PROSTABLOG NZ: The final report from a two-year NZ Parliamentary investigation into prostate cancer detection and treatment has been released by the Health Select Committee. READ MORE>
Posts Tagged ‘NZ Parliament’
NZ Parliament releases prostate cancer report
Posted in SELECT COMMITTEE INQUIRY, tagged Health Select Committee, NZ, NZ Parliament, prostate, PROSTATE CANCER, prostate detection, Prostate inquiry, prostate report, PSA on July 27, 2011| 2 Comments »
Our 1000th post – something special: what reduced the prostate inquiry to tears
Posted in PROSTATE CANCER, SELECT COMMITTEE INQUIRY, Treatment debate, tagged advanced prostate cancer, battling medical system, Health Select Committee inquiry, NZ MPs, NZ Parliament, prostablog, Prostablog's 1000, prostate, prostate blog, PROSTATE CANCER, prostate cancer screening, prostate cancer treatments, prostate saga, prostate treatment, prostate treatment debate on September 25, 2009| Leave a Comment »
PROSTABLOG NZ: This is a very special post – the one thousandth for Prostablog since we launched on April 1, 2009.
It’s special because I’ve reserved it for a brave and resilient couple, Kim and Brian, whose saga with prostate cancer brought tears to the eyes of every person in the Select Committee room at the NZ Parliamentary inquiry into prostate cancer this week.
I’ve never met Kim Cook. We’ve spoken on the phone just a couple of times.
But I know a lot about her from the way she has written for Prostablog over the past winter months.
Her story (entitled John and Mary’s story) is about the struggle she and partner Brian have faced getting treatment for his cancer, which is now advanced.
Kim said she wanted something to come out of their battle: how could she get her message across about the frustrations some prostate patients face with the medical system in NZ?
What better way than to tell the story to the Health Select Committee on the first day of its hearings.
They had already had about 10,000 words from her in a written submission.
What came on Wednesday, via phone teleconference (because Brian was not up to the trip from Auckland to Wellington), was a gritty, emotional but devastatingly precise introduction to their story.
Kim’s voice broke only once, near the end, when she talked of crying herself to sleep most nights.
MPs, reporters, audience, dabbed their eyes at this point.
It was important for the MPs on the committee to hear from this brave woman.
It was a reality check for them, a respite from the mostly dispassionate testimony of medics and bureaucrats.
Kim, Prostablog salutes you.
CLICK HERE to see what Kim said.
FOOTNOTE: prostablog has come a long way from the first days of April, when views were lucky to hit double figures.
Yesterday we had nearly 400 page uploads, the most for a single day. So far.
As I write this, I see that 21,278 people have taken a look since we launched. Probably, it’s a lot more than that, since direct RSS feeds are not recorded.
The most recent indication we have “arrived” was a request from a New York robotic prostatecomy clinic to please put a link to their website on our home page. Happy to oblige.
Widespread confusion over prostate cancer advice in NZ ‘untenable’ says chair of Parliamentary inquiry
Posted in PROSTATE CANCER, Screening debate, SELECT COMMITTEE INQUIRY, Treatment debate, tagged Dominion Post, Dr Paul Hutchison, early detection and treatment, Health Select Committee, leading New Zealand urologist, NZ Parliament, prostablog, prostate, Prostate advice, prostate blog, PROSTATE CANCER, prostate cancer screening, prostate confusion untenable, prostate treatment, prostate treatment debate, PSA, PSA test, Robin Smart, Screening debate, select committee prostate inquiry, urology, widespread confusion on September 1, 2009| Leave a Comment »
PROSTABLOG NZ: The widespread confusion many men feel over the advice they receive on early detection and treatment of prostate cancer is untenable, says Dr Paul Hutchison, chairman of the NZ Parliamentary Health Select Committee. READ MORE>
He says this in an article he wrote for today’s Dominion Post newspaper in Wellington, just two weeks from when his committee will be hearing submissions to its inquiry into prostate cancer screening and treatment.
That a leading New Zealand urologist, Robin Smart, recently concluded ‘‘the evidence suggests that between 200 and 300 of the 600 men who die annually of prostate cancer could be saved by current technology’’ indicates greater efforts need to be made, he writes.
Some tough questions for the NZ parliamentary inquiry into prostate cancer
Posted in Govt prostate policy, PROSTATE CANCER, PSA tests, Public health system, Screening debate, SELECT COMMITTEE INQUIRY, Uncategorized, tagged advisers, annual check-up, Auckland ghost tour, Bain, cancer inquiry, digital examination, director-general of health, Eden Park, epidemiologists, GPs, health professionals, managers, Maori and Pacific Island men, McAnulty, medical checkups, Ministry of Health, Movember, Mt Eden Bed and Breakfast, National Screening Advisory Committee, NZ Cancer Society, NZ Parliament, NZ prostate community, oncologists, politics of health care, prostate, prostate blog, Prostate Cancer Foundation of NZ, Prostate cancer patients, prostate-specific antigen, researchers, Rugby World Cup, screening and testing programme, Screening debate, Select Committee Inquiry in Prostate Cancer, survivors, unnecessary treatment, urologists, urology nurses, Weatherston on August 18, 2009| Leave a Comment »
PROSTABLOG NZ: The NZ parliamentary inquiry into prostate cancer closes off its submissions this Friday…and to mark the occasion, I want to write about a man called Tony.
He’s a mid-50s Kiwi bloke. Friendly, articulate, life-experienced, a bit more adventurous, perhaps, than some.
He and wife Marlene (at right) run an excellent bed and breakfast in Mt Eden, Auckland, under the shadow, almost, of where $300 million of my money is being spent revamping Eden Park for the rugby world cup in 2011.
