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Posts Tagged ‘Prostate Cancer Foundation of NZ’

PROSTABLOG NZ: Exact meaning of the word “encourage” will be pivotal  in the continuing New Zealand saga on how best to prevent prostate cancer.

“We will be encouraging men to go to their GPs to discuss optionsincluding whether or not they should have a PSA test,” says the chairman of Parliament’s inquiry into prostate cancer, Paul Hutchison, in today’s Dominion Post newspaper (see below).

In the same story, his statement is welcomed by Prostate Cancer Foundation of NZ president Mark von Dadelszen: “…we would certainly applaud that move.”

What they both mean by the term “encourage” is about to become the focus of a debate that has churned around in global prostate cancer politics since PSA testing became commonly available in the early 1990s.

First question: how does “encouraging” men to be tested differ from a national screening programme (which Hutchison signals will be rejected in the inquiry report due in a matter of weeks)?

A national screening programme presumably involves the Ministry of Health spending millions promoting tests to the general populace, as it does with breast and cervical cancers.

Such programmes “encourage” people to get along to their doctor and have the tests.

How will men be encouraged? Not with a lot of advertising, it seems.

So how, exactly?

By training barbers to spread the word to their clients, as has been tried in the US?

By sending doctors into communities to talk about risks and options, as the Foundation did last year when it flew a team to the Chathams?

By leaving it to the Foundation to publicise the disease and urge men to act, as happens now?

Whatever approach the Health Select Committee is about to recommend, it needs to deal with a mammoth in the waiting rooms – the Ministry of Health instruction to GPs that they must not raise the topic of PSA and rectal examination until the patient does or unless they spot symptoms obviously related to what is often a symptomless disease.

This is the real crux of the dilemma the Select Committee has presumably been wrangling with since its first public hearings in September, 2009.

What instruction will it recommend the Government give to the Ministry, whose staff and advisers  adamantly oppose any widening of the availability of PSA testing?

Up to now, men have been the subject of a mild but just as deadly form of Russian roulette when it comes to being diagnosed.

Take my own case.

Over the past 30 years, I’ve been under the care of four GPs. The first never mentioned prostate cancer (to be fair, I was under 50); the second (mid 1990s) refused to consider PSA tests because to him they were unproven; the third insisted on it without my bidding; and my current one responded readily to my request for tests (saying Ministry instructions forbade him raising the matter unless I spoke up first!).

Anecdotal evidence suggests the Ministry’s obfuscation is becoming increasingly irrelevant – for some people, anyway.

The Foundation’s awareness campaigns have been effective, if I judge by the number of male acquaintances now being diagnosed early and successfully treated.

However, I suspect there are dangerous class factors at play here.

Me and my mates are okay because we have been blessed by education, higher socio-economic status, media awareness and access to health provision.

I fear for those who don’t. The Ministry’s stubbornness condemns them to an uncertain fate.

National prostate screening rejected

Dominion Post April 2, 2011

A PARLIAMENTARY inquiry into prostate cancer screening will not be recommending a national screening programme despite pressure from cancer survivors to do so.

The Prostate Cancer Foundation has backed the committee’s approach, but a former patient says the decision is disappointing.

Health select committee chairman Paul Hutchison said the inquiry, which has been running since May 2009, was not due to report back for another few weeks, but when it did, it would not advocate screening.

There was still controversy over whether blood tests for prostate-specific antigens led to fewer prostate cancer deaths, he said.

Heightened levels of prostate specific antigen – PSA – can indicate the presence of prostate cancer. However, early detection can result in aggressive and unpleasant treatment of tumours that would never have grown or created ill-health.

The inquiry has heard from a huge number of prostate cancer survivors, many of whom asked for a screening programme for all men aged 50 and older.

Dr Hutchison could not go into detail about the committee’s findings but said there were two main conclusions.

‘‘We will not be recommending a PSA screening programme. However, we will be encouraging men to go to their GPs to discuss options … including whether or not they should have a PSA test.

