’ in psychotherapies. These are therapeutic conversations incorporating broader ideas of mindfulness practice. The work of Jon Kabat-Zinn in the USA has been fundamental in showing the ways mindfulness-based meditation practice reduces pain and lessens need for some types of medications. Prostate cancer support groups find ways of providing peer-to-peer support. Sometimes though, people want to
speak to a health professional who can assist with specific issues such as anxiety, depression, relationship and sexual issues. People can be referred through their general practitioner into a network of Medicare-funded health professionals such as nurses, psychologists, social workers, exercise physiologists, dieticians, etc. Referrals can occur as part of specific care packages accessible by General Practitioners and many of these health professionals have skills in relationship and sexual counselling. When looking for a professional to speak to, make sure it is someone you feel comfortable with, who listens well, clarifies issues and assists you to make your own decisions about options. Your General Practitioner, local community health centres and specific professional associations are useful places to start to find an appropriate person in your community.
mindfulnessbased meditation practice has been shown to reduce pain and lessen the need for some types of medications
Margaret Bennett, National Manager of Awareness and Education, PCFA
Support group advertising campaign launches PCFA’s Support Group team recently launched a four month high intensity national advertising campaign to encourage men and their families affected by prostate cancer to take action and get in touch with their local support group Promoting the availability and benefits of PCFA’s information, educational resources and affiliated support groups, the campaign features A4 posters and take-away cards in public conveniences right across Australia. As part of the national campaign, 20 groups have been randomly selected from across the nation (to cover a cross section of urban, suburban and rural locations) so that we can test and see if the campaign helps to get the message out to all the groups in the country. The area around the 20 support groups
selected will be more heavily targeted for a trial period to see if this is an effective way to change men’s help seeking behaviours. PCFA has set up a dedicated 1300 number for the campaign and phones will be manned by experienced volunteers drawn from PCFA’s support group network. The aim is to ensure that everyone who calls the 1300 number will speak directly to someone who understands from firsthand experience the issues faced by men and their families affected by prostate cancer.
The volunteers will put callers in touch with their local support group. We will be carefully evaluating the success of the campaign from focus group testing the advertisements, through to analysis of call volumes, nature of enquiries and ultimately attendance at support groups. The evaluation will assist us in refining a model that can be used more broadly in future. John Friedsam, National Manager, Support Groups, PCFA
The 2012 Convenience Advertising campaign artwork:
there are over 125
prostate cancer support groups across australIa. If you need support, call 1300 109 831.
If you’ve dIscovered you’ve got prostate cancer If you need support, call 1300 109 831 between 9am and 6pm, Monday to Friday.
you’re not alone.
Affiliated Group Snapshot This edition’s Affliliated Group Snapshot shines the spotlight on the Bendigo and District Support Group in Victoria with some interesting insights shared by the group’s Facilitator, Mark Nally
Hi Mark, thanks for making the time to talk with us. Would you mind sharing what it was that compelled you to become involved in a prostate cancer group?
My employer, St John of God Hospital (Mark is the Critical Care Services Manager), has had a long history of supporting the Bendigo and District Group. Additionally, my father has had prostate cancer and hence I am keen to support our group and as a result our community.
What do you consider to have been the greatest accomplishments for the Bendigo and District Support Group? There are two primary accomplishments: 1. our care of those within our group and; 2. engagement of community in encouraging men’s health issues. We have had many events such as “Paint the Town Blue”, where we coloured a significant building in our main street to signify support for prostate cancer, and “BendiMO” where we changed the city’s name to support Movember. These, and other events, have resulted in men across the region considering and taking control of their health. Although we do lots of things in our community, we ensure we care for those in our group first and foremost. While that is our main concern, keeping the members active and feeling like they are making a difference for others and our community is also crucial.
What sorts of strategies do you use to recruit new members to the Bendigo and District Support Group?
We have a significant amount of support from our medical colleagues – I stay in touch with each of the surgeons and they refer people to our group. Our group has a large number of couples who attend... men and their partners are important to us. Additionally, our group has many events that have attracted publicity, which in turn encourages people to track us down.
