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LIFEBUOY BUOY BUOY - Dear Readers

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					                                                     the
                                                                                                                              ISSUE 4 2009




                                                  BUOY
                                              LIFEBUOY
St Vincent’s Hospital
Prostate Cancer Support Group
    affiliated with the
    Prostate Cancer Foundation of Australia


                                              Dear Readers
                                              On reflection, 2009 has been a busy and most fulfilling year. Being part of the ongoing research work
                                              conducted through the Centre and the Garvan Institute is, as always, most rewarding. In March I attended
                                              the American Urological conference in Chicago which was a real buzz. The lectures and presentations
                                              were very well delivered and interesting. The launch of the prostate cancer DVD “So, How Do You Choose”
                                              at Parliament House in Canberra was exceptionally successful and a real highlight of the year.

                                              This year our support group meetings have covered many different topics and have been well attended.
                                              I thank all the speakers who have generously given their time to share their knowledge with us. Our last
                                              meeting held on November 4th was particularly well attended with just over 150 people. Dr Joe Enis was
                                              the guest speaker and it was a most interesting talk. The feedback has been overwhelming. A copy of his
                                              powerpoint presentation is in this newsletter.

                                              Please note the dates of the support group meetings for 2010. Our first meeting kicks off with Dr Charles
                                              “Snuffy” Myers on Monday the 8th February at the Garvan Institute. Dr Myers will be speaking in Sydney,
                                              Melbourne & Brisbane. You will be required to register to attend. This can be done through the PCFA
                                              website www.prostate.org.au. For further details see page 8. Topics for the remaining meetings of 2010
                                              are as yet to be finalised.

                                              I would like to acknowledge all those who have generously donated to the St Vincent’s Prostate Cancer
                                              Centre throughout the year. In particular Lang & Sue Walker & the Walker Foundation, the “Paint a
                                              Rainbow Foundation”, the Freedman Foundation, Riversdale Mining Ltd and the late Sir Ian McFarlane. A
                                              special thanks also to those people who constantly support our Centre year after year. These donations
                                              allow ongoing prostate cancer research, community development such as the production of the DVD “So,
                                              How Do You Choose”, the continual upgrade of our website www.prostate.com.au, the production and
                                              distribution of this newsletter to over 1000 readers plus many other projects. I also wish to thank the
                                              family of the late John Turnbull for the memorial gift donation to the Centre in his memory.

                                              I look forward to having a holiday and to return feeling refreshed to face the challenges of 2010 and
                                              build on the work that is currently in progress. Finally, I would like to wish you all a wonderful festive
                                              season with your family and friends and may 2010 bring happiness and good health. Enjoy the read!


                                              Jayne Matthews - Coordinator


                                                             prostate cancer
                                                                                    centre
                                              www.prostate.com.au
                            A robotic fellowship
                                  down under?

                                                              southern France well known for almost 3 reasons: Airbus (A380), Football
                                                              (Stade Toulousain), Architecture (pink bricks). The choice to go overseas
                                                              wasn’t an easy one, but I found 3 good reasons to do it: learning the
                                                              robotic surgery in a high volume institution, travelling and experiencing
                                                              the life “Down Under”, and…improving my English! So, as an Australian
                                                              expression says, please excuse my French…sorry my English. My fiancée
                                                              and I arrived on the 8th January 2009. We left London in a freezing winter
                                                              and landed in Australia during a warm summer. Welcome to Australia,
                                                              mate!

                                                              My fellowship year was dedicated to two main topics: learning the robotic
                                                              prostate surgery and research in prostate cancer. The first difficulty I met
                                                              (except the English language) was to learn the robot assisting. Despite my
The robotic fellowship program was first introduced to
                                                              laparoscopic background, it was a really new technique to be confident
St Vincent’s Private Hospital in 2008 under the supervision
                                                              with. Given that the quality of the assisting directly impacts the functional
of A/Professor Phillip Stricker. It is                                                                                 and pathological
formally accredited as a fellowship                                                                                    outcomes of the
by the Urological Society of                                                                                           surgeon, the help of
Australia and New Zealand (USANZ)                                                                                      my colleague and now
and is funded through the St                                                                                           friend Dr Carlo Yuen
Vincent’s Prostate Cancer Centre.                                                                                      was crucial. Thus, case
                                                                                                                       after case I became
Bonjour, je m’appelle Nicolas Doumerc...                                                                               autonomous. Then,
sorry…G’day, I’m Nicolas Doumerc, 34                                                                                   the second difficulty
years old and a fully certified urologist                                                                              met was to adapt my
in France with a laparoscopy surgery                                                                                   assisting to 3 different
background. I live in Toulouse, a city of                                                                              surgeons’ techniques
(Dr Brenner, Dr Kooner and A/Prof. Stricker). The robotic fellow should be
flexible in his assisting to meet the highest standards of each surgeon.
The research aspect of my position was just as interesting as learning to
use the robot. The high level of interaction between St Vincent’s Clinic,
St Vincent’s Private Hospital and the Garvan Institute allowed me to deal
directly with the largest database in the southern hemisphere. I do think
that a modern health institution requires this partnership to improve the
quality of healthcare provided to patients.