Tony drove trucks across America for a while, until the mid-2000s. Marlene missed him, so joined up, taking the wheel during daylight. They had a fantastic time.
But now they’re back home, with Tony working three jobs as they build up the B & B (left) during the recession.
He runs a disability transport service with his vans, walks people around central Auckland city at night telling them ghost and murder stories, and helps Marlene with the homestay.
By all odds, Tony has a 50% chance of hosting a cancer in his prostate.
He doesn’t know it yet, either way. He hasn’t been checked. He’s been too bloody busy.
But now he’s going to the doc and he’ll endure the finger up his backside and the scratch in his arm.
Why? Because Lin and I stayed with Tony and Marlene last weeked and he got an earful from me about getting checked.
Why am I telling you this? Because Tony is fairly typical of most of the Kiwi men I know (the ones who haven’t had prostate cancer). They either don’t get tested, get only the PSA, or were tested “once” and think it’ll be fine for a few years.
They are what the Health Select Committee inquiry into prostate cancer screening and testing is about.
Two bitterly opposed protagonists
Anyone who thought NZ’s recent prominent murder trials (Bain, Weatherston, et al) were problematic for their juries, spare a thought for the Health Select Committee.
Not only must it contend with the politics of health care, it also faces two ferociously opposed lobby groups that can each present a compelling case.
On one side will be the NZ prostate community, comprising prostate cancer patients, survivors, some of their medics (GPs, urologists, urology nurses, oncologists, etc), and a vociferous band of patient advocates, the 330-strong Prostate Cancer Foundation.
On the other is the health care bureaucracy, encompassing a heavyweight team of health professionals, managers, advisers, epidemiologists, academics, researchers and various subgroups that include some GPs…and the NZ Cancer Society.
Both will lobby the inquiry with statistics, research, study results, precedents, and on one side, at least, some emotionally gruelling anecdotal evidence.
What will each side say?
The bureaucrats (the Ministry of Health and its pilot fish advisory committees) will say what it has always said: we should not adopt a screening and testing programme like that offered to women for breast and cervical cancer because it will do more harm than good.
Their argument is strong, and is the same one argued by other governments’ medical agencies.
It is this: many men (maybe 50%) will get prostate cancer in their lifetime, but only a few (12% to 16%) will contract a form that has the potential to kill them – and there is, as yet, no way to know (before treatment) which kind a man has got.
They say if there is outright encouragement for all men to be tested, whether they have symptoms or not (most won’t, initially), it will lead to unnecessary treatment.
This would cost the government a lot more as well, some argue, but that’s not a point the bureaucracy will highlight, since it doesn’t sound very humane.
Meantime, leave it to patients to raise such matters with their GPs, then make their own decisions based on facts they glean from consultation and research (ie, Dr Google).
The bureaucrats will say there is good reason to trust GPs to do the right thing.
A survey of nearly 350 general practitioners published in 2003 (GP survey 2003) found 74% would PSA test a 55-year-old man who asked (or presented for an annual check-up), with that number rising to 93% if the man’s family history included prostate or breast cancer.
The prostate community argues that since PSA blood tests became widely available in the 80s there has been significant decline in the number of deaths from prostate cancer, and this could be accelerated if screening and testing were promoted to the whole male population.
They say leaving it up to men to raise prostate testing with their doctors is not good enough.
Some men don’t go to the doctor unless they have to, which is a particular problem with prostate cancer, a devious disease that often shows its face when it’s too late for treatment.
Non-consultation is a factor that may apply particularly to Maori and Pacific Island men: the former have twice the death rate of non-Maori. No statistics are available for PI men, it seems.
The prostate community is concerned that some GPs are confused about their role in the prostate process.
Some refuse to test, some don’t proffer advice unless the patient speaks up first, some offer PSA only, some offer both PSA and digital exam. Some men die as a direct result of such a hit-or-miss system, the PCF says.
The foundation and its medical advisers know many cases of men who discover prostate cancer too late.
These are tragic stories, exemplified by the account being written on this website by Mary about her struggle with the medical profession to get treatment for her husband, John. It’s a heart-breaking tale.
There is some bitterness in this debate.
The prostate community is seen as deeply swayed by the emotional influences of suffering the disease or benefiting from dispensing treatment; the bureaucracy is considered heartless, unduly influenced by statistics, gender-biased, and penny-pinching.
Both sides are gathering their forces as this is written.
The Ministry’s line, probably, is encapsulated in advice it received from its satellite National Screening Advisory Committee this winter, after the committee examined the results of the two large overseas screening studies reported in March.
It recommended the Director General of Health should note that:
a) the benefits of PSA screening for prostate cancer identified in the European trial were small;
b) no benefit of prostate cancer screening was identified in the US trial;
c) both trials identified considerable screening harms related to over-diagnosis and over-treatment;
d) the benefits of PSA screening identified in the European trial were observed using an average screening interval of four years, whereas a screening interval of one to two years is more commonly used in general practice;
e) the utility of prostate screening increases with age;
f) a longer study follow-up period may alter trial results; and
g) a watching brief of these two prostate cancer screening trials should be kept, including similar trials of prostate cancer treatment effectiveness, to inform men about making prostate screening decisions.
There is some inevitability, then, about how this inquiry will proceed.
The Ministry hasn’t changed its stance, and the PCF has grown all the more powerful since it gathered considerable funding from the Movember crusade in 2007.
Which suggests the outcome will be influenced by political expediency. As these things usually are.
It’s not a good time to be appealing to a government that’s busy slashing spending in all sectors.