What would you like to see achieved in the next two years by the national network of PCFA affiliated groups? This year we facilitated “Run for Dad” on Father’s Day. It was an astoundingly successful event and there is no reason in my mind that this should not go national. It was an incredibly emotional event, with all participants sharing in the heartfelt passion. At the finish line, our group formed a guard
Top: “BendiMO” event to support Movember; Bottom: “Run for Dad” event, held on Father’s Day
of honour, cheering people across the line and handing out medals. This type of event gives Prostate Cancer Support Groups an opportunity to be involved in their community.
Victorian Prostate Cancer Specialist Nurses PCFA is proud to introduce the Prostate Cancer Specialist Nurses hosted in Victoria as part of its three year pilot program. Each nurse is employed by the host hospital to provide an expert nursing service to patients with prostate cancer who are attending each host centre for treatment.
he PCFA Prostate Cancer Specialist Nursing Service was launched in Melbourne in May this year. This first ever national Prostate Cancer Specialist Nursing Service, funded initially by the generous contribution of the Movember Foundation, will provide a reliable central point of contact that guides men through every stage during and after their cancer diagnosis and treatment.
PCFA Prostate Cancer Specialist Nurses are trained to work alongside medical teams like oncologists, radiotherapy doctors and urologists to co-ordinate care plans, and give men clear and accurate information so they understand at each step whatâ€™s happening to them. The nurses are also an important link to available other community support services.
Initially, PCFA has placed nurses in 13 metropolitan and regional hospitals across Australia.
PCFA Nurses Education Award 2012
PCFA would like to recognise the Movember Foundation as a key funder of its national Prostate Cancer Specialist Nursing Service
PCFA would like to invite Australian Registered Nurses to apply for the PCFA Nurses Education Award The aim of the award is to provide registered nurses from across Australia with the opportunity to advance their knowledge and skills in the field of prostate cancer nursing, by providing financial assistance to enrol in a post-graduate education program with a focus on prostate cancer nursing. The award will aid increasing the nurses knowledge and exposure to best practice management and support of those affected by prostate cancer, ultimately improving the quality of care provided to these men. The award, valued in total at $12,600, will be distributed to successful applicants, with each applicant receiving a
maximum of $4,200 towards their chosen program of study. Applications are open now until 30th November 2012. TO APPLY Please visit www.pcfa.org.au for further details and to download an application form or contact Julie Sykes, Director of Nursing at firstname.lastname@example.org
Meet our Victorian nurses...
David Heath Prostate Cancer Specialist Nurse, Bendigo Health, Victoria David works three days a week as Prostate Cancer Specialist Nurse at Bendigo Health and is also a paramedic working in Bendigo. David’s appointment followed a successful application by the Loddon Mallee Integrated Cancer Service on behalf of Bendigo Health. “The application process was very competitive and we are thankful to all who contributed to its success, it really highlighted the need for such a role in the community. This is not only a wonderful opportunity for Bendigo Health but also for the region,” Miss Janelle Brennan Urological Surgeon, Bendigo Health said. David advises “My role as Prostate Cancer Specialist Nurse involves me working closely with urologists and other members of the treating team, providing a point of contact for men and their families whom have prostate cancer. Ensuring timely access to information and available resources, coordination of care across the cancer journey and assisting with access to services within the hospital and community are also important aspects of the role”.
Kelly Koschade Prostate Cancer Specialist Nurse, Latrobe Regional Hospital, Victoria Kelly is employed in a part-time capacity at Latrobe Regional Hospital (LRH) and joins this hospital from a nursing background in community nursing, cancer nursing and palliative care. LRH’s Director of Nursing, Midwifery and Clinical Services, Amanda Cameron, said the Prostate Cancer Specialist Nurse would work with existing health care providers to ensure effective care for men with prostate cancer. “Kelly has advanced knowledge of the health needs and preferences of men with prostate cancer and will provide specialised and tailored information and education, psychological support and clinical care,” Ms Cameron said. “Prostate cancer treatment can include surgery, hormone therapy, radiotherapy and chemotherapy. Kelly will be involved in all types of patient care and will also provide expert advice and support to other health professionals.” Kelly hopes her position will be pivotal in increasing the education and support provided to those in the community who have been affected by prostate cancer at all stages of the cancer journey.
