Letter from the Editor

Don't tell me it's July already! It’s later than I thought. It means the football season is in full swing. There is more than one brand of football...so I'm told. So that means tackles, goals, tries, penalties, stiff arms, spear tackles, yellow cards, red cards and sin-bins are all the rage. Rage is perhaps not the best choice of words but, when it comes to rage, sin-bin is appropriate in this instance.

I'd like you to think of one man who doesn't like football. Well, perhaps there is just one. It's a universal male language, with a vocabulary all of its own, and they never explain the terminology...not in real words, that is. Even the explanations about the rules are incomprehensible to some people.

Women on the other hand comprehend only a portion of the game. They understand this is ritual male behaviour, dating back to pre-historic times. A non-participant or a non-follower of the game might wonder if the rules have changed in all that time.

Women understand the colourful football jumpers with numbers on the back and the tight football pants, the kick-off whistle, half- time, full-time whistle. And of course women understand goals and tries. Women will never understand the preoccupation with ‘behinds’ in football, especially when the team might be winning at the time. In addition, there is a lot said about ‘moving the goal posts'. At what point in the game does this happen, for they never tell you.

Playing by the rules is considered fair play. Good sportsmanship is in line with the spirit of the game, particularly in the case of the losing side, (or should I say the defeated side). The referee's word is final. Unless you score more than one yellow card, or a red card, then it’s off to the Tribunal for a deliberation behind closed doors or perhaps an appeal, pleading and begging if the decision does not go well. Women understand this concept, too.

Men know about sportsmanship. My understanding of men's

Queensland Prostate Cancer NewsThis magazine is a publication of the Queensland Chapter, Prostate Cancer Foundation of Australia. July 2013

www.pcfa.org.au qpcn@cancerqld.org.auThe Queensland Chapter of the Prostate Cancer Foundation of Australia is grateful for the generous support of Cancer Council Queensland in the printing of this magazine. The content of this magazine is selected by the Queensland Chapter of the PCFA. Cancer Council Queensland does not necessarily endorse, or otherwise, any content contained within this publication.

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In this issue2 Calendar of Events;

Queensland prostate and associated support groups.

3 Help wanted - reduce cost of producing QPCN.

Program for Men with Prostate Cancer.

4 Contributing Guest Editor - Judge Kevan Townsley.

Dimity Dornan.

5 Brisbane Prostate Cancer Support Presentation.

8 Spotlight on Ipswich.

9 Support Group for Gay Men with Prostate Cancer.

10 'Facing the Tiger' - Book Launch.

11 FDA Approves New Treatment for advanced Prostate Cancer Patients.

New Advanced Prostate Cancer Support website.

12 News Round-up.

13 Study: Cholesterol Drugs Reduced Risk of Prostate Cancer Death.

14 Letters to the Editor; Special Monthly Bonus.

15 Tell your story; Cartoon; Thought For The Day; Resources.

16 Forward a Copy; Brisbane Program; Contact Details; Disclaimer; Privacy.

Editor-Judith O’Malley-Ford. MBBS (Qld), MPH, JP(Q), FRACGP

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QPCN | July 2013

Calendar of Events 20137 July Gold Coast Marathon (online Queensland fundraiser)

Anytime BBQ for Prostate Cancer www.pcfa.org.au

Anytime C-vivor (free sessions) www.cancerqld.org.au

Associated Support Group

Group Contact Phone

Kingaroy Robert Horn 07 4690 5800

Prostate Cancer Support Groups in the Queensland ChapterThere are 32 PCSGs in the Chapter with a total membership of approximately 3,500 men.

Peer Support Group Contact Phone Peer Support Group Contact Phone

Advanced (all areas) Jim Marshall 07 3878 4567 Hervey Bay Ros Male 0407 157 590

Biloela Trevor Douglas 0409 235 891 Innisfail Peter Coxen 07 4065 5070

Brisbane Peter Dornan 07 3371 9155 Ipswich Terry Carter 07 3281 2894

Brisbane Partners Wendy Marshall 07 38784567 Mackay John Clinton 07 4942 0132

Bundaberg Rob McCulloch 07 4159 9419 Maryborough Leoll Barron 07 4123 1190

Capricorn Coast (Yeppoon) Jack Dallachy 07 4933 6466 North Burnett Russell Tyler 07 4161 1306

Central Queensland (Rockhampton)

Lloyd Younger 07 4928 6655 North Queensland (Townsville)

Clarke Berglin 07 4773 3303

Far North Queensland (Cairns)

Col Johnson 07 4052 0891 Northern Rivers (Evening) Craig Thurgate

0412 661 924

Far North Queensland Partners (Cairns)

Margaret Rolfe 07 4045 1031 Northern Rivers (Day) David Hughes 02 6687 0008

Gay/Bi David Wells 0411 081 653 Northern Tablelands Peter Martin 07 4096 6315

Gladstone Geoff Lester 07 4979 2725 North West Qld (Mt Isa) Yvonne McCoy 07 4743 2054

Glass House Country Bob McLean 07 5496 9601 Redcliffe Fred Travis 07 3480 5904

Gold Coast Central Peter Jamieson 07 5570 1903 Sunshine Coast Rob Tonge 07 5446 1318

Gold Coast North John Caldwell 07 5594 7317 Toowoomba David Abrahams

07 4613 6974

Gold Coast Partners Maggie Angus 07 5577 5507 Twin Towns and Tweed Coast Ross Davis 07 5599 7576

Gympie Robert Griffin 07 5482 4659 Whitsunday Dave Roberts 07 4945 4886

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QPCN | July 2013

continued from page 1

Letter from the Editor

interpretation of sportsmanship is that they can fight, shout, punch, biffo for a full 80 or 90 minutes as the case may be and when the full-time whistle blows men can remain friends all in the name and the spirit of the game. The referee is a powerful arbitrator on the field, or in the little square box hiding somewhere in the wings interspersed with the audience.

Men know about another playing field, a horizontal playing field, and another powerful arbitrator. The wife. When she says, "Time's up. It's off to the doctor for a prostate check," men usually dutifully oblige. Or it’s off to the sin-bin for you, a red card, withdrawal of privileges for the duration. You all know what that means without my having to tell you. But there are variations on

this theme. This is all part of her wifely role.

