Posts Tagged ‘cholesterol’

URO TODAY: Eating food with high trans fat content increases the risk of prostate cancer – but other possible risks like cholesterol, total proteins, total fat, mono-unsaturated fats, poly-unsaturated fats, mono-saccharides and total carbohydrates don’t rate.

These are the findings of a survey of 1800 men across eight Canadian provinces. READ MORE>

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URO TODAY: Statin use is associated with a decreased risk of prostate cancer diagnosis, a survey of nearly 2500 men found. READ MORE>

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robertclark_200JULY 14: PROSTABLOG NZ: The UK scientist leading the research project that is about to report on folic acid risk factors and prostate cancer is Robert Clarke at Oxford University, says Otago University’s Professor Murray Skeaff.

Professor Skeaff is quoted in the Otago Daily Times newspaper as saying the team led by Clarke (pictured) will soon release details of a large study that found folic acid – about to be added to most NZ bread – is not a cancer risk.

The conference where preliminary results were presented was the 7th International  Conference on Homocysteine Metabolism, which Professor Skeaff attended last month.

According to the Oxford Uni website, Dr Robert Clarke joined its Clinical Trial Service Unit and Epidemiological Studies Unit in 1991.

He is an honorary consultant in Public Health Medicine, and Reader in Epidemiology and Public Health Medicine at the University of Oxford, and a Fellow of the Faculty of Public Health Medicine and a Fellow of the Royal College of Physicians.

His research interests include the importance of traditional risk factors (blood pressure and cholesterol) and novel risk factors (homocysteine and genetic markers) for cardiovascular disease and for cognitive impairment through large-scale meta-analyses involving individual participant data from observational studies and trials.

In addition, he co-ordinates aspects of the PROCARDIS study of the genetics of coronary heart disease, Whitehall study of London Civil Servants and Oxford Healthy Aging Project.

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MAY 29: NEW PROSTATE CANCER INFO-LINK: Researchers have reviewed a variety of prostate cancer prevention strategies, including use of 5α-reductase inhibitors, statins (a class of compounds used to reduce cholesterol), NSAIDs, selenium, vitamins E and D, lycopene, allium vegetables (garlic, scallions, onions, chives, and leeks), soy/isoflavones, and green tea polyphenols. READ MORE>

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PART 21 of My PC Adventure – see full story HERE>

The headline for this – the penultimate chapter of my prostate story – isn’t what it seems.

SunsetIt’s not a goodbye, nor a resignation to impending death, nor a signal I’m giving in to the vicissitudes of age.

It’s a metaphor, of course, drawn from a famous NZ play by that name ( The End of the Golden Weather  by Bruce Mason ) which spoke to my boyhood of  “…the eternal optimism of the child and the harsh certainty of age…”

To quote one tribute to Mason’s 1959 work:

“Golden Weather tells the story of the loss of innocence and of human fallibility…”

The end of my golden weather refers, in part, to the “official”  finish of my recovery from the surgery that took out the prostate cancer, a two-month idyll during which I’ve researched and written about prostate cancer in this forum, which began as a personal blog and has grown to a website with a following around the world.

(That’s one reason, incidentally, why I have explained “end of the golden weather” – now two of five visitors to this site are from the US. The proportion of Kiwi readers is about one in three).

In this case, “end of the golden weather” also has a literal meaning, since my time at home has been blessed with a remarkable (for Wellington) patch of fine, still weather, an “Indian summer“.

In the last few days, winter has roared in from the Antarctic, bringing snow to the South Island and to hills around Wellington.

Rain hits the windows on the southerly side of the house as I write this, and I know the days of teeshirts and sunhats are over for a while.

Tomorrow, I return to work. Truly, the end of the golden weather, but in fact something well overdue if I am to feel fully restored.

Which is what I want to write about: how do I feel about what’s happened (that classically banal and inappropriate journalistic question)?

Perhaps I should begin with what I don’t feel.

I don’t feel old. At 62, the body and mind are in the kind of shape my parents’ generation, the Depression and war-shaped cohort, associated with their 40s. My mindset accords with that silly epithet, “60 is the new 40”.

I am getting old, of course, but cancer has had no obvious role in that gradual process.

It didn’t turn my beard white, steal the hair from the top of my head, slow up my legs in social soccer games, nor account for loss of memory for people’s names after we’ve just been introduced, nor the keeping to speed limits, and restricting of booze intake to a Heinie a day, and the working day hours to no more than a dozen.

All those things have been creeping up since I was 30.

I don’t feel debilitated. I’m back to the fitness I enjoyed prior to the operation in March, easily able to walk briskly over my personal training challenge, Wellington’s Mt Victoria.

These pictures show the 151 steps I climb on the route to the top, and a view from that top after my first post-surgery ascent, about six weeks after the operation:

MtVic 1

MtVic 2

As I rather over-excitedly reported in an earlier chapter, my urinal turn-around time is reduced to that of a youngster.

I have no major problems with incontinence – just a little drip of a leak sometimes when I’m tired and forget to brace the pelvic muscle when I laugh or cough.