What’s a typical agenda of a robotic fellow? The robotic assisting was
shared with the second robotic fellow Dr Carlo Yuen. Thus, I usually assisted
4 procedures or so a week. The remaining time was used to carry out
research studies as my paper has just been published in the British Journal
of Urology International “Should open experienced prostatic surgeons
convert to robotic surgery? The real learning curve of a single surgeon over
3 years.” N.Doumerc, C.Yuen, R.Savdie, B.Rahman, K.Raziah, R.Pe Benito, AM.
Haynes, J. Matthews, P.Stricker. Research and clinical meetings (radiology
and onco-pathological) helped me not to lose my general urological
reasoning in a very specialised environment like St Vincent’s Prostate
Cancer Centre. Finally, I was involved in the public hospital roster - 1 or
2 days on call a week. Thus, I experienced the management of urological
emergencies in a public Australian healthcare centre.

What have I learnt? Firstly, the management of patients in a very
specialised centre was very interesting to observe and to learn about. I was    educational tasks... such as travelling to the Red Centre, the Top End and
particularly amazed by the time spent to inform patients before and after       the Kimberley!
the surgery. Frenchies should improve especially in that area! Secondly, the
high level of the robotic surgeons’ experience was a very precious asset        To conclude, I would say that more than just a simple year in my training,
for a young robotic surgeon like me: knowing all the assistant difficulties     it was one of the best years of my life and I want especially to pass my
and how to fix them is crucial, avoid the mistakes of the early learning        sincere gratitude to St Vincent’s Prostate Cancer Centre and its donors.
curve when considering a new technique is precious as well. I do think that
nothing could replace the experience of high volume centres.

What’s coming up for me? Paradoxically, this robotic fellowship year will
benefit me next year. My institution has recently bought a robotic device
and I’m expected as a consultant to start the robotic programme. In my
country, few robotic surgeons have previously completed a fellowship year
dedicated to the robotic-assisted laparoscopic prostatectomy. However,
when considering the introduction of a new technique, the most difficult
part is to complete your own learning curve - my real learning curve is
still ahead! But I hope that my laparoscopic background combined with
my fellowship in St Vincent’s Private Hospital will dramatically shorten this
learning curve. To tell you the truth, I hope my agenda will allow other
                                                      Dr Joe Enis                            Advanced Prostate Cancer

                                                                                                                       a
                                                                                              Brighter
                                                                                               Future
                                                                                             Hormone Therapy, Diet, Supplements

                                                                                                                   My Story
                                                                                                  •! Diagnosed 7 years ago, aged 55, with PC,
                                                                                                     multiple metastases
                                                                                                  •! Early signs of spinal cord compression
                                                                                                  •! PSA 554
                                                                                                  •! Given < 3 years to live
                                                                                                  •! Last 2! years PSA < 0.01 and no mets
                                                                                                     following first- then second- line HT
                                                                                                  •! Last 1! years on maintenance program…




 Dr Myers’ Approach to Advanced PC                      Dr Myers’ Approach to Advanced PC                        Attaining Complete Remission
•! Several cancers, even if metastatic, can now be     •! But in PC, attaining complete remission isn’t a     •! To attain complete remission, many with
   cured. Only possible if first achieve a complete       cure. Some patients have microscopic deposits          advanced PC need hormone therapy at time of
   remission                                              of cancer that will regrow over time                   surgery or radiotherapy, others after these
•! Complete remission possible in advanced PC,         •! So second step is to start a program to help           have failed
   even with metastatic disease                           maintain complete remission by keeping any          •! HT essential for the few who present with
•! So first step in managing advanced PC is try to        remaining cancer cells dormant as long as              metastatic disease
   attain a complete remission                            possible                                            •! Diet, supplements and lifestyle changes help
   (PSA< 0.01, CT and bone scans clear)                                                                          hormone therapy achieve these goals