Maintaining a healthy community starting with you in particular is also a team effort. Play the game. Don't wait for the referee's whistle and the appearance of a red card in the form of prostate symptoms before having your prostate check-up.

Cancer Council Queensland and the Prostate Cancer Foundation of Australia need your help. They share the costs of the QPCN and there is a real need to contain those costs.

HELP wanted urgently - help reduce the cost of production, handling and postage of QPCN

This means if you convert to an eCopy wherever possible, rather than remaining as a hard copy subscriber, you will be helping to reduce the cost of producing QPCN.

Please become an eSubscriber by forwarding your name and email address to qpcn@cancerqld.org.au

THANK YOU FOR YOUR SUPPORT!

Living Well with Prostate Cancer is a research program being conducted by Cancer Council Queensland with Griffith University and ANZUP Cancer Trials Group, which aims to find better ways to assist men with advanced prostate cancer. The project is trialling patient education and mindfulness-based cognitive therapy to find out if such support programs are effective ways of supporting men at this time.

Program for Men with Prostate Cancer - Living Well with Prostate Cancer

If you would like to take part, and are eligible for the program, we would provide you with support information about prostate cancer by mail. Some men will also receive mindfulness sessions over the telephone. We would also ask you to answer some questions about your health and prostate cancer experiences at different points over the next nine months.

The purpose of this research is to develop better services for men with prostate cancer. By asking men about their experiences, and keeping in touch with them over time, we will be able to identify the best ways to help in the future. If you would like to know more about Living Well with Prostate Cancer please telephone the Recruitment Officer, Tahlee Marian, on 07 3634 5324.

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QPCN | July 2013

Contributing Guest Editor - Judge Kevan Townsley‘Prostrate cancer’ eh? When I first heard this mispronunciation and spelling, I joked to myself that this must be the cancer you get from too much lying down! But as I heard more and more about this 'prostrate’ cancer, I ceased joking about it. Even then, as most Australian men of yesteryear, I thought this is what other people get, not me.

All that changed when, at my wife's prompting, I went to the doctor to talk about a consistent pain I was getting under the right ribcage after eating rich food and imbibing a wine or two. He suggested I have an ultrasound.

The technicians administering the ultrasound looked serious and asked did I get pain at the midline of the abdomen. I said, "No, it was rightsided."

I waited for a while and the technician said, "Dr thinks you

should go on to CAT scan!" I didn't like the sound of that and, after being injected with green dye and otherwise inconvenienced, I said I couldn't stand the strain much longer as I was feeling quite ill.

A ghostly voice then said, "It would be in your own very best interest if you could stay with it a little bit longer." I now knew they had found something wrong. My poor wife who was waiting for an indeterminate length of time outside was now quite fearful, especially when I joined her ’as white as a sheet’ as she put it.

I had good reason to be fearful. They had found my right kidney was 85% occupied with carcinoma! I had no symptoms except a sore back radiating through to the front, over a period of some years. But that had been put down to muscular strain from tennis and /or squash, which I played at the top grade.

Looking back on it, the tests saved my life as the removal of the kidney was exposed and uneventful with a marvellous surgeon leaving a minimal scar on my right abdomen. All this was in 1994, in August, and by Christmas I was fighting fit. Over the ensuing years there was no metastasis, and I was finally pronounced restored to health (now for 19 years).

What is the moral of this story?

Gentlemen, get the tests for prostate cancer, without delay if you have any of the symptoms laid out in this wonderful magazine.

Judge Kevan Townsley BA, LLB (ret.) Barrister-at-Law Former Senior Consultant Crown Prosecutor for Queensland Ex-Hong Kong magistrate Retired Justice of the High Court of the Fiji Islands

A great Queenslander - Dimity Dornan REFERENCE: The Courier-Mail, 3 June 2013.

Every year since 2001 the Queensland Premier has awarded a plaque to individuals and organisations who are Queensland Greats. This presentation happens during Queensland Week and in 2013 plaques were awarded to five individuals and one organisation. Since the award’s inception there have been 73 recipients and their plaques are immortalised in a display at Brisbane’s Roma Street Parklands.

One of the 2013 'Queensland Greats' was Dr Dimity Dornan, wife of Peter Dornan (Convenor of the Brisbane

Prostate Cancer Support Network). Dimity was an integral part of the Brisbane Support Group in the early days of the organisation and is well known to many of its members.

As a speech pathologist Dimity founded the 'Hear and Say Centre for Deaf Children' in 1992 and since then the focus of her work has been

on children with hearing difficulties. She later established the Children’s Cochlear Implant Program, and in 2006 'Hear and Say' became international with 'Hear and Say Worldwide'. 2010 saw the launching of an online auditory-verbal training course to instruct health workers wherever they’re based.

Prior to Dimity’s latest award she was admitted as a Member of the Order of Australia in 1998 and in 2010 she was 'Queenslander of the Year'. Her entry into the realm of 'Queensland Greats' is well deserved. A truly remarkable woman.

Dimmity Dornan

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QPCN | July 2013

Looking back on it, the tests saved my life as the removal of the kidney was exposed and uneventful with a marvellous surgeon leaving a minimal scar on my right abdomen. All this was in 1994, in August, and by Christmas I was fighting fit. Over the ensuing years there was no metastasis, and I was finally pronounced restored to health (now for 19 years).

What is the moral of this story?

Gentlemen, get the tests for prostate cancer, without delay if you have any of the symptoms laid out in this wonderful magazine.

Judge Kevan Townsley BA, LLB (ret.) Barrister-at-Law Former Senior Consultant Crown Prosecutor for Queensland Ex-Hong Kong magistrate Retired Justice of the High Court of the Fiji Islands

Dr Kumar Gogna is the Senior Radiation Oncologist at the Mater Radiation Oncology Centre. He gave a presentation in March covering the advances that have been made in treating prostate cancer with radiotherapy.

Most readers of this magazine will be familiar with the factors involved in the diagnosis of prostate cancer and the subsequent tests to determine the extent and aggressiveness or otherwise of the cancer. Briefly, an early indication that cancer may be present can follow a prostate-specific antigen (PSA) reading, which may be higher than expected or rising over a number of tests, and a digital rectal examination (DRE) in which a medical professional inserts a gloved finger through the anus to feel for any irregularities on the surface or within the prostate gland.