And the big one – suffice to say, that’s not a problem either, without the use of Cialis or the dreaded injections. Bang goes my excuse to browse in the adult shops for a cheap pump.

I don’t feel apprehensive. I’ve got cancer, but we got it early, it would seem, and it was slow-growing – Gleason grade 6 (I’m now thinking it was there for years before my GP, bless him, encountered it with his digit).

It hadn’t migrated out of the prostate, and prior to the operation my PSA was a mere .77.

I’m a little less sanguine about the “let’s cut the bastard out and be done with it” mindset I had early on, because research tells me there’s never any guarantee that something microscopic didn’t escape into my system during the op, or even during the biopsy. Highly unlikely…but possible.

I expect when my PSA is tested in August I’ll show the required nil level, but I’ve also read data which shows it might rise again after a couple of years. I need to show nil PSA for a decade before I can possible say I’m cured.

But something has changed. Ever so subtly.

It can only be described as an odd sense of betrayal. My body – until now more or less organically sound – has finally let me down in a most shocking way.

Okay, I’ve had marginally elevated cholesterol since 1991, but there is still medical disagreement about what that actually means. And I take a light dosage of blood pressure medication for something that runs in the family.

Neither of these has felt anything other than a mild indication of getting through the years towards maturity.

But cancer! That’s systems failure. That’s involved the first major invasion of my body, leaving a scar (physical and mental), and thoughts – which will no doubt recede – of organic deterioration, of a hurrying of the first steps towards the grave.

Sound morbid?

It does, doesn’t it, but actually it’s not something I’m dwelling on in a neurotic way. It emerges merely as one of the more philosophical after-effects of a mortal event, a reminder that, yes, there is death at the end of the journey, and there’s no way to dodge it.

It doesn’t affect my optimistic view of life in the slightest.

I come from a line of long-livers. My great grand-father died in his baker’s shop in London at the age of 99. My grandfather lived to 84, and my father convinced himself he would go at the same age, so did. On my mother’s side (she lived to 80), there was grandma lasting till 94 and grandfather going to 86. We don’t pop off early in my family.

Age expectation is a tricky calculation, incidentally. One of the interesting things in Michael Dattoli’s new prostate cancer book (reviewed recently on this blogsite) is a reminder that average longevity calculated at birth (about 78 for male Kiwis) is way shorter than that enjoyed by someone at 60 and beyond.

This chart from the Dattoli book shows what I mean:


This is important in the debate about population-based prostate screening. One of the arguments against it (and against surgical treatment after about 75) is the thesis that because many tumours are slow-growing, something else will getya before the prostate.

As age expectation rises significantly once you’ve reached 60 (compared with what you started out with, when accidents and other factors are probably much more influential), so presumably does the point at which “watchful waiting” should apply.

My life expectation in terms of surviving prostate cancer is also being extended as we speak by the massive effort by scientists and doctors – in the US especially – to achieve breakthroughs in testing, diagnosis and treatment.

Any time soon they’re going to find a quick, non-invasive method of helping the medics know how bad the cancer is and how (or if) it should be treated.

This is undoubtedly an effect of the great surge into old age of my generation, the baby boomers, with our more positive attitude to aging and our demands (and wherewithal to pay) for better medical options.

So. How am I feeling?

Bloody good, bloody lucky, bloody optimistic.

Even so, I will be taking a few precautions.

The number of red meat meals will be dropped from four or five a week to one or two, the already fat-free diet will be applied even more rigorously, the brisk walks will be taken even more regularly, stress at work will be avoided (hah!), sunsets and scenery will be noted more diligently, the regular evening hit of red wine will be replaced with pomegranate juice (which looks exactly the same in a wine glass and, amazingly, tastes like a slightly sweet version of a Central Otago pinot noir)…but the single daily can of that nectar of life, the Heineken (no, they’re not paying me a cent), will continue.

This weekend we had a pleasant visit from my journalist colleague, Barry Young, who also happens to be president of the NZ Prostate Cancer Foundation.

Barry is 10 years free of prostate cancer after his prostatectomy, his PSA is nil, he can enjoy a good glass or three of red wine, and he tucked into seconds of lamb shanks (grown on the open fields of the Canterbury Plains, no doubt).

I’d be tempted to say us journos have an extra gene that bodes well when we get prostate cancer, but I know that’s not true (witness the death of the legendary Frank Haden a couple of years ago).

But our sense of outrage might help. It comes from our journalism-driven suspicion that there are people in positions of medical power who – with their dogmatic opposition to the promotion of prostate testing – are deciding the fate of a lot of men in this country.

This comment in no way applies to the medics who have treated me – surgeon Rodney Studd and the team at Wellington Hospital, Bob Hale at the urology department, the nurse-manager of the rehab clinic, and to GP Rob McIlroy.

Thanks to them, I feel confident of a long life. I don’t care about speaking too soon – I’m just not suspicious about tempting fate.

NEXT (some time away): PSA – wherefore art thou?

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REUTERS:  Cholesterol-lowering statin drugs may protect men against prostate cancer and other urological complaints.