David Gray Prostate Cancer Specialist Nurse, Austin Health, Victoria
David is employed at Austin Health which is one of Victoria’s major prostate cancer treatment centres. David is based in the recently opened Olivia Newton-John Cancer and Wellness Centre and is and is an essential part of an extensive multidisciplinary team, providing care to a large number of men attending the facility for a wide range of prostate cancer treatments and therapies. David has a background of working in urology nursing, most recently assessing patients prior to their admission to hospital for prostate cancer surgery. It was in this position that David realised the need for a service that would help answer patients’ questions and coordinate care for men having all types of treatment and at all stages in the cancer pathway. David hopes that during the three year pilot he can contribute to the development a successful program that supports men and their families during the journey with prostate cancer, and continues to run beyond the three year pilot period.
Big Aussie Barbie campaign fires up around the nation PCFA has turned up the heat on prostate cancer all over the country by firing up barbies to promote International Prostate Cancer Awareness month and the 2012 national Big Aussie Barbie fundraising campaign With the support of Major Sponsor Commonwealth Bank, PCFA’s 2012 Big Aussie Barbie campaign officially kicked off on 31st August in Sydney’s Martin Place with further official events held in Adelaide, Perth and Canberra, in all raising over $15,000 for prostate cancer awareness and support. Sydney couldn’t have asked for more barbie-licious weather for its launch, a superb start to the national campaign with cooking demonstrations by Celebrity Chef Ambassador Ben O’Donoghue and Brigid Treloar from the Sydney Fish Market, high profile support from Underbelly actor Les Hill and 2GB’s Darryl Brohman and an abundance of great barbie food.
Main shot: Adelaide launch at Central Market Left: Commonwealth Bank volunteers at the Sydney launch Below: The Hon Wayne Swan MP, Mark Dreyfus QC MP, Dr Mal Washer MP and Dr Anthony Lowe at Parliament House
Adelaide’s launch took place in the heart of the city on 6th September in bustling Central Market with a strong show of support including the Lord Mayor, Stephen Yarwood. Perth’s leafy Central Park was the location for WA’s launch the next day, which drew an impressive community crowd and contingent of local celebrities. The official events wrapped up with a special Big Aussie Barbie held at Canberra’s Parliament House on 20th September, hosted by Steve Georganas MP – Chair of the House of Representatives Standing Committee on Health and Ageing – and attended by a number of key ministers including The Hon Warren Snowdon MP, The Hon Wayne Swan MP, The Hon Tanya Plibersek MP and The Hon Anthony Albanese MP.
Major Sponsor Supporting Sponsor
A few words from our sponsors PCFA’s generous Big Aussie Barbie sponsors share why supporting the foundation’s biggest fundraising campaign is important for them “Prostate cancer is a very serious health issue touching millions of people, not only in Australia, but around the world. The Commonwealth Bank is passionate about playing its role in supporting those affected and contributing to finding a cure. PCFA continues its crucial work in providing support to those affected by prostate cancer, raising awareness about the disease across the country and funding world-class research. No matter how big or small, every contribution made to the Big Aussie Barbie campaign this year will help PCFA further its valuable work.”
“Rosella Foods is proud to be a Supporting Sponsor of PCFA’s Big Aussie Barbie campaign. Prostate cancer is a very real health concern for men in Australia and we want to add our support to help PCFA hit its target of raising $800,000 to ensure it can contunue its important work in furthering research, awareness and support programs.”
Wade Gillooly, General Manager Rosella Foods
Ian Narev, Chief Executive Officer Commonwealth Bank
Rosella bottles, featuring a PCFA Big Aussie Barbie blue ribbon, displayed in store at Woolworths and Coles
An extra BIG thank you to our generous barbie sponsors!