If these tests indicate that cancer may be present a biopsy can be carried out to confirm the diagnosis. This can either be a TRUS biopsy carried out via the anus and rectum or a perineal biopsy carried out through the perineum. In either

Brisbane Prostate Cancer Support Presentation - What's new in radiation for prostate cancer

case a number of biopsy cores will be taken and these will be examined by a pathologist for the presence of tumour cells.

If prostate cancer is confirmed the patient and his doctor are able to look at the preliminary results from the early testing and decide on the way ahead, further tests or perhaps active surveillance. The key testing results at this time will be the PSA reading, the 'stage' of the cancer (the local extent of the tumour within the gland) and the pathology of the cancer or 'Gleason Score' which can indicate the aggressiveness of the cancer.

Normal PSA blood levels are generally low but do tend to rise when prostate cancer is present, however there are a small percentage of men with prostate cancer who may still have a low PSA. The PSA reading can give an indication of the disease status. A PSA of <10 shows a low risk that the tumour has spread beyond the prostate. As the PSA goes above 20 the risk of spread beyond the prostate increases.

Initial staging of the cancer can be carried out via a DRE. The 'stage' will be given a number ranging from T1 to T4 (with sub-sections within these groups). T1 is where the tumour is small and cannot be felt with a finger examination. T2 means the tumour can be felt but is probably confined within the prostate. T3 is where the tumour cells have spread into the tissue surrounding the prostate or into the seminal vesicles and T4 means the cancer has spread into surrounding organs.

The 'Gleason Score' is a number up to 10 which the pathologist gives

the cancer following examination of the biopsy cores. A figure of 6 (or less) is considered to be a low-grade cancer, 7 – 8 is intermediate grade, above 9 – 10 high grade. The 'score' is arrived at by adding together two numbers each between 1 and 5. The first number is the predominant or primary pattern of cancer cells detected from the biopsy cores and the second is the next predominant pattern with a 1 meaning a predominance of normal cells, 5 meaning a predominance of tumour cells and 2, 3 and 4 graded proportionally between 1 and 5 depending on the concentration of tumour cells present.

Once these key results are available further tests may be organised to confirm that the tumour(s) is confined to the prostatic capsule or, if spread further afield, where the cancer cells are now situated. These tests could include MRI scans, CT scans and other tests to see if the tumour has reached other organs or the bones.

With all this information in hand treatment options can be narrowed depending on the risk profiles the tests have revealed.

Dr Kumar Gogna MBBS, DCH, FRCP, FRANZCR.

continued on page 6

Staging investigations: Bonescan

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QPCN | July 2013

Prostate cancers with Stage T1/T2a, PSA <10, Gleason Score 6 or less are considered low risk and treatment options could include surgery, seed brachytherapy, external beam radiotherapy or close observation (active surveillance).

Intermediate risk cancers have Stage T2b/T2c, PSA 10 – 20 and Gleason 7 – 8. Treatment options include external beam radiotherapy either alone or combined with high-dose (HDR) brachytherapy, possibly plus hormone therapy.

Cancers with Stage T3, PSA >20 and Gleason 9 or 10 are high-risk and treatment will consist of hormonal therapy plus external beam radiotherapy alone or with HDR brachytherapy.

A patient opting for radiotherapy will encounter a number of new terms relating to the equipment, processes and staff he will come in contact with. The machine that delivers the external beam radiation (usually x-rays) is a linear accelerator, or 'Linac'. The 'Linac' is housed in a 'bunker', a room with thick concrete walls to provide radiation protection. External beam radiation delivered by the 'Linac' is measured doses of x-rays. The term 'radium' is still used, however radium has not been used as a source of radiation for well over half a century and in Australia radiotherapy is carried out using x-rays. 'Grays' (Gy) and 'rads' are units of radiation (1Gy = 100rads). During a course of external beam radiotherapy a patient may receive around 70 – 75 Gy. Brachytherapy refers to internal radiation treatment which may be via 'seeds' (low-dose or LDR) or via hollow

needles or catheters (high-dose or HDR). Radiation treatment staff can include radiation oncologists (radiotherapist = doctor), radiation therapists (radiographer = technologist), physicists, nursing staff and paramedical support staff.

Radiation works by damaging the tumour cell’s DNA, eventually causing the cell to die. Normal cells and tissue surrounding the cancer cells are able to repair themselves providing the dose of radiation is within certain limits. When prostate cancer is treated using external beam radiotherapy treatment can last up to 6 – 8 weeks and the usual radiation dose is around 2 Gy per day.

With brachytherapy the radiation source, whether seeds or needles, is placed within the tumour and a higher radiation dose is delivered. When combined with external beam, HDR brachytherapy will reduce treatment times however brachytherapy is an invasive procedure carried out whilst the patient is under a general anaesthetic so it will not suit everyone.

Whether a patient is to receive radiotherapy via external or internal means, or a combination of both, extensive planning takes place beforehand to assess that the area to be treated will be correctly targeted during treatment. The planning process can use CT and MRI scans to pinpoint the position of the prostate and to work out the most advantageous way of delivering the radiation without causing damage to surrounding tissue and organs whilst avoiding such things as hip replacements and deciding on treatment positions.

During the past decade there have been enormous improvements in the guidance of radiation beams, which has helped reduce the possible side-effects that may occur following prostate cancer radiotherapy.

Multiparametric MRI scans can now pinpoint the position of tumours within the prostate down to around 3mm in diameter which enables more precise planning.

The position of the prostate within the abdomen is not static. It can move on a regular basis depending on such things as the fullness of the bladder, gas or solid matter within the bowel and general activity. This internal organ motion can now be compensated for by using Image Guided Radiotherapy (IGRT).

In this process fiducial seed markers are inserted into the prostate gland and, using a Cone Beam CT scan prior to treatment, allow daily verification of the position of the gland prior to treatment.

The 'markers' are small grains of non-reactive metal (mostly gold) about the size of a grain of rice (see above slide, markers can be seen in the centre of the images).

