KELOWNA PROSTATE CANCER SUPPORT & AWARENESS GROUP NEWSLETTER

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1 KELOWNA PROSTATE CANCER SUPPORT & AWARENESS GROUP NEWSLETTER OKANAGAN PROSTATE RESOURCE CENTRE SOCIETY Okanagan Prostate Resource Centre To make an Appointment Call CCS Cancer Information Line Publisher/Editor Bren Witt VOLUME 17 - ISSUE 3 - (NUMBER 197) - NOVEMBER 2014 A t our October meeting I discussed a recent interview by Dr. Charles Myers with Dr. Paul Lange of the University of Washington in Seattle, that appeared in the latest issue of the ProstateForum. Dr. Lange has established a leading prostate cancer research facility at the University of Washington. Dr. Lange and his colleagues have developed a very sensitive technique to detect prostate cancer cells in the blood of prostate cancer patients who were good candidates for a radical prostatectomy. They found that a large proportion of these men had prostate cancer cells in their blood. They went even further and discovered that these men also had prostate cancer cells in their bone marrow. Thus, the cancer had already spread widely prior to surgery, however, after surgery, the cancer cells disappeared from blood and bone marrow in most patients. However, in some patients the cancer cells could still be found. These patients were at increased risk for the cancer to return years later. The point was that while cancer cells persisted, the disease could remain clinically invisible - 1

2 for years. Studies by other groups have documented that prostate cancer could recur even 20 years after surgery. I will have a more lengthy report on the interview with Dr. Lange in the December newsletter. The Paradox of PSA Screening for Prostate Cancer - The following is a brief excerpt of an article from the Fred Hutchinson Cancer Research Center in Seattle Wash. I n 2012, the U.S. Preventive Services Task Force concluded that prostate cancer screening provides "very small potential benefit and significant potential harms" and issued guidelines recommending against it. A new study by experts at Fred Hutchinson Cancer Research Center, that was published in the Journal Cancer, explores the impact that stopping prostate-specific antigen (PSA) screening would have on American men. The researchers used statistical models to predict prostate cancer incidence rates and related deaths from 2013 to Their findings indicated that discontinuing PSA screening altogether would result in a 13 to 20 per cent increase in prostate cancer mortality (an additional 36,000 to 57,000 deaths in the U.S.) compared with continuing PSA screening during this period. There are many different ways to use the PSA test for screening, however. "We feel more nuanced guidelines are more appropriate," said study co-author Dr. Ruth Etzioni, a biostatistician in the Public Health Sciences Division at Fred Hutch. The research showed that stopping screening at age 70 (agerestricted screening) is a better option that would reduce the number of men who receive unnecessary treatment while preventing most of the additional deaths that would come from discontinued screening. Discontinuing screening altogether would clearly eliminate 100 percent of all overdiagnosed cases. But stopping screening would also more than double the number of prostate cancers that had already advanced, or metastasized, by the time they were discovered. "Intensely and aggressively screening would be associated with more lifesaving [than discontinuing all screening]," said Gulati, "but more men would be overdiagnosed. In this study we also considered the middle ground, which provides a much more favorable tradeoff." Under age-restricted versus discontinued PSA screening, the models synthesized data to represent prostate cancer progression, detection, treatment and survival. The models in the study were developed at the University of Michigan and Fred Hutch to investigate national prostate cancer trends. The models predicted that mortality rates will rise with both age- 2

3 restricted and discontinued PSA screening, but that additional deaths will increase significantly more slowly under age-restricted versus discontinued screening. PSA screening limited to men under the age of 70 could prevent a majority of the deaths that are avoided with current screening while dramatically reducing the number of overdiagnoses. Restricting PSA testing to men under 70 years of age is just one approach. More generally, rather that discontinuing screening completely, our results support developing more efficient ways to use the PSA test to screen for prostate cancer." WITT'S WIT (ON THE LIGHTER SIDE) - Catholic Golf I hope everyone will enjoy this - Catholics and non-catholics A Catholic priest and a nun were taking a rare afternoon off and enjoying a round of golf. On his next swing, he missed again. "Shit I missed." "Father, I'm not going to play with you if you keep swearing," the nun said tartly... The priest promised to do better and the round continued. On the fourth tee, he misses again. The usual comment followed. Sister is really mad now and says, "Father John, God is going to strike you dead if you keep swearing like that." On the next tee, Father John swings and misses again. "Shit I missed." A terrible rumble is heard and a gigantic bolt of lightening comes out of the sky and strikes Sister Marie dead in her tracks. And from the sky comes a booming voice. "Shit, I missed." The priest stepped up to the first tee and took a mighty swing. He missed the ball entirely and said, "Shit I missed." The good Sister told him to watch his language. 3

