Financial toxicity is an expansive term which refers to the economic ramifications and subjective burden brought on by a cancer diagnosis and treatment1. Escalating costs include direct, or out of pocket (OOP) payments, as well as indirect costs associated with foregone earnings for both patient and caregiver, which amplify financial burden. The notion of financial toxicity arose from fears that escalating costs of anti-cancer medications coupled with insurers’ increased cost-sharing with patients may lead to undesirable outcomes similar to traditional toxicities associated with treatment, such as ......
For now PSA (prostate specific antigen) is the most widely used screening test (as discussed in previous blogs). But there is a large amount of research examining other ways to determine who gets screened and how they will be screened. Prostate cancer screening was very topical at the recent European Association of Urology (EAU) virtual meeting in July. Some new blood tests and formulas have been suggested along with imaging to guide algorithmic developments. This blog will focus on
Screening is a means of detecting potential conditions or risk markers for disease. These programs identify conditions which could turn into disease in the future. One could deduce that by doing this the disease can be detected and treated earlier, reducing morbidity and .....
Prostate specific antigen (PSA) is an enzyme produced only in the prostate and acts on a protein in semen called seminogelin to give the semen a more liquid consistency. PSA shows up in the blood when sampled. Prostate cancer can raise the level of PSA in the blood but so can age related prostate enlargement causing trouble with urination (benign prostatic hypertrophy); infections (prostatitis); surgical procedures (prostate biopsy, cystoscopy) and natural increase with age. The PSA level may be ........
The main goal of focal therapy is the targeted focal destruction of cancer tissue with the preservation of surrounding healthy prostate tissue. There have been conflicting opinions on the definition, but it seems the consensus is “ablation of the dominant or index lesion”1. The principle of targeted therapy has been applied to other cancers such as breast, liver, brain, and thyroid. It represents the middle ground between active surveillance and treatments such as radical prostatectomy and radiation therapy.......
One of the treatment options for locally advanced non-metastatic prostate cancer is external beam radiation therapy in conjunction with androgen deprivation (testosterone blocking) therapy. If there are no lymph nodes (glands) that are obviously involved, then radiation would be confined to the prostatic bed. However, within the radiation oncology fraternity there has .....
Kerry Santoro, Prostate Cancer Specialist Nurse (Southern Adelaide Local Health Network) says that around 200 prostate cancer patients are diagnosed within her local health network each year, and that generally they remain in contact for a period of three years, meaning that at any one time Kerry is managing up to 600 patients on a rolling basis, consulting with .......
The focus on this year’s meeting was on advanced cancer. Two types of cancer were presented: those that would respond to anti-androgen therapy (Castrate sensitive prostate cancer – CSPC) and those who have had anti-androgen therapy and developed resistance to treatment (Castrate resistant prostate cancer- CRPC) .......
With many parts of the country back in lockdown, medical care and support for cancer patients has reverted to the online space. This includes telehealth consultations, virtual support groups and the use of social media for peer-based support.
Despite the availability of this technology some of the emotional and mental well-being needs of these patients remain underexplored and underreported. Many have tried to address the void by .....
Dr Nathalie Bock and her team from the Queensland University of Technology have developed and validated a highly reproducible microtissue-engineered human construct in the lab that comprises osteocytic and osteoblastic cells (the cells responsible for the breakdown and formation of bone), with relevant protein expression and mineral content. The mature mineralized engineered tissue are cultured for up to 12 weeks. They then add metastatic prostate cancer cells to the mineralized microtissue. This model reproduces some of the cellular alterations seen ......
In observing NAIDOC Week, (4-11th July 2021), it seems fitting as a point of departure to acknowledge the impediments Indigenous Australians may encounter in engaging with treatment and receiving optimal health care in general (and cancer care in particular). Some of these factors include: difficulties communicating with health professionals; a lack of patient navigators; lower health literacy; lack of access to support from an Indigenous care provider; logistical barriers; and inadequate linkages with .........