   Attaining Complete Remission                             Intermittent First Line HT                              Intermittent First Line HT
                                                       •! Start with intermittent first line HT, initially    •! Lucrin/Zoladex stop testosterone production
•! Prostate cancer cells need testosterone and
   DHT to survive and thrive …                            for 12 months. Aim to suppress influence of            in testes (but DHT levels often unchanged)
                                                          male hormones on prostate (Lucrin/Zoladex,
•! These combine with androgen receptor in PC                                                                 •! Effectively suppress testosterone in > 90%
   cells to promote cancer cell growth                    Cosudex/Anandron and Avodart/Proscar)
                                                                                                              •! Cosudex/Anandron (antiandrogens) prevents
•! Most testosterone produced in testes, but some      •! Diet, supplements and lifestyle changes
                                                                                                                 any remaining testosterone, DHT combining
   made from androgens produced in adrenal                important part of this program…
                                                                                                                 with androgen receptor
   glands                                              •! After first cycle of treatment ends, some remain
                                                                                                              •! Combining Cosudex and Lucrin improves
•! Testosterone can be converted to DHT. DHT              in complete remission for years
   is 10 times stronger                                                                                          clinical effectiveness of Lucrin by 20%...
        Intermittent First Line HT                               Intermittent First Line HT                        Side effects of First Line HT
 •! Proscar/Avodart block DHT formation…                  •! First cycle continued 12 months to allow
                                                                                                               •! Hypertension, hyperlipidemia, diabetes, leading
                                                             maximum tumour shrinkage. Resume as soon             to cardiovascular disease
 •! By adding Avodart to Lucrin and Cosudex,
                                                             as PSA next begins to rise
    response more rapid and more complete                                                                      •! Impaired sexual function
                                                          •! Important to reduce PSA to < 0.01. If not, PC     •! Breast symptoms
 •! After first course completed and Lucrin,
                                                             regrows rapidly as testosterone recovers
    Cosudex suspended, continuing Avodart helps                                                                •! Weight gain
    delay next cycle                                      •! Most complete 3-7 cycles before they become       •! Loss of muscle bulk, strength
                                                             hormone resistant
                                                                                                               •! Osteoporosis
                                                          •! Benefits of IHT: fewer side effects, may delay    •! Depression, poor concentration
                                                             onset hormone resistance




      Intermittent Second Line HT                              Intermittent Second Line HT                         Intermittent Second Line HT
•! If first line HT not enough to produce complete        •! Most doctors use one or two agents eg another     •! Dr Myers uses Ketoconazole, Leukine,
   remission (often the case in metastatic disease),         antiandrogen and Ketoconazole. Rarely use            Estrogen patches, all together, as this is best
   or after it has failed, go straight to second line        oral Estrogen because of its major vascular          way to avoid drug resistance …
   HT …                                                      complications …                                   •! Multi-targeted therapy successful in other
•! Get on to this early, don’t wait for disease to take   •! Usually use these separately, happy if PSA           diseases where resistance a problem eg TB,
   hold. All therapies most effective when tumour            halves. Only 25-50% achieve this                     malaria, HIV
   volume is small                                        •! Response usually lasts months not years. Less     •! Used together, complete remission much more
•! Diet, supplements and lifestyle changes still             with second drug as resistance develops to           frequent, often lasts years and patients survive
   important                                                 each in turn                                         a lot longer




      Intermittent Second Line HT                              Intermittent Second Line HT                                    Chemotherapy
 •! First cycle of second line HT given for               •! Estrogen skin patches suppress testosterone       •! Chemotherapy only considered if hormone
    12 months                                                production. Avoids major vascular                    therapy can’t achieve full remission
 •! Ketoconazole suppresses adrenal androgen                 complications seen when Estrogens first used
                                                                                                               •! Often unnecessary, or at least greatly delayed
    production. Half dose just as effective. Used            orally…
                                                                                                               •! More effective when cancer volume reduced
    alone, PSA halved in 50%...                           •! When patches added to Ketoconazole and
                                                                                                                  by earlier treatment
 •! Leukine improves immune response against                 Leukine, PSA halves in 80%. Even with
    PC. Combined with Ketoconazole, 75%                      metastatic PC, 50% may achieve a complete
    achieve halving of PSA. Usually well tolerated           remission. This may last years…
    (expensive, must be imported)




     Maintaining Complete Remission                           Maintaining Complete Remission                      Maintaining Complete Remission
•! At diagnosis, all PC patients have cancer cells in     •! At present no way of knowing who will recur          The following agents are thought to keep
   blood, 80% in bone marrow                                 and who won’t                                        cancer cells dormant in 3 ways…
•! Only small portion of these cells survive in a         •! Thus wise to think about PC as a lifelong
                                                                                                               •! Prevent new vessel formation –
   dormant state. May re-emerge years later as               problem, like diabetes & hypertension
   metastatic disease                                     •! Once in complete remission, start program to         Avodart, Celebrex
•! In time, up to one third may relapse following            reduce risk of recurrence                         •! Promote immune attack – Leukine
   surgery …                                              •! Includes changes to diet and lifestyle,           •! Reduce ability of cancer to grow and spread
•! Relapses may occur as late as 22 years or more after   •! Relatively non toxic agents to help keep cancer      – Resveratrol
   surgery                                                   cells dormant                                     •! Possible role for Statins