‘‘Those are the two points that are loud and clear.’’

Prostate Cancer Foundation president Mark von Dadelszen said the organisation did not support a national screening programme because of ‘‘issues’’ with the PSA test.

‘What it does advocate is that men should be encouraged to have screening tests . . . we would certainly applaud that move.’’

Napier farmer Duncan McLean, who has just got the all-clear five years after being diagnosed with prostate cancer, said encouragement was good but the committee should recommend a full screening programme.

Mr McLean, 57, had his prostate gland removed in 2006 after several years of increasingly high PSA readings, followed by a biopsy that confirmed the cancer.

‘‘PSA testing is essential. I’m alive today because of it. It’s really disappointing they’re not [recommending screening].’’

Fears about over-treatment were ‘‘bollocks’’, he said. ‘‘You don’t leap in and go under the surgeon’s knife – I was monitored for three years before I had surgery.’’

International research on the matter is split, with several largescale studies under way.

The results of a 20-year Swedish study, published yesterday in the British Medical Journal, found screening did not significantly reduce prostate cancer deaths but the risk of overdetection and unnecessary treatment was considerable.

However, another Swedish study found death from prostate cancer more than halved among men who were screened.

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PROSTABLOG NZ: Nothing has been publicly announced so far as I know, but what has happened to NZ’s Mr Prostate Cancer?

Barry Young – long the voice of prostate cancer in this country – seems no longer to be president of  the Prostate Cancer Foundation, the organisation he steered for the last decade.

Go to the foundation’s website and you’ll see the president is now listed as Hawkes Bay lawyer Mark von Dadelszen.

Barry announced at the 2009 foundation AGM that he would be stepping down.

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My PC Adventure – PART 24:

Cliche is true – cancer makes you re-evaluate

April 13, 2010

A year ago, I lay in bed at home in the mornings and stared out the window at blue skies, wishing I could be under them.

I’m looking through a different sort of bedroom window as I write this – the window of the campervan, and we’re parked beside Orewa Beach, north of Auckland.

Pohutukawa boughs frame a view beyond green and straw-coloured kikuyu and marram grass, out to the end of Whangaparaoa Peninsular, Tiritiri Matangi Island and the hill tips of Great Barrier Island popping up into the horizon of the Hauraki Gulf.

OREWA SUNRISE: Portents of rain over Great Barrier Island.

It’s a year post-prostatectomy.

We’re on holiday for a few weeks, and this April there is the same Indian summer weather, but no catheter, no bright new scar slashing the lower abdomen, no need to hold back from coughing, laughing or leaping off the bed to go for a walk.

The only “slashing” these days is at the urinal, when the flow never fails to mimic that of  mythical 18-year-olds.

The year has passed with many highlights:

  • The birth of Oliver Thomas Tucker, first grandchild (thank you Megan and Kirk).
  • Two PSA undetectables.
  • A journalism graduation dinner I was actually able to attend last month (rather than imagine from the haze of anaesthetic recovery, as happened last year).
  • A return to fitness, following walks and a change of diet to reduce red meat.
  • A couple of months’ membership of the Prostate Cancer Foundation of NZ.
  • Six months of blogging about prostate cancer, then “retirement” apart from occasional blogs. The site had 70,000 hits in the year, with about 20,000 people reading My PC Adventure.
  • Many kind messages from readers, who seem to appreciate the candour of my account.
  • Selling our house and buying a campervan, and so far several tours to beautiful parts of NZ.  We may never own another property, having fallen in love with being on the road.
  • Most important – the support of friends, colleagues and family.

YOUNG OLLIE: Me and Lin with Oliver Tucker - grandparenthood is such a bonus.

I’m now more aware than ever how widespread is the prostate cancer “epidemic”, and without compunction will ask every 40-plus male I meet  whether he gets himself tested.

An early stop on this current trip was at Palmerston North (the place John Cleese said made him suicidal) to visit my mate Lance, who is halfway through external beam radiation treatment for low grade prostate cancer. His prognosis is good.