Brisbane Prostate Cancer Support Presentation - What's new in radiation for prostate cancer continued...continued from page 5

continued on page 7

Image Guided XRT(IGRT) Fiducial Seed markers inserted into Prostate gland to allow daily verification of position of the gland prior to receiving treatment.

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QPCN | July 2013

Brisbane Prostate Cancer Support Presentation - What's new in radiation for prostate cancer continued...continued from page 6

Another recent advance is the use of Intensity Modulated Radiotherapy (IMRT). In this process the radiation field can be divided into multiple segments and the radiation dose intensity can be modulated within each segment. This is useful in treating non-uniform disease where the tumour(s) may be present in only one section of the gland. It allows for the dose of radiation to the tumour(s) to be increased whilst decreasing the dose to normal tissue close to the tumour(s) giving improved cancer control and decreased side-effects.

Another form of radiotherapy not currently available in Australia is Proton Beam Therapy (PBT). The intensity of the proton beam can be adjusted to dissipate at a certain point rather than continue through the body like x-rays. Consequently it reduces the chances of damage to other organs such as the bowel and bladder. The use of IMRT and IGRT over the past ten or so years has overcome much of the benefit offered by PBT and a recent USA study (J Nati Cancer Inst. 2013;105:25-32) comparing PBT with IMRT concluded that there was no difference in rectal or bladder side-effects at 6–12 months.

The 'CyberKnife' is another method of delivering conventional x-ray radiation. Known as a robotic radiosurgery system, 'CyberKnife' produces radiation from a small linear accelerator mounted on a robotic arm and allows the oncologist to direct radiation to any part of the body from any angle.

Hypofractionated Radiation Therapy refers to conventional radiotherapy being delivered at

a higher than normal daily dose. Trials are being carried out around the world, including Australia. With conventional external beam radiotherapy the daily dose of radiation is normally 2Gy with a total dose of up to 78Gy given over 7–8 weeks. With hypofractionated treatments a total dose of 50–60Gy is given over 4–5 weeks using IGRT with the aim of killing the tumour cells with the higher daily radiation levels in a shorter period of time. It will be some years before definitive results are known.

With high risk prostate cancer, radiation treatment is generally combined with hormone therapy. Prostate cancer relies on male hormones for growth so initial hormone therapy is designed to reduce the burden of cancer cells, kill any cancer cells that may have escaped from the prostate and shrink the prostate gland. The treatment sequence is hormone therapy for 3–6 months followed by radiation therapy, followed by longer term hormone therapy (12–24 months).

Unfortunately hormone therapy can result in various undesirable side-effects which may include hot flushes, loss of energy, loss of muscle tone, weight gain and loss of sexual function. In the longer term it could cause anaemia, alteration to lipid levels, osteoporosis and an increased risk of heart disease. Also with time some prostate cancers will become resistant to hormone therapy. These cases are known as Castrate Resistant Prostate Cancer (CRPC).

Clinical trials are being carried out with new drugs to attempt to counter the problems which can

be caused by long-term use of hormone therapy. Two of these newer agents, abiraterone (Zytiga) and MDV3100 (Xtandi) are anti-androgenic drugs which show great promise in blocking tumour growth and their use together with radiotherapy is being further investigated.

An Australian study (RAVES Trial) is investigating post-prostatectomy radiation therapy to ascertain the timing and likely benefits of radiotherapy following surgical removal of the prostate and where a pathology report shows that the removed gland has positive surgical margins. In these cases it’s possible that the tumour has spread beyond the prostatic capsule and tumour cells have remained in the surrounding tissue. As well as this extra capsular spread, in these cases there can be involvement of the seminal vesicles and the neuro-vascular bundle. Following the prostatectomy the PSA reading may fail to drop below 0.02 and/or there could be a consistent rise in PSA readings. The RAVES Trial is investigating whether it’s better to begin radiation therapy (salvage therapy) immediately after the positive margins are detected or to delay treatment until other signs (PSA readings) become apparent and which may be the best approach for individual cases.

Ongoing clinical trials (hypofractionated radiotherapy and perhaps HDR brachytherapy as a monotherapy) may reduce treatment times, and a reduction in side effects with improved guidance and intensity of radiation beams will ensure that radiotherapy continues to play a important part in the treatment of prostate cancer.

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QPCN | July 2013

SPOTLIGHT ON IpswichIpswich is Southeast Queensland’s fastest growing area and acclaimed as one of the world’s most liveable cities. It extends 1000 square kilometres from Gailes/Goodna in the east to Grandchester in the west, and is 39km southwest of Brisbane.

With a proud past, and an impressive future, this city of ours combines beautiful heritage and progressive modern architecture along with quaint country townships.

Previously known for our railway workshops, woollen mills and coal mines, huge industrial estates now surround us bringing greater employment and prosperity. Tourism attracts millions of visitors to Ipswich each year.

Amberley RAAF Air Base is Australia’s largest air force base and has been an important part of Ipswich since 1940. The RAAF Heritage Aviation Centre is established at the base and is open on the 3rd Sunday of each month. On Tuesdays and Thursdays the Centre is open for groups by arrangement. Impressive.

Ipswich Prostate Cancer Support Group held their first awareness evening in March 2004 and since

then a dedicated group of men and their partners has worked fervently to disperse the message throughout the region for early diagnosis and treatment options for prostate cancer.

Meeting times: 3rd Thursday each month 7pm (except December)

Location: Humanities Building, Cnr South & Nicholas Streets IPSWICH

Our Group Leaders are Terry Carter (Convenor), Len Lamprecht (2IC), Jeff Dowling (Newsletter), Neville Black, Geoff Dickenson, Desleigh Dowling and Doug Kelly.

Activities of Convenor, Contacts and Dedicated Workers.