     Maintaining Complete Remission                             Causes of death (PC " 65 years)                                   Obesity
    Dr Myers has successfully applied this                •! 40% will die from prostate cancer                 •! Increases risk of developing more aggressive
    maintenance program to 3 groups                       •! 30% will die from cardiovascular disease             prostate cancer, cardiovascular disease, other
 •! Those currently in complete remission                     (1st line HT may contribute to this)                cancers, esp. colon cancer
    following RP or RT, but at high risk of cancer        •! 12% will die from other cancers, esp. colon       •! Increases risk of recurrence following RP
    recurring                                                                                                  •! Weight gain common in men on first
                                                          •! The same dietary and lifestyle factors that
 •! Those with metastatic disease currently in               increase risk of PC also increase risk of heart      line HT
    complete remission following HT                          disease and colon cancer                          •! Weight loss helps reverse all these problems.
 •! Those on ‘active surveillance’                        •! Mediterranean diet and lifestyle changes             Aim for BM1 # 25 …
                                                             greatly reduce impact of all 3 diseases…
                    Exercise                                                Stress                                         Autopsy Studies
•! Regular aerobic exercise also reduces risk of       •! Stress may hasten the development and              •! PC as common in Japan as USA and many
   advanced prostate cancer, cardio- vascular             progression of PC                                     western countries, but death rate from PC 90%
   disease and colon cancer                                                                                     lower in Japan
                                                       •! Hormones released during stress may stimulate
•! It will reduce some side effects of first line HT      growth of PC and reduce immune response            •! When Japanese men migrate to USA, death
   - weight gain, muscle weakness, osteoporosis           against it                                            from PC increases toward that of local
•! Need minimum of 30 minutes daily. A brisk           •! Relaxation in the form of meditation,                 population, in proportion to time they have
   walk will do…                                          gardening, walking or listening to music may          lived there
                                                          help                                               •! Suggests environmental factors contribute to
                                                                                                                development of PC




                 Role of Fats                                             Bad Fats                               Diets that suppress PC growth
•! Prostate cancer cells, unlike many other            •! Arachidonic acid found in red meat, pork,          •! OKINAWAN DIET Lots of fish, fruit,
   cancers, depend on fat, not glucose, for energy        dairy fat and egg yolk                                vegetables, grains and soy. Little red meat,
•! US and Japanese diets differ greatly in the         •! Alpha Linolenic Acid (ALA) found in many              eggs and dairy products
   amount and type of fat they eat                        vegetable oils eg canola and esp. flaxseed oil.    •! MEDITERRANEAN DIET (Crete) Lots of
•! Two fatty acids strongly associated with               Also found in walnuts and pecans                      fish, fruit, vegetables, grains, legumes, olive
   advanced PC are arachidonic acid and alpha          •! Most of these foods typically found in many           oil, nuts and red wine. Little red meat, eggs
   linolenic acid…                                        western diets                                         and dairy products
                                                                                                             •! Mediterranean diet studied most, easiest to
                                                                                                                adhere to over time




               HALE Project                                     Lyon Diet Heart Study                                         Saxe Study
•! When > 2,000 healthy Europeans aged 70-90           •! 600 admitted to ICU with first heart attack        •! Among a group of men with recurrent PC after
   adopted four healthy changes over ten years            randomised to Mediterranean or control diet           RP, Mediterranean diet plus stress management
   (Mediterranean diet, brisk walking,                 •! After only 4 years, patients on Mediterranean         increased PSADT by 2/3
   moderate alcohol, no smoking)                          diet had 50% fewer deaths, 50% fewer new           •! This took them from a high risk of death at 10
•! Risk of death from all cancers (incl. prostate)        heart attacks and 60% fewer new cancers               years, to a very low risk…
   and from cardiovascular disease reduced by
   two-thirds!




            Mediterranean Diet                                    Mediterranean Diet                                               Meat
•! Important for all patients with PC, regardless      •! High fat diet (30-40% fat), best reduced to <      •! No red meat or pork. More dangerous when
   of severity, past or future treatment                  20% when treating PC                                  burnt (browned or blackened) esp. hamburger
                                                       •! Emphasizes good fats: omega 3 fats (fish)             meat, as it forms chemicals that damage DNA
•! Slows PSADT in most by 2/3
                                                          and monounsaturated fats (olives, nuts)               which may aggravate prostate cancer …
•! Once disease has metastasized, difficult to         •! Excludes bad fats: omega 6 (red meat, egg          •! Chicken and turkey good, but must be skinned
   obtain durable, complete remission without             yolk, dairy fats) and omega 3 fats from plants        and trimmed. When burnt, DNA changes less
   these diet and lifestyle changes                       (vegetable oils, eg canola and esp. flaxseed)         likely with poultry (or fish)
                                                       •! Also rich in antioxidants