In medicine we often speak of prevention over cure. Professor Manish Patel at the University of Sydney found physiotherapist guided-pelvic floor muscle therapy (PG-PFMT) commenced 4 weeks before surgery may have a beneficial effect in reducing the duration and severity of incontinence2. Six weeks after prostatectomy, the intervention was associated with a lower degree of incontinence, with a significantly shorter duration to one and zero pad usage2. A meta-analysis which pools the results of several studies showed there is a 36% reduction of incontinence risk at 3 months after surgery if preoperative PFMT was performed3. Best outcome is achieved by .....
The two major interventions for prostate cancer treatment are radiation and surgery (radical prostatectomy). Radiation very rarely results in leakage of urine, but may irritate the bladder and cause the urgent desire to urinate or the need to urinate with increased frequency. Surgery to remove the prostate most certainly can put one at risk of developing stress urinary incontinence. But what do we mean by stress? It does not mean incontinence brought on by a stressful incident. By stress we mean that any rise in the pressure inside the abdomen (such as during coughing, sneezing, defecating, positional shifts or exercise) may press down on the bladder and cause urine to leak. In rare instances, it may continuously leak on its own........
In many of our research blogs we have highlighted the psychological and beneficial effects of exercise. It has been shown that lack of strength and/or muscle power has been associated with poor survival1. During this Men’s Health Week2 (14-20 June 2021) the Prostate Cancer Foundation of Australian (PCFA) is encouraging everyone to do 45 sit-ups a day for one week (and hopefully long-term) to stay fit but to also start a conversation. But why 45? That’s because, “45 men are diagnosed each day, and over 3000 will die this year,” according to CEO of the PCFA, Professor Jeff Dunn (AO). He goes on to add that this is “currently the most prevalent cancer in Australia and by 2040, an estimated 372,000 men will be living with or beyond prostate cancer, a 60 per cent increase from around 230,000 today.”
At the COVID-19 pandemic’s peak or during one of it’s waves when there are many active cases in the community, the management of viral cases is given precedence over less acute cancer cases. In such circumstances a triage system is established in order to prioritise cancers according to stage and type....
A recent study by Paschalis et al from the Institute of Cancer Research at the Royal Marsden Hospital London examined the sampled tissue of 74 participants in an effort to search for a new potential therapeutic target site for metastatic castrate resistant prostate cancer.
The last stop for erectile dysfunction treatment By Kalli Spencer
At this juncture in one’s prostate cancer journey, spirits may be down, frustration levels high and all hope for a more fulfilling sex life might seem lost. As per last week’s blog various erectile dysfunction medications, mechanical devices and self-injections may have been attempted and either deemed ineffective or failed.
There is one final option in the third tier of the treatment strategy and that is the insertion of a penile prosthetic or inflatable balloon placed within the penis. This procedure eliminates the need for any further medication and an erection depends on a device to occur.
For more information on sexual issues following prostate cancer treatment click the following link to access the PCFA resource - "Understanding Sexual Issues"
The purpose of this discussion is to explore the next level of medical treatment available. Assuming all medication based options (and even mechanical ones, such as vacuum erection devices) have failed: what’s next?
New imaging technology, using prostate specific membrane antigen (PSMA) PET combined with computerised tomography (PET/CT), has proven highly useful for staging prostate cancer in both the newly diagnosed and recurrent setting (disease that has returned after primary treatment). Benefits include greater utility in making treatment decisions and lower radiation doses.
There is limited research examining the impact of exercise on psychological distress in men with prostate cancer. Galvão et al1, from the Exercise Medicine Research Institute at the Edith Cowan University in Perth, focused on this particular issue, with specific reference to men with prostate cancer undergoing ADT.
We would like to introduce Kalli Spencer to everyone! Kalli will be writing weekly updates on the latest in prostate cancer research and treatments, so you’ll be hearing from him regularly.
Kalli is an internationally renowned Urological Surgeon, specialising in oncology and robotic surgery. He trained and worked in South Africa, before relocating to Australia where he has worked at Macquarie University Hospital and Westmead Hospital. His passion for what he does extends beyond the operating room, through public health advocacy, education and community awareness of men’s health, cancer and sexuality.
Kalli has been involved with the Prostate Cancer Foundation of Australia for many years, advocating for improved cancer care and facilitating community prostate cancer support groups. Kalli has joined the team and is now helping to deliver evidence-based research blogs for PCFA on a regular basis. PCFA's Research Blog is regularly updated with articles, written in simple language, about recent and topical research in prostate cancer.