Independence Australia supports the Prostate Cancer Foundation of Australia (PCFA) and those living with Prostate Cancer. We can provide information and assist PCFA clients to choose the right continence products. Talk to our Urology Continence Nurse Advisor on: 1300 788 855 or email email@example.com Download our brochure of products for the “Active Man” at; www.independenceaustralia.com/health-solutions/ products-services/download-catalogues/
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Of mullets and metastases - a return to life before PSA testing I presume that everyone reading this piece will have at least some memories of the 1980’s? For me, as I spent all of my teenage years in the 1980’s I therefore have abundant memories - a mixture of nostalgia, enlightenment and embarrassment. I wore my mullet with pride and presumed that my careful attention to Jon Bon Jovi’s dress sense would lead to great personal success in my adult years. Other heroes included Michael Hutchence, all members of Duran Duran, Diego Maradona, Michael Lynagh, Pat Cash (big hair and mullets being a common theme here), and it goes on. Yes those were fun days following on from the psychedelic 60’s and the swinging ‘70’s and before life got too yuppie in the ‘90’s, the 1980’s were a decade of fun. Unless of course, you happened to be diagnosed with prostate cancer there was nothing fun about that. A diagnosis of prostate cancer at that time was invariably a clinical diagnosis, either made on the basis of urinary symptoms due to locally advanced cancer, or of symptomatic metastatic disease due to obstructed ureters or painful bone metastases (secondary cancer). The diagnosis was confirmed by an x-ray or scan or occasionally a finger-guided biopsy of the inevitable hard, craggy cancer, no longer confined to the prostate. Management was aimed at controlling progression and reducing symptoms through medical or surgical castration, before the inevitable onset of castrate-resistant cancer for which there was no treatment. Death, and an unpleasant death at that, was assured. Treatment with curative intent was rarely considered and even when possible, the morbidity of surgery before modern techniques meant that surgeons and patients alike were justifiably terrified. But that was the 1980’s. As you can see from this graph (figure 1) from the
Figure 1: Relative survival by period of diagnosis, prostate cancer, 1972–2006
New South Wales Cancer Institute, the five-year survival rate for men diagnosed with prostate cancer has jumped from less than 60% in the 1980’s to, quite incredibly, over 90% for men diagnosed in the 2000’s. There is no other cancer which has seen such a huge improvement in outcomes during this time period and the reason for this is simple: the introduction of PSA testing in the early 1990’s and the resultant shift to an earlier diagnosis of prostate cancer. It is a simple fact in cancer: early diagnosis leads to a higher chance of cure and this data demonstrates that men diagnosed with prostate cancer have now the option to benefit from earlier diagnosis. So it might therefore seem strange that a medical oncologist is asking for us to return to this era by abandoning PSA testing and all attempts at the early diagnosis of prostate cancer. Yet that is precisely what Dr Ian Haines of Melbourne’s Cabrini Hospital called for in a series of newspaper, radio and TV interviews in August and September 2012 when he called for men “only to
present when they develop symptoms and not to look for the disease otherwise”. He admits that his view is considered “heretical” by many and defends it by saying that palliative care treatment has improved considerably since the 1980’s. Unfortunately, despite the increase in the proportion of men presenting with curable disease today, there are men reading this article who will have presented with symptoms of advanced prostate cancer and who I know are angered by comments such as these. Symptomatic advanced prostate cancer is painful and often devastating and men who find themselves in this situation will often ask if their outcome would have been different had they been diagnosed earlier. The answer of course is yes. Huge randomised trials have shown that the risk of dying of prostate cancer is reduced by 44% in men who chose to have regular PSA testing compared to those who do not. So why should we even consider abandoning PSA testing? Well, as with all cont’d next page
cont’d from previous page screening tests, there is always an element of over-detection and overtreatment of patients who have no symptoms of a particular condition. In prostate cancer, Dr Haines and others have argued that we do more harm than good by offering men the possibility of early detection of prostate cancer. For those of us working full-time in this area, we would suggest that men deserve to have this option made available to them. It is both disrespectful and inappropriate to deny men the possibility of early detection and avoidance of death from prostate cancer should they so choose.
