PROSTABLOG NZ: Rates of prostate cancer detected in NZ are expected to rise about 23% in the decade leading up to 2016, moving from 91 cases per 100,000 to 112.
That’s the finding of a Ministry of Health cancer projection report released late last month, but only just picked up by news media (none of whom looked in detail at prostate cancer).
Something the report calls the “burden of new cases” is expected to increase by 71% over the 2006-2016 period. This term is not explained (for the uninitiated).
Interpreting the report is something of a challenge.
The Ministry’s researchers have chosen to single out prostate cancer projections as the only ones that “could not be updated (although they have been extended), as these are based only on data up to 1984-88″.
The reason given is something they dub the “PSA effect”.
It’s hard to be sure, but this apparently means that because of a sudden upsurge of PSA testing in the late 1980s and early 1990s – leading to perhaps half of the Kiwi aged male population getting tested – there has been a massive blip in the detection statistics.
A half generation of men who would otherwise have not been detected until symptoms showed at an older age have been diagnosed “early”.
This has distorted trends to such an extent, it seems, the projection models can’t cope.
Graphs from the report, reproduced here, show the “bulge” effect. In the bottom one, the solid lines showing rates up to 2006 are extrapolated out (dotted lines) from 1986, ignoring what really happened because of PSA testing:
The Ministry says until rates return to what would have been expected “pre-PSA”, it cannot provide reliable predictions.
Despite that constraint, it has a go anyway: it concludes the rate of prostate cancer will continue to rise (presumably because of the baby boomer bulge moving through).
Confused? Join the club.
Why is prostate cancer being dealt with differently from other cancers that have been the subject of widespread screening and marketing campaigns, such as breast and cervical?
Is it because those screening campaigns were Ministry-approved, while PSA is frowned by the Ministry because it leads to a problem – once prostate cancer is found there is no reliable way to know if it needs treatment, leading to possible over-treatment, and with it, unnecessary cost on the health system.
It would be useful to hear from epidemiologists on this, despite their inherent bias against PSA testing casting doubt on their views.
Still, they might help unravel the technicalities of the Ministry’s convoluted explanation.
PROSTABLOG NZ: You Tube’s silent treatment of my plea to restore my piddling video because it has a social value transcending their “community guidelines” raises some issues.
These have nothing to do with prostate cancer, but bear with me.
As a journalist with nearly half a century’s experience, I’m finally waking up to the fact that media accountability has slipped even further away from the ideal.
It was never strong. Large media organisations have tended to deal arbitrarily with complaints, often calling on the utility of press freedom to justify their frequent breaches of public trust.
But at least there were actual mechanisms for holding them to account.
You could write to the editor, and if that didn’t do it, complain to the regulatory body – although, because it was usually self-regulatory, you didn’t hold your breath waiting for satisfaction.
You got a better deal with broadcasting in countries like NZ, which (under the guise of governments “needing to allot frequencies in orderly fashion”) have laws regulating media behaviour, laws with teeth.
Now, we have You Tube, which – like still images website Flickr, and aggregators like Google – is a global behemoth run by computers, and a law entirely unto itself.
If they choose to ignore your complaint, they will. And in my case, have. And there are no regulatory agencies to whom I can take my case, except perhaps the courts, if I had enough money.
There is an irony here. I could perhaps go to the “old media” and have them air it, if they could be persuaded.
They might be interested. After all, it’s a fairly bizarre case, isn’t it: prominent Kiwi journalism educator gets pissed off after his socially important video on, um, pissing, is taken off line.
It’s the sort of weird story that appears daily in newspaper “odd spots” round the world.
Then, and only then, might the new model of media conglomerate sit up and take notice.
PROSTABLOG NZ: Well, here’s something good for a chuckle – my short video (right) showing improved urine stream after prostate surgery has just been taken down by You Tube.
Here’s what they say:
The following video(s) from your account have been disabled for violating the YouTube Community Guidelines:
Stream – (Tuckr001)
Your account has received one Community Guidelines warning sanction, which will expire in six months. Additional violations may result in the temporary disabling of your ability to post content to YouTube and/or the termination of your account.
Sincerely,
The YouTube Team
So, I’m on notice for offending good taste, I guess.
I’d love to know who complained.
Here’s my response to You Tube (be interesting to see what they say):
I have received your message with some alarm.
The video clip you refer to is a serious attempt to illustrate to men recovering from the effects of prostate cancer surgery the results such surgery have on improving urine flow.
I refer you to the blog on which this video appears. From that, hopefully, you will see the context.
To remove the video for reasons that can only be imagined shows that You Tube has little understanding of the purpose of such an item.