               Eggs and Dairy                                                Fish                                                   Fish
                                                       •! Fish ! twice a week reduced risk of recurrent     •! Fish caught wild in cold ocean waters best eg tuna,
•! Avoid egg yolk (incl. mayonnaise), but egg             cancer following RP by 2/3                           cod, salmon, trout, herring, sardines. Obtain
   white excellent source of protein                                                                           healthy omega 3 fatty acids (EPA, DHA) from
                                                       •! Fish ! four times a week halved risk of getting
•! Avoid dairy fat, but skim milk, non-fat cheese         metastatic PC                                        algae they eat
   and ice cream fine                                                                                       •! Other fish fine but no benefit for PC
                                                       •! Fish best eaten 5 times per week
•! Avoid margarine (ALA)                                                                                    •! Salmon and trout farmed here. May be fed flaxseed
                                                       •! Best grilled, baked or poached. Benefits lost        (ALA), but salmon can’t convert this to EPA,
•! Avoid milk chocolate, but dark chocolate fine          if fried in unsafe oil. If fried, use olive,         DHA, trout can
                                                          avocado or hazelnut oil                           •! Salmon may only be good wild not farmed…
                                                       •! Avoid heating till browns or blackens
                 Nuts and Oils                                  Fruit and Vegetables                                  Grains and Legumes
                                                     •! All fruit and vegetables good, should form
•! Pistachios, almonds, cashews, macadamia and
                                                        bulk of diet. Don’t add too much to total calorie   •! Grains good eg bread, cereal, pasta, rice. Eat
   hazelnuts very good (monounsaturated fats,
                                                        intake. esp. olives, avocados, tomatoes (best as       in moderation because of their high caloric
   antioxidants). Don’t skin or roast. Avoid
                                                        juice or cooked).                                      value
   walnuts and pecans (ALA).
                                                     •! Dark red/purple fruit esp. good eg dark             •! Legumes good eg beans, peas, lentils
•! Olive oil, avocado and hazelnut oils very good
                                                        grapes, berries and pomegranates
   (monounsaturated fats, antioxidants), but avoid
   vegetable, canola and esp. flaxseed oil (ALA)     •! Cabbage family (best raw) very important:
                                                        cabbage, cauliflower, broccoli, brussel
                                                        sprouts, onions and radish




                    Red Wine                                         Antioxidants                                           Caution
                                                     •! Oxidative damage is a major factor in               •! Patients who do worse than expected are
•! Red wine better than white
                                                        development of PC, and in time, more                   commonly obese, don’t exercise and/or
•! One glass of red wine a day reduced risk of          aggressive disease                                     continue to consume red meat …
   high-grade PC by 2/3
                                                     •! Antioxidants help prevent PC and manage
•! Red wine contains several useful ingredients,        established disease                                 •! Patients who do better than expected
   esp. Resveratrol
                                                     •! Foods containing antioxidants: fruit,                  commonly follow a healthy diet and exercise
                                                        vegetables, nuts, olive oil, dark chocolate            regularly




                  Supplements                                          Vitamin D                                            Pomegranate
•!   Vitamin D *                                     •! Giving 2,000 IU Vitamin D daily to men who’d        •! Giving 250 ml pomegranate juice daily to men
•!   Pomegranate *                                      relapsed following surgery or radiotherapy             who’d relapsed following surgery or
•!   Lycopene                                           almost doubled PSADT                                   radiotherapy almost quadrupled PSADT..
•!   Fish Oil *                                      •! Recommend 4,000 to 5,000 IU daily. 2,000 IU         •! Pomegranate is a strong antioxidant
                                                        daily may do if routine sun exposure…               •! Keep in cool, dark place and refrigerate once
•!   Vitamin E (gamma or delta)
                                                     •! Must monitor blood levels, aiming for upper            opened
•!   Selenium (as Selenium- yeast)
                                                        half of therapeutic range                           •! Take 250 ml pomegranate juice daily
•!   Soy Isoflavones *