As the PCFA Community Attitudes Survey has shown, GPs remain the primary source of information and counselling for men seeking advice about prostate cancer and we must therefore ensure that GPs have the necessary information and materials to help men make a decision about whether to have a PSA test or not.
time was certainly not fun. The PSA test is not perfect, but it remains the foundation for the progress we have made in the fight against prostate cancer over the past thirty years and despite calls from “PSA heretics”, well-informed Australian men will continue to have this option available to them should they choose to be tested.
But an unqualified return to a pre-PSA era would do Australian men a great disservice. While we should fondly remember all that was fun about life in the 1980’s, we should also remind ourselves that the outlook for men diagnosed with prostate cancer at that
Associate Professor Declan G Murphy Urologist & Director of Robotic Surgery, Peter MacCallum Cancer Centre, Melbourne Director of Outcomes Research, Australian Prostate Cancer Research Centre, Epworth Richmond Hospital, Melbourne
Australians urged to respect difference A major new beyondblue campaign urges Australians to stop discriminating against people because they’re simply being themselves beyondblue, the national depression and anxiety initiative, has launched a major national awareness campaign aimed at reducing discrimination and bullying, particularly against young gay, lesbian, bisexual, trans or intersex (GLBTI) people. Chairman of beyondblue,The Hon. Jeff Kennett, said: “It’s unreasonable to think
you would discriminate against someone just for being themselves. We don’t want people to feel they have to hide who they are because they fear discrimination, ridicule or violence. “beyondblue research shows that, discrimination and bullying are major contributing factors to depression and anxiety, and risk of suicide. The GLBTI community, in particular, faces widespread discrimination which contributes to much higher rates of anxiety and depression than in the general population. “GLBTI people are at least two to three times more likely to experience depression and anxiety than the broader population and are at greater risk of suicide and self-harm. Almost half hide their sexuality or gender identity in a range of situations fearing violence or discrimination – with young people aged 16 to 24 years more likely to do so than any other age group. “This is why beyondblue, together with Movember, has contributed $1.5 million
to this major national antidiscrimination and stigma-reduction campaign which includes cinema ads,TV, print and outdoor ads, and personal video stories from GLBTI people who have experienced depression and anxiety as a result of discrimination.The ads and videos can also be seen on beyondblue’s website, Facebook and Youtube pages.” The ads focus on the outdated practice of past generations which forced children who were born left-handed to use their right hand, as this was deemed to be ‘correct’. Mr Kennett said: “Now it seems ludicrous that adults tried to make lefthanded children conform to what they considered was the ‘right way’ of doing things.This campaign draws a parallel and makes us question if our society isn’t doing exactly the same thing to people whose sexuality or gender identification is different. Is it all right to be left-handed? Of course. Is it all right to be gay or lesbian? Of course.” beyondblue CEO Kate Carnell AO said: “Things need to change. We want everyone in Australia to STOP the discrimination,THINK about how comments you make could cause real distress and harm, and RESPECT people who are different from you.”
What it means to be a better man
PCFA would like to recognise the Movember Foundation as a key funder of its National Research Program and national Prostate Cancer Specialist Nursing Service
Over the past two years, Movember has paid homage to the Modern Gentleman and Country Gentleman, exploring his appreciation and penchant for luxury items, etiquette, craftsmanship, pride and honour. In 2012, the campaign gets down to the raw hard truths of the past two years by taking a look at what it means to be a better man. 2012 is the year of Movember & Sons. Knowledge shared from one generation to the next and wisdom passed down by oneâ€™s Dad or father figure, plays a meaningful role in shaping who we become. This learning continues throughout life, but also reaches a point at which the exchange is reversed and insight is passed back up the chain. This Movember, men will be encouraged to seek and share knowledge and wisdom with loved ones, to learn their family health history and predispositions and to understand the risks they face. These simple actions can have a significant impact of the quality and longevity of your journey through this life. Last year, Movember had its most successful year to date with over 850,000 Mo Bros and Mo Sistas across the globe raising a phenomenal AUD $124 million for prostate cancer and male mental health. Register at www.movember.com
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