Throughout 2012/13 Terry and his dedicated group have set up and manned stalls at the Relay for Life 2012/13, Finnemore Park; Kalbar Awareness Evening - arranged by Len & Wilson Neuendorf at School of Arts Hall, Kalbar (Dr M Gillman & Dr HS Teng, Speakers); DVA Health & Welfare Expo, RSL Hall, Ipswich; DVA Health & Welfare Expo, RSL Hall, Goodna; Ipswich Men’s Shed (Terry Carter, Speaker); Seniors Week Variety Day (Ipswich City Council); Bunnings BBQ (great turnout of helpers for this day!); Aussies Against Cancer, Mt Crosby Bowls Club; Ipswich Awareness Evening, UQ Campus (Len arranged

this with Prof Geoff Mitchell, Dr M Gillman, Dr HS Teng & Prof Geoffrey Mitchell); Ageing Stronger, Aging Longer - Ipswich 60 & Better.

Lowood Slimmers Club is donating part of all their events takings to Ipswich PCSG, and in return the members help at the events: Youth Rodeo-Fashion Parade (Betty Keller attended); BBQ Fernvale (several members volunteered); Terry, Len & Margaret & Geoff Dickenson had a great time with the Motorbike Long Ride participants at Yamanto where they departed on the leg to Cairns (this is PCFA’s Graeme Higgs’ baby - good one Graeme!).

Donations Received: Swanbank Social Group ($3074.49); Bunnings BBQ ($716.00); Boonah Golf Day ($1559.70), Rotary Club Ipswich ($1000); Men’s Shed ($750.00);

Donations Outward: Jim Marshall ($500); Awareness Night ($400); QLD First Aid ($199.00); Men’s Shed ($1028.59); Cancer Council ($500); Switch Signs ($750.00).

Patrons: Dr HS Teng and Dr Wesley Hii, both Urologists, are our Patrons and supportive of our Group, referring patients to our meetings.

Liaison with other groups: Commonwealth Care Link; Blue Care; Ipswich & West Moreton/Oxley Medicare Local GP Super Clinic;

continued on page 9

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QPCN | July 2013

Queensland gay and bisexual men living with prostate cancer and their partners can now benefit from a new support program funded by Prostate Cancer Foundation of Australia (PCFA). This new group will deliver improved support to men and their partners from other gay men living with prostate cancer in the Brisbane area.

The PCFA Gay/Bisexual Men’s Prostate Cancer Initiative (GBMPCI) has the support of ACON, Cancer Council NSW, Cancer Council Victoria, Victorian AIDSs Council, La Trobe University, Monash

Support group for gay men with prostate cancerUniversity, the Urological Society of Australia and New Zealand, and Male Care USA.

The initiative aims to improve awareness of prostate cancer risk, and provide access to support for individuals and their partners who have either been diagnosed with prostate cancer or have survived it. PCFA has already established support groups for gay/bisexual men in Sydney and Melbourne, and plans are underway to conduct workshops to establish more support groups for gay/bisexual men in capital cities and major regional areas in 2013.

A one day workshop was held on December 8 at Cancer Council Queensland’s office (553 Gregory Terrance, Fortitude Valley) to share findings from initial consultations conducted with gay/bisexual men. It was facilitated by Greg Millan, who is collaborating with PCFA on these initiatives, and provided opportunities for men to share their stories and discuss their support needs and work. The workshop led to the establishment of an ongoing Support Group in Brisbane, whose contact details appear in the Contact List on page 2 of this magazine.

UQ Campus; 60 & Better; Shane Neumann MP (Federal Member for Blair); Ipswich City Council; Scenic Rim, Somerset and Lockyer Valley Regional Councils.

Special mention: We were grateful to have great speakers throughout the year - Dr Brett Curr (Skin Cancer); Kev Clayton (Chemist); Lorraine Hagaman (PCFA Coordinator); Kate Bolam (UQ St Lucia Exercise Program); Dr James McKean (Radiation Oncologist); Chris Kerle (Continence & Pelvic Floor Physiotherapist); Dean Olafsen (Ipswich Men’s Shed); Ann Mitchell (Physio Active); Wendy Marshall (Concerns facing women supporting Prostate Cancer sufferers); Rahchell Cornish (Thesis on Coffee Fatigue - Support Group members

volunteered for this UQ program); Nardina Kurtschenko (Artius Health UQ); Bradley Jarrett (Queensland Carers); Naitik Mehta (West Moreton/Oxley Medicare Local).

Convenors’ Workshop: From Thursday 2 to Saturday 4 August 2012. Cancer Council Queensland (CCQ) and Prostate Cancer Foundation of Australia (PCFA) informed us of every facet of the volunteer role, endeavouring to increase our knowledge with programs designed to overcome most problems we will encounter. It is great to meet other Convenors and share experiences. A very tiring, but worthwhile, few days. Thank you CCQ and PCFA just for being there for us. Len and Margaret represented Ipswich at

the conference, Terry and Wilson Neuendorf attended one day each. As usual, Margaret got in everyone’s face with the camera, no-one seemed to mind too much and received a DVD for not complaining.

Contact details

Terry Carter - Convenor Ph: (07) 3281 2894

Len Lamprecht - Contacts Ph: (07) 3281656

Jeff Dowling Ph: (07) 3201 4521

Neville Black - Lockyer Valley (07) 4637 4018

http://www.qldcancer.com.au/Prostate/BranchesIpswich.html

SPOTLIGHT ON Ipswich Continued...continued from page 8

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QPCN | July 2013

Professor Suzanne Chambers

Facing the tiger! An expression many men and their partners can relate to following a prostate cancer diagnosis and subsequently trying to work through the myriad of challenges that treatment options and post-treatment life may throw up.

Because of the demographics of Australian society the number of men being diagnosed with prostate cancer will increase enormously in the coming years. Nationally by 2017 there will be around 267,000 men living with a diagnosis of prostate cancer. This also means that there will be 267,000 partners and families of men who have been diagnosed with prostate cancer sharing the experience that follows diagnosis. Whilst this will affect some more than others, all will experience fears about the future including the uncertainty about treatment options, concern about relationships and masculinity, worry about family and financial pressures, possible problems with treatment side effects such as coping with both the physical aspects and the psychological effects of heightened distress and anxiety and increased risk of depression.

Professor Suzanne Chambers is a Griffith University health psychologist who for over 20 years has worked as a practitioner and researcher in psychological support for people with cancer. Most recently she has focused on trials of interventions that address couple support and psychological distress in men with prostate cancer and has gained an extensive insight into the difficulties facing those who have been diagnosed and how they can cope with the above problems.