                    Lycopene                                           Vitamin E                                              Selenium
•! Adding low dose Lycopene to first line HT         •! Giving low-dose alpha Vitamin E to a normal         •! Giving Selenium (as Selenium-yeast) to a
   doubled frequency of complete remission in           group of men reduced death rate from PC by             normal group of men reduced death rate from
   men with metastatic PC                               40% after only 5-8 years                               PC by 2/3 after 10 years
•! Giving Lycopene for several weeks prior to        •! Vitamin E is a strong antioxidant                   •! Selenium is a strong antioxidant
   RP reduced extent of disease found at surgery     •! Best given as gamma or delta (not alpha) in         •! Best given as Selenium-yeast in dose of 200
•! Lycopene is a strong antioxidant                     dose of no more than 200 IU daily                      mcg daily
•! 10 mg Lycopene tds seems optimal                  •! May cause bleeding tendency, esp. at higher         •! Avoid if diabetic
                                                        doses. Stop prior to surgery                        •! SELECT trial…




                     Caution                                             Fish Oil                                        Soy Isoflavones
                                                     •! Fish oil supplements not as good as fish. Take      •! Metastatic PC uncommon in countries where
•! Radiotherapy acts in part by causing oxidative                                                              soy intake high
                                                        2,000 IU twice daily, at least on non-fish
   damage to its target
                                                        days                                                •! Giving 100 mg twice daily to men who’d
•! Antioxidants Vitamin E, Selenium,                                                                           relapsed following surgery or radiotherapy
                                                     •! Keep in cool, dark place and refrigerate once
   Lycopene, Pomegranate should be avoided                                                                     slowed PC growth in 84%
                                                        opened
   whilst receiving radiotherapy
                                                     •! Avoid if has fishy odour                            •! Take 100 mg twice daily
                                                                                                            •! Monitor PSA carefully in beginning
DR CHARLES ‘SNUFFY’ MYERS IN AUSTRALIA
            FEBRUARY 2010
The Prostate Cancer Foundation of
Australia and St Vincent’s Prostate
Cancer Centre are honoured to welcome
Dr Charles ‘Snuffy’ Myers to Australia.

Dr Charles Myers opened the American Institute for Diseases
of the Prostate in 2001 to provide men with comprehensive
treatment of all stages of prostate cancer. The Institute draws
patients from all over the world. Dr Myers is the Medical Director
of the Institute and President of the Foundation for Cancer
Research and Education. He draws upon his wealth of experience
as Chief of Clinical Pharmacology at the National Cancer Institute
at the National Institutes of Health and Director of the Cancer
Center at the University of Virginia. He has published over 250
research papers in the clinical and basic sciences of cancer and
other diseases. Dr Myers speaks frequently to patient groups and
physicians. He is editor of the Prostate Forum and has written
several books on prostate cancer.
VENUES:                                                              COST:
Sydney  8 February, 7-9pm, Garvan Institute                          $10.00 (including GST)
        384 Victoria Street Darlinghurst                             Including refreshments - served at the venue 30 minutes
                                                                     prior to commencement of the event.
Brisbane     10 February, 3-5pm,
             Queensland Conservatorium of Music                      BOOKING:
             16 Russell Street South Bank                            Online only at www.prostate.org.au. (Due to expected
                                                                     demand tickets are only available via online pre-purchase
Melbourne 11 February, 4.30pm-6.30pm, RACV                           Seats are limited so book early to secure your place at
          Level 17 Function Room, 501 Bourke Street                  these special events. Groups bookings available.
          Melbourne

TOPIC:
Advanced Prostate Cancer – How to Tailor Treatment for               Dr Myers' lecture tour is supported by the Prostate Cancer
Your Disease                                                         Foundation of Australia and St Vincent’s Prostate Cancer Centre.




                                                                                           prostate cancer
                                                                                                                  centre
Making A Difference                                                                 Meetings for 2010
                                                                                   n    Monday February 8th - Dr Myers at Garvan Institute
Dear Jayne Matthews                                                                n    Wednesday May 12th - tba
                                                                                   n    Wednesday August 11th - tba
My name is Shalyce Corney, I am 17 years old and in year 12 at St Clare’s          n    Wednesday November 10th - tba
High School in Taree. My dad is a patient of A/Professor Phillip Stricker          All meetings are held in the Clinic Function Room, Level 4
                                                                                   St Vincent’s Clinic 438 Victoria Street (Cnr Victoria & Oxford Sts)
and was treated earlier in the year for prostate cancer. A couple of weeks         Darlinghurst. NSW
ago Dad asked me what I was getting him for Father’s Day, and when I               Car parking available - entry via Barcom avenue
said that I didn’t know, he said that I should take any money that I was
                                                                                   Check www.prostate.com.au for details
going to spend on him and donate it to the Prostate Cancer Foundation of
Australia to raise awareness and money for research.