I have one disappointment – lack of news about the NZ Parliament Health Select Committee inquiry into prostate cancer detection. It started with a hiss and a roar in September, but nothing has been heard so far this year.

My state of mind is rarely troubled by thoughts of whether or not I am “cured” of prostate cancer. It just doesn’t figure.

What scar?

However, now and again there are reminders. An acquaintance who had his prostatectomy a decade ago told me recently he was suddenly suffering peeing problems, apparently caused by scar tissue resulting from radiation he had all those years ago.

And just yesterday I had to sit down for a few minutes after feeling a bit dizzy. But that may have been an over-zealous intake of resveratrol (erm, pinot noir) the night before, and absolutely nothing to do with anything else. But you do wonder for a moment.

For those who are curious but too polite to ask, “functionality” is fine. Erection firmness is as good as ever, although the lost inch is still a little disconcerting.

Libido is normal – ie, it disappears with work stress and goes berserk during holidays.

Orgasms are just as enjoyable and intense as before, and a lot less messy, of course. No more careless maps of Asia on the bottom sheet.

The only bad in my life is stress from work. I continue the task of rebuilding Whitireia Journalism School into a half-decent hall of learning, but at times the workload is immense.

In February and March this year I found myself toiling seven days a week every week just to meet the demands of graduating 28 diploma students.

As I enter the last quarter of my life, I’m thinking seriously about how to avoid doing that for too much longer.

That’s one of the upsides of getting cancer: you take a hard look at your lifestyle.

And the view. There’s a couple of kite surfers out there on the sea. Our spell of 15 straight days without rain is about to end, by the look of the gathering nimbus and the feel of the breeze.

Bugger cancer – I’m off for a walk.  See you later.

READ the full story here: MY PC ADVENTURE

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OPINION

PROSTABLOG NZ: For now, the debate about whether all men should be screened for prostate cancer is dead.

For now.

For sure, it will re-ignite at some future time, as prognostic tests are improved to the point where doctors can tell when  a prostate tumour discovered in a man needs treatment and when it can be left alone.

Why is the debate dead in the meantime?

Two studies published by the British Medical Journal today back up what most analysts have been saying since the March publication of early results of the two big randomised trials that have been looking at PSA/digital testing.

That mass screening will uncover a lot of cancers that are harmless. Over-treatment will result. It has already.

Even the NZ Prostate Cancer Foundation appears to have conceded this is the case.

At last week’s initial hearings by the Parliamentary inquiry into prostate cancer, Foundation president Barry Young said the organisation was “not dogmatic” about screening.

So where does this leave things?

Should we abandon PSA and rectal exams?

Hardly. They are reliable tools for diagnosis and must still be available to men who ask for them, men whose families have a history of prostate or breast cancer, men with symptoms like reduced urination, unexplained pains, blood in the urine, etc.

Where the debate still needs to continue is in the arena of primary health: how can the confusion that appears to reign among GPs and their patients be clarified.

And does all this rule out a marketing campaign urging men to be checked?

No way. It just needs to be done with a clear message.

Not a lot to ask.

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mikeleenzpaPROSTABLOG NZ: Why would anyone say that getting prostate cancer was actually good for them?

In his speech to open a Blue September event earlier this month, Auckland Regional Council chairman Mike Lee (left) said just that.

Talking about his experience with prostate cancer, he described trying to ignore his rising PSA levels, finally being diagnosed, making drastic changes to his lifestyle and diet, and undergoing brachytherapy. Then he made this comment:

“In some ways, in terms of all-round health, in a funny sort of way, getting prostate cancer was good for me.”

READ MORE>

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PROSTABLOG NZ: A minor matter for the record – as of today, the author of this blogsite, Jim Tucker, is no longer a member of the board of the Prostate Cancer Foundation of NZ.