Using this knowledge Professor Chambers has written a book detailing her experiences in this area and titled it appropriately 'FACING THE TIGER – A Guide for Men with Prostate Cancer and the People Who Love Them'.

The book aims to provide a road map to assist in negotiating the difficult path that awaits men following a prostate cancer diagnosis. It’s not a book about treatment options and doesn’t give medical advice (although it does list sources where you can obtain this information) but is about suggesting different perspectives on where these men are now, where they would like to be as they move forward in their cancer journey and proven strategies to help them get there.

In April Suzanne Chambers spoke to the Brisbane Group about her reasons for writing the book and detailed some of the extensive background work that brought it all together. 'Facing the Tiger' covers all aspects of the prostate cancer journey for all stages of the

disease. It contains many personal stories from men and their partners covering their own problems and solutions following diagnosis.

A few of the subjects covered include; Why Me? On Being Diagnosed; Developing a Tool Box to Meet the Challenges; Making Decisions You Can Live With; Understanding the Stress Cycle and the Consequences of Ignoring Stress; Exercise; Identifying and Managing Thoughts; Keeping a Balance; Sex – What Now?; We’re in This Together; and many more.

In 'Facing the Tiger' a number of eminent people, both local and international, involved with prostate cancer have commented on the content of the book. Two of these, Professor RA (Frank) Gardiner and Peter Dornan, both of whom will be well known to many readers of this magazine, have commented as follows:

“An excellent handbook. Suzanne Chambers has had an enduring and innovative commitment to helping to resolve the many difficulties encountered by those involved with prostate cancer for many years. Tracing the many dilemmas faced in what is so often a long journey with this condition, this book proposes practical ways to straddle the hurdles that appear in the paths of patients and partners. The book is written ‘from the heart’ and provides a self-help guide in simple and unambiguous language. A major strength is the inclusion of sections by a number of courageous patients and partners who have openly shared what are so often regarded as private experiences.” - Professor RA (Frank) Gardiner AM

'Facing the Tiger' - Book Launch

Professor Suzanne Chambers Signs Her Book In Brisbane. All Royalties from the Sale of the Book Are Donated to Prostate Cancer Foundation of Australia.

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QPCN | July 2013

REFERENCE: www.xofigo.com

Ever wonder why the flu is seasonal?

The FDA has approved Bayer and Algeta's drug Xofigo (radium Ra 223 dichloride, formerly known as alpharadin) to treat men with symptomatic late-stage

FDA Approves new treatment for advanced prostate cancer patients

(metastatic) castration-resistant prostate cancer that has spread to bones but not to other organs. It is intended for men whose cancer has spread after receiving medical or surgical therapy to lower testosterone.

Xofigo binds with minerals in the bone to deliver radiation directly

to bone tumors, limiting the damage to the surrounding normal tissues. It is the second prostate cancer drug approved by the FDA in the past year that demonstrates an ability to extend the survival of men with metastatic prostate cancer.

“A must read for anybody coping with a prostate cancer diagnosis. It is equally as useful and important for their partners. I wish it had been around when I was diagnosed." - Peter Dornan AM

'FACING THE TIGER – A Guide for Men with Prostate Cancer and the People Who Love Them' is available from Prostate Cancer Foundation

of Australia (online or via toll-free phone – details on Page 16 of this publication) or online from www.aapbooks.com at RRP$24.95. As mentioned above all royalties from the sale of the book will be donated to Prostate Cancer Foundation of Australia to be used for prostate cancer research and awareness.

Facing the Tiger' - Book Launch Continued...continued from page 11

Congratulations Jim Marshall on your initiative in creating a sharing website, all in the name of promoting the cause and awareness of prostate cancer. The power of social media is not to be underestimated.

New advanced prostate cancer support websiteJim, whilst I wish you every success, my greatest wish is for fewer new cases of prostate cancer.

QPCN Editor.

For more information visit: http://forums.jimjimjimjim.com/index.php?/forum/5-my-story/

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QPCN | July 2013

The European Breast Cancer Conference News Round-upFinasteride Reduces Risk of Prostate Cancer Diagnosis, 19 February (HealthDay News)

Use of finasteride reduces the risk of a prostate cancer (PCa) diagnosis, but does not significantly affect mortality rates after following men for 18 years. Phyllis J Goodman, of the SWOG Statistical Center in Seattle, and colleagues, conducted a survival analysis using data from the Social Security Death Index to assess any evidence of an increased risk of death in men randomised to finasteride, a potential indicator of a 'true' increased risk of high-grade disease. The study was presented at the American Society of Clinical Oncology's annual Genitourinary Cancers Symposium, held from 14-16 February in Orlando, Florida.

Anticoagulant Use Predicts Metastatic Prostate Cancer Survival, 19 February (Health Day News)

Anticoagulant use is associated with improved overall survival in men receiving docetaxel chemotherapy for treatment of metastatic castration-resistant prostate cancer (mCRPC). Caroline F Pratz MSN of the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore, and colleagues, retrospectively reviewed the records of 247 consecutive mCRPC patients who received first-line docetaxel chemotherapy (1 January 1998 to 1 January 2010). The authors sought to ascertain information on anticoagulant use. The research was presented at the American Society of Clinical Oncology's annual Genitourinary Cancers Symposium, held from 14-16 February in Orlando, Florida.

Virus That Kills Prostate Cancer Cells Shows Treatment Potential, 26 February

A modified Newcastle disease virus that targets and kills all types of prostate cancer cells and leaves normal cells untouched shows promise as a cancer treatment that avoids the side effects which normally accompany hormonal treatment and chemotherapies, says a team of veterinary scientists in the US. Corresponding author Subbiah Elankumaran, an Associate Professor of Virology at Virginia-Maryland Regional College of Veterinary Medicine, and colleagues, are due to report their findings in an April edition of the Journal of Virology; a pre-print issue of which was released online on 25 January.