4 A Decade of Prostate Cancer Progress - The following is a reprint of an article that was published by the FDA - (The U.S. Food and Drug Administration) - Don't Fall for Unproven Products - Prostate cancer is the second most cause of cancer-related deaths among American men. (Third most common in Canada). The prostate is a gland in the male reproductive system. It makes most of the semen that carries sperm. The walnut-sized gland is located beneath the bladder and surrounds the upper part of the urethra, the tube that carries urine from the bladder. Prostate cancer is frequently a very slow growing disease, often causing no symptoms until it is in an advanced stage. Most men with prostate cancer die of other causes, and many never know that they have the disease. But once prostate cancer begins to grow quickly or spreads outside the prostate, it is dangerous. While the disease is rare before age 50, experts believe most elderly men have traces of it. A Decade of Drugs on the Market - This year marks the tenth anniversary of the approval of docetaxel, the first chemotherapy for metastatic prostate cancer that showed a survival benefit. The FDA approved docetaxel in 2004 after years of research failed to find a treatment that would prolong the lives of metastatic prostate cancer patients. Metastatic is a term used to describe a cancer that spreads from the original location to other areas of the body. "When prostate cancer metastasizes to another location in the body, it is in most cases incurable, and the goal of treatment is to improve a patient's symptoms or function or to extend the length of the patient's life," says Paul Kluetz, M.D., acting deputy office director for FDA's Office of Hematology and Oncology Products and the Centre for Drug Evaluation and Research. Since docetaxel, five additional therapies have been approved, and all of them have shown improvements in survival. Kluetz says it is unprecedented for so many drugs to demonstrate a survival advantage in an individual metastatic solid tumour setting. Although the median extension of life for each of these approved drugs in metastasized prostate cancer is on the order of 2-6 months, it is hoped that when these drugs are used one after another, the survival benefit of each drug will be to some degree additive, particularly given that many of the drugs work through different mechanisms of action. The optimal order and combination is not yet known and will be an area of research over the coming years. Moving Forward - One area of prostate cancer research that is garnering attention is related to patients whose cancer has not yet metastasized. Critical for this research will be the selection of patients who are at high enough risk of dying or becoming symptomatic from their prostate cancer to require treatment. 4

5 Because of the widespread use of prostate-specific antigen (PSA) testing in the United States, prostate cancer is detected very early, and in some cases the prostate cancer found can be very slow growing. "In early stages of prostate cancer relapse, either at first diagnosis or following initial treatment where PSA is increasing but there is not evidence of cancer in the bones or other organs, there is great interest in better defining who needs to be treated because many of these patients will go on to die of other natural causes prior to their cancer becoming a problem," Kluetz says. Tests to identify patients at high risk for prostate cancer related death or morbidity are an area of intensive research. These tests have the potential to save many American men from the significant side effects of prostate cancer treatment which result in symtoms related to the removal or radiation of their prostate or severe reduction in androgens through either surgery or androgen deprivation drug therapy. These significant side effects highlight the need to reduce the burden to patients of overtreatment if the prostate cancer is slow growing. Don't Fall for Unproven Products - As with most cancers, there are companies selling so-called "natural remedies." Men with prostate problems who rely on these "remedies" rather than approved treatments may delay or forgo getting the proper diagnosis and treatment says Gary Coody, FDA's National Health Fraud Coordinator in the Office of Regulatory Affairs. A wide variety of prostate supplements are sold online and in retail stores with unproven claims, such as: * - "Shrink enlarged prostate" * - "treat benign prostate hypertrophy" * - "lower or slow rise in PSA levels" * - "Decrease or slow prostate cancer growth" The FDA has issued warning letters to firms marketing supplement products with these claims. The products have not been proven safe and effective for these purposes and may include the following ingredients: saw palmetto, beta sitosterol, pygeum, stinging nettle, cranberry and others. The Kelowna Prostate Cancer Support & Awareness group does not recommend treatment modalities or physicians: However, all information is full shared and confidential. The information contained in this newsletter is not intended to replace the services of your health professionals regarding matters of your personal health. The Kelowna Prostate Cancer Support & Awareness Group would like to thank Janssen - manufacturer of Zytiga - Abiraterone for their support in producing this newsletter. November 2014 marks the 18th Anniversary of the Kelowna Prostate Cancer Support & Awareness Group 5

6 UP COMING MEETING DATES- PLEASE NOTE THE DATE OF OUR DECEMBER MEETING December 6th - Please Note this Support Group meeting will be held in the Orchard Rooms at the Parkinson Rec. Centre. The Parkinson Rec. Centre will be the location of all future meetings - January 10th 2015, - Feb. 14th. - March 14th Meeting Location: Our regular monthly meetings are held on the second Saturday of each month in the Orchard Meeting Rooms at the Parkinson Recreation Centre Harvey Ave. with access off Spall Rd. Our meetings begin at 9:00 A.M. and are generally over by 11:00 A.M. Thank you for helping us Win the War Against Prostate Cancer. The Okanagan Prostate Resource Centre operates on donations. We would like to thank the Companies, Service Clubs, Organizations and Individuals that have made donations in order to help us operate this very valuable center. If you wish to make a donation please feel free to fill out the form below. Your support is gratefully appreciated. Our official Registered Charitable Number is RR0001 NAME - ADDRESS - CITY - PROV. POSTAL CODE $25. $50. $100. $250. $500. $ Other amount Please make your cheque payable to the Okanagan Prostate Resource Centre Society, c/o # Guisachan Place, Kelowna, B.C., V1Y 9X8 An official charitable receipt will be issued and mailed out to you. Canada Revenue Agency: 6

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