We look forward to bringing you more regular news updates soon!
Australia has been leading the world in its practice of performing prostate biopsy via the skin (Transperineal Biopsy) instead of via the rectum (Transrectal). Movember’s Prostate Cancer Outcomes Registry shows that in Victoria, the majority of prostate biopsies are now performed via the skin. In 2013, it was only 5%.
Please click through to read more from Dr Jeremy Grummet on TREXIT.
Research shows that how we think about our cancer and exercise may influence how much we exercise.
Research by Dr Siân Cole and the Psycho-oncology Research Team at the Olivia Newton-John Cancer Wellness and Research Centre – Dr Gemma Skaczkowski and Prof Carlene Wilson - found that beliefs around exercise and cancer influence levels of exercise engagement in adults undergoing treatment for cancer.
Receiving a diagnosis of prostate cancer is a major life stress for most men and their loved ones. Suddenly, the things that matter most seem threatened and it is very normal to experience a wide range of feelings and emotions.
Sometimes you may feel more distressed than at other times. Your feelings might be more intense while waiting for test results, making treatment decisions or just before commencing treatment. Side effects from treatment may also cause stress and upset. After treatment, you may worry about the cancer returning.
Today, there are over 220,000 men living after a diagnosis of prostate cancer. For most men the long-term outlook is very good - relative to the general population and considering other causes of death, 95% of men with prostate cancer will survive at least five years after diagnosis and 91% of men with prostate cancer will survive 10 years or more.
To help improve the lives of men living with prostate cancer, there is a need for more evidence-based strategies to help them manage the challenges of living with the disease. There is growing evidence that mindfulness is one strategy that can be used to reduce symptoms of anxiety and depression associated with prostate cancer.
Prostate cancer is the most commonly diagnosed cancer in Australian men, with about 17,000 men newly diagnosed each year. For most men the long-term outlook is very good - relative to the general population and considering other causes of death, 95% of men with prostate cancer will survive at least five years after diagnosis and 91% of men with prostate cancer will survive 10 years or more. Today there are around 220,000 Australian men alive after a diagnosis of prostate cancer.
Of concern to our mission, for men who develop advanced prostate cancer, the outlook is not as good. Prostate cancer kills more than 3,000 men in Australia every year, representing about 12% of all male deaths from cancer. So, what is advanced prostate cancer, how is it detected and how is it treated?
If you’ve been diagnosed with prostate cancer, your overall health and fitness can impact your treatment options, as well as influencing how you physically recover from surgery and other types of therapy. Maintaining a healthy weight is key, a point backed up by new Australian research.
Medicare data suggests that up to 21% of Australian men aged 45–74 choose to have a Prostate Specific Antigen (PSA) Test each year, and about 19% of men aged over 74 also undergo testing.
While PSA testing helps to identify men with an increased risk of undiagnosed prostate cancer, and can help to diagnose prostate cancers earlier, it can also produce false positive results, and in some men picks up cancers that are so slow growing that they do not affect a man’s life expectancy, a finding known as over-diagnosis. False positives and over-diagnosis can cause harm, which means men and their doctors need to carefully consider the pros and cons of testing, based on each man’s age and other individual characteristics.
For men with no family history of prostate cancer and no symptoms, the current guidelines recommend that men who decide to undergo regular testing should be offered PSA testing every two years from age 50 to 69.
For men with a family history of prostate cancer who decide to undergo testing, the guidelines recommend men be offered PSA testing every two years from age 40/45 to 69, with the starting age depending on the strength of their family history.
If you have low risk prostate cancer, Active Surveillance is increasingly being recommended as a management option for your disease, in order to avoid unnecessary and invasive treatments when it is clinically safe to do so. Estimates suggest about 60% of low risk prostate cancers in Australia are managed with Active Surveillance.
So, what is Active Surveillance, and is it a good treatment option for you?
A world-first international prostate cancer quality of life study has been carried out by prostate cancer patients themselves. This is the largest study ever conducted by patients and its findings suggest that the different types of treatment for prostate cancer have differing impacts on quality of life. The study suggests that significant numbers of men struggle with urinary incontinence and sexual problems after treatment and that the impact on their quality of life may be greater than previously thought.