Is enrolling in a clinical trial tied to survival?, 28 February (Reuters Health)

People with certain cancers enrolled in clinical trials survive longer, not necessarily from the treatment itself but potentially because those enrolled are better off to begin with, according to new research. "The survival benefits for an individual to be on a cancer trial are not necessarily to be on a trial itself. Cancer trials select patients who are healthier and are able to tolerate treatments," said senior study author Dr Waddah Al-Refaie, Chief of Surgical Oncology at MedStar Georgetown University Hospital in Washington, DC. The research was published in the Journal of the American College of Surgeons, online 13 February 2013.

First Study Ever To Analyse 25 Years Of Data After Radiation Therapy For Prostate Cancer Patients, 28 February

The March 2013 issue of The Journal of Urology includes a study conducted by four physicians from Radiotherapy Clinics of Georgia (RCOG), a Vantage Oncology affiliate. This study, '25 Year Disease Free Survival Rate after Irradiation of Prostate Cancer Calculated with the Prostate Specific Antigen Definition of Recurrence Used for Radical Prostatectomy', is the first-ever to analyse 25 years of follow-up data after radiation therapy treatment for prostate cancer patients. The analysis includes over 300 men whose prostate cancer recurred who were treated 16-25 years ago. Recurrences were PSA defined and results showed the majority of recurrences occurred within the first five years after treatment and no recurrences were noted 15.5-25 years after treatment.

Skin patches 'tackle prostate cancer', 4 March

Skin patches which deliver oestrogen into the blood may be a cheaper and safer treatment for prostate cancer than current therapies, a study says. The main treatment is injections of a chemical to cut levels of testosterone - the driving force of many prostate cancers - but it causes side effects. The Imperial College London study in the Lancet Oncology compared patches and injections in 254 patients. It found patches were safe and should avoid menopause-like side effects.

continued on page 13

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QPCN | July 2013

Processed meat 'early death' link, 7 March 2013

Sausages, ham, bacon and other processed meats appear to increase the risk of dying young, a study of half a million people across Europe suggests. It concluded diets high

in processed meats were linked to cardiovascular disease, cancer and early deaths. The researchers, writing in the journal BMC Medicine, said salt and chemicals used to preserve the meat may damage health. The British Heart Foundation

suggested opting for leaner cuts of meat. The study followed people from 10 European countries for nearly 13 years on average.

Information Sourced from CANCER DAILY NEWS

continued from page 12

News Round-up

REFERENCE: Anna Azvolinsky, PhD, Freelance Science Writer and Cancer Network Contributor, 13 May 2013.

A cohort-based study of 1,001 men with prostate cancer shows that those men who took cholesterol-lowering statins had a lower risk of dying from their prostate cancer vs men who did not take these medications. The study also found that recurrence and progression were not related to statin use. The study is published in 'Prostate'. The study found that men with prostate cancer who took cholesterol-lowering statins had a lower risk of dying from their prostate cancer.

“I think this study goes along with the growing body of evidence of observational studies—which have their strengths and weaknesses—that statins may have a role for delaying prostate cancer progression,” said Stephen Freedland MD, a prostate cancer oncologist at the Duke University Medical Center in Durham, North Carolina, who was not involved in the research.

The men in the population-based study, all based in the Seattle area, were followed for an average of 7.5 years. The long-term analysis

found those men who used statins throughout their prostate cancer diagnosis and treatment to control their cholesterol had a 1% risk of death compared with a 5% risk of death for non-statin users at 10 years. This five-fold increase in risk of death was after controlling for major patient characteristics, including age, stage of prostate cancer, body mass index, type of treatment, history of comorbidities (such as diabetes), and smoking. There were a total of 123 deaths during the follow-up period, including 39 deaths from prostate cancer.

Previously, cohort-based studies have analysed the link between statin use and prostate-specific antigen (PSA) levels, but this is the first study to link statin use and prostate cancer–specific mortality, said Janet L Stanford PhD - lead author of the study, epidemiologist, and co-director of the Prostate Cancer Research Program at the Fred Hutchinson Cancer Research Center in Seattle. A recent meta-analysis did not find a link between PSA recurrence and statin use.

Of the participants, 29% (289 participants) were statin users prior to their prostate cancer diagnosis, and 71% were non-statin users.

The majority of patients in both groups (72%) had localised prostate cancer, and 14% had regional prostate cancer. Key differences between the statin user and non-user groups were age and co-morbidities: Statin users were slightly older (mean age of 63.1 years compared with 60.9 years for non-statin users), more likely to have diabetes, and more likely to use aspirin or other nonsteroidal anti-inflammatory drugs. Statins used by patients were atorvastatin, simvastatin and lovastatin.

Previous studies have suggested that statins may have an anti-cancer function. Whether the anti-activity of statins is related to their role in cholesterol-targeting or if it is through a different mechanism remains to be seen.

The study does not yet suggest that clinicians should recommend statins for either prostate cancer prevention or treatment. Previous cohort-based studies have had varying results - supporting the benefit of statins for prostate cancer, or showing no link, as well as a study that showed an increased risk of prostate cancer. The jury is still out on whether statins can benefit a patient’s prostate cancer prognosis.

Study: Cholesterol Drugs Reduced Risk of Prostate Cancer Death

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QPCN | July 2013

Letters to the EditorMay be forwarded to QPCN using the address or e-mail in the contact details section. As the editor of your newsletter I welcome and encourage your feedback, and will attempt to address areas of your concern.

Copy and paste this link below into your search engine: Voice recognition Elevator ...from Scotland... http://dotsub.com/view/6c5d7514-5656-476a-9504-07dd4e2f6509

Special monthly bonus for email subscribers

Letter 1Hi Judith,

I wish to thank you for publishing my story, as I believe I have helped some men understand the issues they may face. I am amazed by the numbers of men who contacted me after my story was published in QPCN March 2013 edition.

The queries were many and variable in content and many of them

focused on the problem with my hip ligaments and the pain I suffered following the operation.

Here's a thing, a number had experienced the same problem following surgery and were unaware of this potential problem. I was able to send the draft questions to ask their prospective Urologists regarding surgery that I have

developed for patients to use in the consultation.

The guys that have used the questions have given feedback about how comprehensive the questions are, even though they are in draft form.