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WHITIREIA journalism student CARL SUURMOND went to the Chatham Islands with the Prostate Cancer Foundation last weekend. Here’s his first report (see below for his SLIDE SHOW):

Chathams 8

FLYING PROSTATE TEAM: from left, Carl Suurmond, Dene Ainsworth, Daniel Marshall, David Mason, Ash Zoias, Kelvin McDonald and Joe Tapara.

PROSTABLOG NZ: The men of the Chatham Islands are a tough  breed of fishermen and farmers whose work environments have shaped their hardwearing demeanour – but it’s the women of the island who are really tough.

Without the support and encouragement of wives, partners and mothers, many of the male inhabitants of the island may not have turned up at the presentations on prostate cancer held over the weekend.

Chathams 10

Prostate Cancer Foundation board member Dene Ainsworth (left) and Joe Tapara.

That’s the view of Joe Tapara (Ngāti Ruanui),  cultural adviser for the Hao Te Ora o Wharekauri Trust and member of the Chatham Islands Māori Community Health.

“The wives and the partners were the reason why so many men turned up,” he said. “Without them nagging, I’m not sure how many would have bothered.”

Chathams 15

Dene (right) in the jump seat behind the pilots.

The weekend presentations aimed to raise awareness of prostate cancer and promote early detection, with a focus on reducing fatalities amongst Māori men.

Maori are less likely to be diagnosed early and suffer a death rate after diagnosis that is twice that of non-Māori.

The trip was funded and organised by the NZ Prostate Cancer Foundation, in conjunction with Māori Community Health and Chatham Island Health Care.

Chathams 13

David Mason (right) and Daniel Marshall get checked out on a boat at Port Hutt.

Chathams 19

ISLAND FOOD: The team is spoiled at Kaingaroa.

The team included the expertise of urologist Dave Mason and trainee urologist registrar Daniel Marshall, both from Hastings.

Otaki’s Dene Ainsworth (Te Āti Awa Iwi), a board member on the foundation, and prostate cancer survivor, shared his own experience during four well-attended presentations to several communities around the island, which is 800km off the coast of Christchurch.

Chathams 11

Dene speaks to one of the Chathams gatherings.

In total, 40 men out of 135 over the age of 40 – and a few women – turned out, and in small communities like Kaingaroa Harbour, Owenga and Port Hutt just about all the male population was there to have their questions and concerns answered.

The tour round the main of the Chathams group was organised by Mr Tapara, with plenty of help from other locals.

Mr Ainsworth said the weekend was a great success and the desired outcome had been achieved.

“It was a bloody awesome weekend.  I think we achieved more than we could have ever hoped for.  The reaction from the islanders was first class and they’re really keen to get us to go back and do this on a regular basis.”

Chathams 17

Mr Mason and his colleague were there to address medical concerns and provide advice.

“I think the turnout has been amazing,” said Dave Mason.  “Each place that we’ve been to, the guys have come out and talked about things in different ways and brought up different concerns.

“There was a good bit of interest and a good spread of age groups.”

Mr Marshall said the men were not shy about asking questions.

“From talking to them afterwards it seems they’ve got a lot out of it.  They certainly haven’t been shy in asking questions and finding out what they want to know, which is what it’s all about.

“Seeing the island, seeing the style of life here, the way everyone gets on so well in the community here – it’s been brilliant.”

ChathamsPano1

The waterfont at Waitangi, the main settlement.

The weekend came about through a serendipitous meeting between Dene Ainsworth and Joe Tapara at the first-ever Māori men’s health conference, Tane Ora, held in Blenheim earlier this year.

Chathams 9

MAORI TV: Kelvin McMcdonald (left) & Ash Zoias.

Dene spoke about prostate cancer in a presentation at the conference and was heard by Joe Tapara.

The two talked about men’s health and prostate cancer and Joe told Dene that his presentation was needed on the Chatham Islands.

“I agreed that Chatham Islands men should have the same access and opportunity to these sorts of presentations as ‘mainland’ New Zealanders,” said Dene.