A clinical study following 2447 men over 15 years found those taking statins were less likely to develop prostate cancer. Just 6% of men on statins were diagnosed with prostate cancer, with non-statin users three times more likely to develop the disease, Mayo Clinic researchers have reported at the American Urological Association meeting in Chicago.  READ MORE>

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Part 6 of My PC Adventure (click HERE to read all parts in order)

YOU’D think a big, fat family wedding would be perfectly distracting in the lead-up to a major operation. 

wedding11Normally, you’d be right.

But the wedding of my niece Jaclyn to her Melbourne man, Ash, back in hometown New Plymouth just a couple of weeks out from the big day became a disaster that thrust the family briefly into national prominence.

The wedding itself at the idyllic Ahu Ahu Villas on the coast just south of the city was beautiful.

But within hours my other niece, Philly, the sister of the bride, lay dead after tumbling out of the mezzanine bedroom of her accommodation in the early hours of the morning and suffering an appalling head injury.

Philly and me.

Philly and me.

I was due back in Wellington the next day for a pre-op assessment, but all thought of that was abandoned as my brother (father of the bride) and I and our families struggled through media attention, funeral planning, the funeral, and more grief than you could ever imagine.

Any consideration of my own upcoming challenge simply seems selfish in the face of such emotional upheaval.

However, eventually I have to try to protect my place on the public waiting list, so some negotiating with Wellington Hospital gets the appointment changed to the following week, which will be just a week prior to the operation date.

When I explain the reason for the requested delay, they’re helpful, and assure me I won’t lose my date.

The extended stay in New Plymouth between March 6 and 11 has taken some precious teaching time from my students, who are working furiously to complete their last assignments (the course is due to end on March 20), so there is little chance to dwell on what’s coming up. I sleep well.

Pre-assessment is what it says: they check your fitness to have the operation.

After losing myself in a remote car-park somewhere a kilometre from where I was supposed to be (the signposting was temporary and confusing, given the new hospital building had only just been open a couple of days), I report to the new outpatients department.

wellingtonhospitalIt seems surprisingly cramped and inaccessible behind a vast atrium entrance (pictured, right), with pre-assessment hidden down a corridor. There are no signs up yet, but a string of smiling staff – no doubt thrilled to be in their new quarters – seems to know where I’m going and ushers me through.

I get to a counter behind which are three or four people who appear preoccupied. I put on my best, quizzical “I’m-not-invisible” look and finally someone notices.

She directs me to a small, internal, windowless, largely empty waiting room, where I watch an elderly couple in wheelchairs giving one another constant reassurance and occasionally being fussed over by solicitous staff.

A nurse (although it’s hard to tell: she might have some other, more elevated title) calls my name and takes me around a corner to weigh me and check my height.

ecg-traceShe then leads me to a room where I remove my shirt and jeans and lie on a bed. “Ever had an ECG?” she asks. Nope. “These might pull a bit when I take them off,” as she places small, circular sticky pads all over me, attaching my life forces to a machine whose readout I can’t see. “Keep very still for me, please.”

Back to the waiting room. Wheelchair couple still await their escort to the carpark.

Next, a man comes in and calls my name. He’s an anaesthetist, but not necessarily the one who will be involved in my operation. “I’m just going to run through a few things with you.”

My ECG is “splendid”, he says with a smile. He’s English, but has lived here a while, and says he finds it such a pleasure to deal with so many fit and healthy people. I presume I’m one.

I’ve had 30 years of house renovation work to give me inherent, anaerobic fitness. I’m a few kilos overweight now because the power tools have been retired a couple of years, but lately on the way home from central Wellington to Hataitai, I’ve been getting out of the car at the bottom of Marjoribanks St at the foot of Mt Victoria and tramping up over the top. It’s a tough, 40-minute walk.

My blood pressure has edged up above 90 in recent times, so now I’m on a low dose of blood pressure medication. The cholesterol hovers just above whatever new goal-post the undecided medical researchers are dictating, but it draws nothing more than reminders about diet, which is kept cheese-free but not entirely devoid of rich Sunday lunch desserts.

He explains that I won’t be getting a full dose of general anaesthetic.

spinalIt will be complemented by a jab in the spine with a mixture of local anaesthetic and morphine painkiller, a procedure that reduces the general anaesthetic hangover and boosts pain relief and recovery.

My next interview is with an impossibly youthful Asian doctor, who says he will be assisting with the op. He takes me through a questionnaire I’d filled out when originally responding to the hospital’s invitation to have the operation, re-checking the answers I’d given. He seems confident I’m going to get approval for everything to proceed.

The original nurse returns to fill out blood and urine test forms and directs me back out to the main outpatients’ waiting room, with an instruction to sit on the red seats and wait for the tests. Red seats. Got it. Clever.

carter1The weekend is spent on a couple of final, non-stop charges up and over Mt Vic, and shopping for a post-op “wardrobe” of OXX underpants of the Dan Carter design and very loose-fitting track pants. Classy.

Now I’m ready.

NEXT: Report at 7am – empty.

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