I request that you restore it as soon as possible.
I await your reply with interest, and will report it on the blog.
Here’s the link to my blog (which has so far received 52,000 page uploads and much favourable comment from prostate cancer sufferers and medical experts): http://prostablog.wordpress.com
Thank you
Having read the community guidelines, I’m at a loss to know where the video trangresses. Take a read (see the link above) and let me know what you think.
Here’s where the original video appeared in my series, My PC Adventure:CLICK HERE
I have to say that the video has already been through the scrutiny of the toughest censor of all, my wife Lin, who cut the length (of the video) to a short few seconds. Since she apporoved it, who could possibly take offence?
PROSTABLOG NZ: The NZ Listener magazine has commissioned an article on cancer and the theme will be screening.
I was interviewed for it today and I think the writer has a good grasp of the issues.
Look forward to seeing what she comes up with.
Does anyone know what happened to the NZ Parliamentary inquiry into prostate cancer?
It was supposed to get more evidence from the Ministry of Health in November, when the ministry expected to have completed its analysis of the two big randomised studies into PSA screening.
The "prostabus" and Queenstown's Remarkables on one of our rare fine days.
PROSTABLOG NZ: This a brief bulletin from our campervan deep in the South Island of NZ, which seems to have been by-passed by summer.
The temperature as we sat outside in Dunedin having dinner last night was 8 degrees!
So far we’ve covered about 2000 kilometres around the bottom half of the island and now live a gypsy life, surrounded by rental campervans driven by holidaying couples and families from every part of the world.
Over the next few weeks I’ll post some of the photos I’ve been taking.
This blog, incidentally, continues to get about 300 hits a day and has drawn some nice feedback. Thank you to those who have contributed.
My health is good and any problems are related only to too many hours wrestling the wheel of the van in high winds (sore arms) or feeling a bit seedy in the mornings from too much fine Central Otago pinot noir the night before.
Oh, and one other piece of excellent news – we became grandparents for the first time on December 30 with the safe arrival of “Sparky” Tucker to Megan and our son Kirk.
CHATHAMS MESSAGE: The Maori TV and NZ Prostate Cancer Foundation team at Chatham Islands airport. Dene Ainsworth is second from left.
PROSTABLOG NZ: NZ’s Maori television channel has broadcast a beautifully produced programme on men and prostate cancer on the Chatham Islands.
It features Dene Ainsworth (Te Ati Awa), who goes to the remote islands, 800km east of NZ, with Hawkes Bay urologist Dave Mason to talk to people about the dangers of undetected prostate cancer.
Their visit was funded by the NZ Prostate Cancer Foundation. See the programme here:
I’m not claiming to be cured. It’s just that spending three or more hours a day monitoring, translating and posting on the prostate cancer web discourse is no longer viable.
The blog is parked for now, although this does not seem to have made any difference to the interest shown: hits still average 300 a day (nearly 400 some days), even though I haven’t posted anything much for a fortnight.
This suggests the site has a life of its own, which is kind of weird, but saves me from being a slave to the PC.
One word may explain the continued traffic – “CATHETER”. When I look at tag terms (key words) that attract people to Prostablog, “catheter” averages about 100 a day, with whatever is next ranking in single figures. READ MORE>
I haven’t posted new prostate cancer stories for 10 days…and I’m getting record hits on this site.
What is it with you people? I’m trying to retire (temporarily, probably) here, and still you keep coming in for a look.
Obviously, I’ve got a lot to learn about blogging.
Incidentally, did anyone catch the RadioNZ item about Movember this morning? Pure PR. Hopeless journalism.
I’m ashamed at my own so-called profession’s (journalism) lack of ability to drill down into the story of NZ’s dual prostate cancer awareness and fund-raising campaigns.
One question, though: how much money did Blue September raise and what will it be used for? Anyone care to enlighten us?
Meantime, I noticed a poster on the bus on my way home from work today. It was about the breast cancer Pink Ribbon campaign and it said one in nine NZ women is “affected” by breast cancer.
Not good.
But how much worse is the possibility that one in two Kiwi men is affected by prostate cancer?
PROSTABLOG NZ: This blog is now closed, indefinitely.
Many thanks to those who have offered feedback and support over the past year.
The blog averages 280 hits a day, has had 32,000 since I started in April, most of them on My PC Adventure.
I have nothing further to add to that at the moment, and probably won’t for a while.
Keeping the rest of it going is a good winter job when sitting at the PC every night for several hours is not too much of a grind. But Lin and I have the new campervan to try out and there’s a lot of NZ to see.
So, I’m off line for now.
Good luck to my fellows in the prostate community.