Dad showed me a newsletter called the “Lifebuoy”, and in it I saw that you       Sexual Health Conferences - 2009
can choose a day in September and get people to dress up in blue and give
a gold coin donation. I decided to try this at my school. I arranged a meeting   I attended two sexual health conferences in Europe mid 2009. The first
with my principal and gave him the information and we have organised for         conference in June was the World Association of Sexology meeting in
the “out-of-uniform” day to be held on Wednesday 16th September.                 Gothenburg Sweden. This conference covered the social and psychological
                                                                                 aspects of sexual health as well as some discussion over physical issues.
My dad told me to let you know what I was doing. I organised for posters         There were lectures on the chemistry of sexual behaviour, the effects of
to be sent from the Foundation and spoke in front of my entire school to         cancer on male and female sexual function, the health problems of obesity,
let them know what the day was about and my Dad’s story. Everyone was            diabetes and cardio-vascular disease affecting sexual function and finally a
very receptive and I had people coming up to me, telling me that their pop,      seminar on premature ejaculation and the new treatment for this condition.
grandad or uncle had gone through a similar thing.
                                                                                 The second conference in July was in the beautiful city of Paris, it was the
                                                                                 World Health Organisation Consultation on Sexual Dysfunction. All aspects
Yours sincerely                                                                  of male and female sexual dysfunction were covered. Committees were
Shalyce Corney                                                                   formed to investigate and present their findings on the prevalence and
                                                                                 evidence based treatments of all conditions. Of particular interest to me was
                                                                                 the committee’s presentation on sexual rehabilitation post prostate cancer
                                                                                 treatment. All the modalities of treatment were discussed and surprisingly
                                                                                 none have yet been shown to be superior for the long term recovery of post
                                                                                 treatment sexual dysfunction. As the statistics are constantly being reviewed,
                                                                                 that may change by the next meeting in 4 years.

                                                                                 This means that any type of treatment a man is on for sexual rehabilitation
                                                                                 is superior than not being on any treatment at all. Despite the fact that some
                                                                                 treatments result in an earlier return of erectile function (eg penile injection
                                                                                 therapy), the long term benefits of all treatments still needs clarification. I
                                                                                 hope to be in Paris in 2013 to find out.

                                                                                 Dr Michael Lowy - Men’s Health Physician
Footnote: I have since received another email from Shalyce informing me          40-42 Grosvenor Street Bondi Junction
about the day and that they raised $800. Well done St Clare’s High School        Ph: 02 9387 6966
and especially Shalyce for taking the initiative and making a difference.        www.sydneymenshealth.com.au
NEWSLETTER
KEEPING UP WITH THE TIMES
                                                                               St Vincent’s Private Hospital Urology Ward
                                                                               In this, our Centenary year, St Vincent’s Private Hospital has been busy
                                                                               maintaining a high standard of patient care. During 2009 it applied for
                                                                               Magnet Accreditation. This is an international gold standard granted
                                                                               to healthcare facilities that demonstrate excellence in care provision,
The “Lifebuoy” newsletter was first published in 1996 by a group of men
                                                                               recognising in particular, the high quality care delivered by the nurses.
from St Vincent’s Hospital along with A/Prof Phillip Stricker & Jayne
                                                                               In 2010 SVPH aspires to become the first private hospital outside the
Matthews who felt that there was a need for support for men diagnosed with
                                                                               USA to become a Magnet Designated facility.
prostate cancer. How things have changed since that first short-run edition.
The newsletter has had a design makeover and its print quality improved
                                                                               In May, St Vincent’s Private Hospital in conjunction with the NSW
since it is now produced by offset print. Lifebuoy’s print run is now over
                                                                               Urological Nurses Society (NUNS) hosted the annual NUNS study
1200 and is published as a PDF on our website www.prostate.com.au.
                                                                               day. Approximately 100 nurses from around the state attended with
                                                                               presentations from Urologists from St Vincent’s Clinic, a researcher
In 2000 the newsletter previously published by the St Vincent’s Prostate
                                                                               from the Garvan Institute and St Vincent’s Private nurses. The day
Cancer Support Group joined forces with the Prostate Cancer Foundation
                                                                               was a wonderful success and the hospital and in particular the Level
of Australia (PCFA) and became known as the “Prostate News”. In 2006
                                                                               9 nurses were very proud of their efforts. An exciting partnership
Jayne Matthews decided that the St Vincent’s Prostate Cancer Support
                                                                               with the Notre Dame University located opposite St Vincent’s campus
Group should once again have its own newsletter so the “Lifebuoy” was
                                                                               also hopes to provide the hospital with the opportunity for future
relaunched.
                                                                               educational collaborations.