Best wishes

Darryl Baillie

Letter 2Dear Judith,

I’m the chief editor of a small, boutique publisher, Busybird Publishing (http://www.busybird.com.au/), based in Montmorency Victoria. We’re beginning work on a book about people's experiences with prostate cancer. Currently, the book is simply operating under the working title of ‘Experiences with Prostate Cancer’, (although we’re looking for a better title).

These experiences can take the form of nonfiction stories or poetry and can be written by those who have gone through prostate cancer, are going through it or are the friend, family, or carer of somebody who is going through it or has gone through it.

The point of this book is to raise awareness of prostate cancer, to help educate, and also to offer people who have been touched by prostate cancer a support network of information and experiences. A portion of profits will be going to the Prostate Cancer Foundation.

This book is a companion to a book we published in February 2012, entitled Journey: Experiences with Breast Cancer (http://www.busybird.com.au/?page_id=818), a portion of this book’s profits going to BreaCan and WHOW (Women Helping Other Women). With Journey, we had no problem with submissions. However, we’re finding men a bit more reticent with this book – perhaps men find it harder to share.

In any case, I am writing to you to ask if you could possibly inform people about the call for submissions and the book’s purpose. We have a submission page with information which can be found here: http://www.busybird.com.au/?page_id=775\

Unfortunately, due to our shoestring budget, we cannot offer remuneration for submissions that are accepted, although contributors will get a free copy of the book and a discount on further books.

Please don’t hesitate to contact me if you have any questions.

Regards

Les Zigomanis

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QPCN | July 2013

ResourcesAndrology Australiawww.andrologyaustralia.orgPh 1300 303 878Andrology Australia is the Australian Centre of Excellence in Male Reproductive Health.

APCC Bio-Resourcewww.apccbioresource.org.auThe national tissue resource underpinning continuing research into prostate cancer.

Australian Prostate Research Centre – Queenslandwww.australianprostatecentre.orgResearch, collaborative opportunities, clinical trials, industry news.

Cancer Council Helplinewww.cancerqld.org.au/ Ph 13 11 208am-6pm Monday to Friday.

Cancer Council Queenslandwww.cancerqld.org.auResearch to beat cancer and comprehensive community support services.

Cochrane Librarywww.cochrane.orgAustralians now have free access to the best available evidence to aid decision-making.

HealthInsitewww.healthinsite.gov.auYour gateway to a range of reliable, up-to-date information on important health topics.

Lions Australian Prostate Cancerwww.prostatehealth.org.auThe first stop for newly diagnosed men seeking information on the disease.

Mater Prostate Cancer Research Centrewww.mmri.mater.org.auComprehensive information for those affected by prostate cancer, including the latest research news.

Prostate Cancer Foundation of Australiawww.prostate.org.auPhone 1800 22 00 99Assistance with the experience of diagnosis and treatment for prostate cancer.

Queensland Chapterwww.prostate.org.auInformation, patient support materials, and contacts for advice on living with prostate cancer in Queensland.

Tell your story(Anonymity preserved if requested) For assistance with your writing, contact the Queensland Writers Group, which is located in the Queensland State Library and offers seminars and advice to budding writers and authors.

Contact:qldwriters@qwc.asn.au Ph 07 3842 9922

You cannot prevent the birds of sadness from passing over your head, but you can prevent their making a nest in your hair - Chinese Proverb.

Thought for the day

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QPCN | July 2013

Queensland Prostate Cancer NewsMail: PO Box 201, Spring Hill Qld 4004 Email: qpcn@cancerqld.org.au Phone: via Cancer Council Helpline 13 11 20

Prostate Cancer Foundation of Autralia and Queensland Chapter CouncilMail: PO Box 10444 Adelaide Street, Brisbane, QLD 4000 Email: queensland@prostate.org.au Phone: 07 3166 2140

Brisbane PCSG - 2013 meeting program Cancer Council Queensland, 553 Gregory Terrace, Fortitude Valley.

Mornings at 9.30am (Odd months) Evenings at 7.00pm (Even months)

10 July Dr Elizabeth McCaffery – Oncologist - Multi Disciplinary Clinic PAH. Advanced Prostate Cancer – an update

August TBA

Partners of Men with Prostate Cancer meet on the 4th Wednesday of each month between 6pm and 8pm at Cancer Council Queensland’s Gregory Terrace building. Members come together to share, learn and support each other in a warm open environment. Light refreshments are provided and there is parking underneath the building. For more information phone Wendy Marshall on 07 3878 4567.

Contact Details

Council (ie the Council of the Queensland Chapter) accepts no responsibility for information contained in this magazine. Whilst the information is presented in good faith, it may contain information beyond the knowledge of Council and therefore cannot

be taken to be the opinion of Council. The information in this magazine is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your qualified health provider with any questions you may have regarding

a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here.

Disclaimer

You have received this magazine because you have provided your contact details to Cancer Council Queensland or to a Prostate Cancer Support Group (PCSG). The primary purpose of collecting your contact details was to enable support, resources and information to be offered to you as a person affected by or interested in prostate cancer. Your contact details are held in the local office of Cancer Council Queensland. Cancer Council Queensland ensures compliance with the Privacy Act, and does not

use or disclose your details except as you might reasonably expect. You may access your details and you may request that we correct or amend (ie update) or delete your details.

If you are a member of an affiliated PCSG you will initially receive by post or email your local group’s news-sheet, the monthly Queensland Prostate Cancer News (QPCN), and the national quarterly Prostate News. You may also receive other communications from time to time such as

advice on upcoming symposia, news or surveys from research establishments, details of open clinical trials and guidelines being reviewed. You may ‘opt-out’ of any of these services at any time, ie you will no longer receive any material of that type, by letting us know your wishes. QPCN is available online at http://www.pcfa.org.au/qld/newsletter.htm. Should you receive multiple copies, please let us know which address(es) to remove from which mailing list(s).

Important Privacy Information

Forward a copy of QPCN to a friend, neighbour or relative. The key to conquering prostate cancer is prevention, greater awareness and early diagnosis. Invite a new reader to QCPN - you can never be too young or too old to become interested in prostate cancer.

Contact details: Queensland Prostate Cancer News (QPCN) Mail: PO Box 201, Spring Hill Qld 4004Phone: via Cancer Council Helpline 13 11 20 E-mail: qpcn@cancerqld.org.au

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