The trip, which was funded by the Prostate Cancer Foundation, was filmed by a crew from Maori Television, which will show it on its top current affairs programme, Native Affairs.

VIEW THE CHATHAM ISLANDS TRIP SLIDESHOW HERE

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Chathams5PROSTABLOG NZ: A Chatham Island gale whips up the tail feathers on a passing Weka – but men on the island were far from ruffled by the visit of the NZ Prostate Cancer Foundation team last weekend.

They turned out in big numbers to hear the prostate cancer message from the team, whose visit to the island is being reported by Whitireia journalism student Carl Suurmond (who took these pictures). SEE PICTURES HERE>

Chathams2

CHATHAMS WELCOME: Dene Ainsworth (white hair), urologist David Mason and his colleague arriving at Waitangi airport on Friday.

Carl tagged along with the foundation’s Dene Ainsworth, two Hawkes Bay urologists and a filmcrew from Maori TV, who all flew to the islands on Friday and were due back today.

The men spoke about the risks of prostate cancer to meetings organised by Chathams health worker Joe Tapara.

Chathams4

WILD COAST: Carl Suurmond at Petre Bay, which forms half the main Chatham Island's west coast.

Here’s Carl’s first impressions:

Things are going well here, although the weather has not been the best (set to change to less rain tomorrow (Sunday).

Had to take advantage of a one-hour break in the rain and get some footage of the scenic reserve that is behind the lodge.  Amazing place. The people are really great, as well.

I passed on a boozy night at the local with some friendly young fishermen we met at the Kaingaroa Harbour Social Club, where we had a barbeque.

The presentations went well today, with a large turn out at Kaingaroa.  Good questions were asked and it seemed beneficial to all those who attended.

Dene has been great, and I admire his passion and enjoy his informative presentations where I have learnt a fair bit myself.

Maori Television has been doing a fair bit of filming and I have observed a few techniques.  Kelvin and Ash are really nice guys.

The Urology team from the Hawkes Bay, Dave(Mason) and Daniel, are also really great guys, who answer questions well and are fun to be around.

I’m not sure if there will be any testing, though. The PSA machine is here, but they say it hasn’t been trialled yet.

Chathams6

One of the meeting venues.

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chathamsMAPPROSTABLOG NZ: Men on the isolated Chathams – 10 small islands 800km east of NZ – are getting the message about prostate cancer this weekend.

Prostate Cancer Foundation board member Dene Ainsworth (Te Ati-awa), who has taken a prostate team there to talk to the men and test those who want it, says they are getting good attendances at their meetings.

In an email to his wife, Jan, back on the Kapiti Coast north of Wellington, he wrote today:

We drove to Kaingaroa, a 1hr 45min drive, and we spoke to 13 men there.

Again, a good turnout, as there is only 30 people, total, that live there.

It was a lively meeting, with predominantly fishermen who called a spade a f***n shovel, so there was some lively debate, aided by one of the guys celebrating his birthday and being reasonably well-lubricated when he arrived.

The team – there for just the weekend and heading home tomorrow – includes Napier urologist David Mason and a colleague, Maori TV, and a Whitireia Journalism School student, Carl Suurmond.

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PROSTABLOG NZ: The NZ Health Select Committee has asked the NZ Prostate Cancer Foundation to send any cases it knows about of men being declined prostate cancer tests by doctors to the Health and Disability Commissioner.

The request comes after PCF president Barry Young told the first day of the committee’s hearings into prostate cancer that GPs are doing this in NZ and it may be responsible for some men not being diagnosed in time for treatment.

The foundation already has ample evidence of this problem, says Barry Young, but this invitation by Health Select Committee chairman Dr Paul Hutchison is a chance for all NZ men who have faced this problem to speak out.

 If you or someone you know has been declined a request for a PSA test or digital rectal examination by a GP in NZ, please email details to the PCF at:

nationaloffice@prostate.org.nz

Or PHONE: 0800 477 678


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