Our current “Lifebuoy” is published quarterly. To assist us to maintain
                                                                               In addition to our involvement with extended care programs, the Level 9
accurate records, comply with privacy policies and control costs we are
                                                                               staff are proud to be a part of community education and awareness when
databasing subscribers. In 2010 subscribers will be able to elect to receive
                                                                               it comes to health issues, and participated in the Movember Campaign
the newsletter via email. You can do this now by completing and filling the
                                                                               aimed at raising the awareness of men’s health issues. Sponsored by
return the form below. It would also be appreciated if you change address
                                                                               Beyond Blue and the Prostate Cancer Foundation of Australia, Level 9
or do not wish to receive the newsletter any longer that you inform us.
                                                                               manned Movember displays in the foyers of both the St Vincent’s Private
                                                                               Hospital and St Vincent’s Clinic from 23rd to 30th November 2009.
If you would like to receive newsletters and are not on
                                                                               Jacinta Vanderpuije
our mailing list or your address has changed please
                                                                               Clinical Nurse Educator, Level 9
complete and return this form. If you no longer want to
receive the newsletters please tick the following box:

Name


Address



                                 or
E-mail address



 Please return to:       St Vincent’s Prostate Cancer Centre
                         St Vincent’s Clinic
                         Suite 508 - 438 Darlinghurst Street
                         Darlinghurst NSW 2010
                         or email: jmatthews@stvincents.com.au
                                                                                    n High dose rate brachytherapy compared to open radical prostatectomy
         Prostate Cancer Research                                                   for the treatment of high-risk prostate cancer: 10 year biochemical relapse-
                                   at the                                           free survival. Presented.
GARVAN INSTITUTE                                                                    n A role for GATA-2 in transition to an aggressive phenotype in prostate cancer
                                                                                    through modulation of key androgen-regulated genes. Oncogene Aug 2009.
A productive 2009 has resulted in the publication of numerous manuscripts           n Nerve sparing effect on positive margin in radical prostatectomy. Submitted.
and conference presentations. This research would not be possible without
                                                                                    Anne-Maree Haynes
many men donating biospecimens and completing the quality of life
                                                                                    Clinical Research Coordinator, Prostate Program
questionnaire. We are truly grateful for that.

High Quality Data + High Quality Specimens = High Quality Research                                                             The St Vincents Prostate
                                                                                    prostate.com.au
                                                                                                                               Cancer Centre website
One area of great interest to scientists at the Garvan Institute is personalised                                               started about seven years ago.
medicine, which is the ability to diagnose disease, predict outcomes and                                                       The GBI Creative team took it on
provide therapy that is particularly suited to a patient. Our scientists are also                                              in 2005 with a brief to improve
identifying more reliable markers of clinical prostate cancer progression and                                                  its usability. The site underwent
which treatments respond to a particular therapy. For example, the protein                                                     major transformations. On
gene AZGP1 was discovered by Garvan scientists. It is present in the epithelial                                                completion we monitored the
cells of the prostate. It was discovered that decreased or absent expression of                                                stats to see if our work, especially
this gene in cancer tissue is associated with poor outcomes. We are in Phase                                                   in the area of search engine
3, a prospective trial, of validating its use in routine clinical practice.                                                    optimisation, was being received
                                                                                    positively. Whilst an increase in public awareness and diagnoses no doubt
Urology Fellow                                                                      contributed to the rise in user numbers, we like to think that our web
                                                                                    development played an important part. Check the web-stats that follow:
                                                                                    September 2005                         September 2009
                                                                                    Unique visitors - 386                  Unique visitors - 2189
                                                                                    Number of visits - 642                 Number of visits - 2876
                                                                                    Pages - 1980 [ 3.08 per visit ]        Pages - 11900 [ 4.13 per visit ]

                                                                                    We take ‘Pages’ as our most valuable metric. In four years these have
                                                                                    increased six fold. Consequently, there have been more enquiries sent via
                                                                                    the ‘second opinion’ and ‘general enquiries’ forms.

                                                                                    The web is a constantly evolving place and prostate.com.au will need to
Dr Richard Savdie (above) has completed a fantastic year of urology                 change to meet best-practice web development standards. For 2010 we have
research at the Garvan whilst completing a Master of Surgery at University          scheduled various code upgrades that will improve usability and accessibility
of Sydney. Congratulations to Richard on his innovative research and his            across all browsers. In the second quarter work will commence on a content
successful appointment to the Urological Training Scheme.                           management system to allow staff to populate the site as they require.

Manuscripts for 2009                                                                Is the website succeeding? Well, it is clear that the site is most popular in
n Stage migration in localized prostate cancer has no impact on the post            Australia, serving almost ninety percent of its pages to Australians - about
radical prostatectomy Kattan nomogram. BJUI Jun 2009                                10,000 pages per month. And whilst the rate of growth has slowed a little,
n Should experienced open prostatic surgeons convert to robotic surgery?            the numbers are all still growing. So we are confident in saying that the
The real learning curve for a single surgeon over 3 years. BJUI Aug 2009            website is succeeding and moving in the right direction.
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2009

				
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