By Tim Baker | In the tool kit for managing the distress and trauma of a cancer diagnosis, have you ever considered the role of writing therapy?

By Tim Baker | You hear and read a lot in oncology about the dangers of offering false hope to cancer patients. From spurious folk remedies and snake oil to the uncertain benefits of nutrition and emotional healing...

By Tim Baker | Artificial intelligence (AI) has the potential to transform many areas of healthcare, including cancer care. But can it replace medical professionals? Tim Baker shares his thoughts. 

PCFA is about to start a review of Australia's guidelines for prostate cancer testing, harnessing our chance to change the way we manage the disease. 

Last week we brought together some of the country's leading clinicians to talk about new and emerging treatment options that have vastly improved the way we diagnose and treat prostate cancer. 

The vodcast touches on robotic and open prostatectomies, advances in radiotherapy, and the frontlines of research into side-effect management and treatment of erectile dysfunction and incontinence.

If you have any questions, or need support, call 1800 22 00 99 to speak with a PCFA Telenurse.

You’ve probably heard these three words a fair bit in recent years. You might even be sick of hearing them, but you are probably going to have to get used to it.

In the context of cancer care, most would agree the standard of care you receive should not be determined by your bank balance, ethnicity, postcode, religion, gender identity or sexual orientation. This has been a hot topic at recent oncology conferences and for good reason.

Skeletal related events (SREs), also known as symptomatic skeletal events, occur due to bone instability related to the treatment of advanced prostate cancer or due to the spread of prostate cancer to the bone (metastases). This results in localised pain at the site of spread and increased risk of fractures. Metastases to the spinal column can result in a pathological fracture with collapse of the vertebrae leading to spinal cord compression. SREs are associated with increased risk of mortality, pain, and low-quality of life. Symptomatic bone lesions may require radiotherapy or surgical intervention to improve symptoms. Patients may also present with high calcium levels in the blood.

On Wednesday 19 October from 10am to 8pm we’re holding a national call-in day on erectile dysfunction (ED) for men and their partners.

If you want to talk about management and treatment of ED or things such as low libido, shrinkage, body image or just plain frustration with it all, please call us for information and advice.

We’ll have our specially trained Telenursing team on deck to take your calls on 1800 22 00 99.

Thank you to everyone who joined us on Thursday for our latest webinar, CANCER, SEX & SIDE-EFFECTS: Managing erectile dysfunction after prostate cancer

If you missed it, you can watch it back here: https://www.youtube.com/watch?v=N1jdTbgDdx0 

https://theconversation.com/physician-heal-thyself-after-4-years-of-treatment-for-stage-4-cancer-i-j...

I was supposed to write this blog post yesterday.

But I was a bit … well, frankly, I was a bit tired. Which, in the ruthless world of freelance journalism, is about as valid an excuse as the proverbial dog eating your homework.

Except, in this case, the client – the delightful folks at the PCFA – have a good understanding of and empathy for cancer-related fatigue (CRF), especially the acutely debilitating kind inflicted by hormone therapy...

Prostate cancer is often spoken of as a couple’s disease because it can affect the partner of the person living with the diagnosis so acutely (if they have a partner).

Statistically, men with prostate cancer in long term relationships tend to do better over time than single men. It’s not hard to understand why. Another set of ears at medical appointments to help recall and process the overwhelming tide of information. A gentle reminder when tests, oncologist’s appointments or treatments might be due. The companionship. Emotional support...

Written by Exercise Physiologist Molly Lowther in collaboration with Exercise & Sports Science Australia (ESSA).

Prostate cancer is currently one of the most common cancers in Australia, with 1 in 6 men diagnosed by the age of 85¹. Receiving a cancer diagnosis can be traumatic and life changing for patients. The time immediately after diagnosis has been described as lonely, stressful and frustrating, particularly prior to treatment². Exercise is now considered a primary treatment throughout the cancer care continuum, and helps men prepare and recover from surgery, chemotherapy, radiation and hormone therapy...

As you navigate a prostate cancer diagnosis, coming to terms with treatments, side effects, lifestyle changes, the existential dread and angst, it’s easy to overlook one very important element of your cancer care. Bone health...

Imagine if there was a single treatment that neatly addressed many of the side effects of prostate cancer and its treatment. A silver bullet that could improve cardio-vascular health and bone density compromised by hormone therapy, reduce fatigue, improve mental health, that might slow cancer’s progress and even assist sexual function?

What is this miracle treatment, you might ask?

Did you know that more than half of Australian men over the age of 45 have some form of erectile dysfunction (ED)? The risk of ED increases with age, and for men with prostate cancer, it’s a major concern.

The good news is, there are a range of options for managing ED...

“Sexual incontinence is a broad term that encompasses climacturia (urinary incontinence at the time of orgasm) and arousal incontinence (urinary incontinence at the time of physical or psychological arousal or both).”...

Bladder neck contracture (BNC) is also known as bladder neck stenosis or alternatively a urethral stricture (which is not technically the correct term for this condition). The prostate lies between the underneath surface of the bladder and the end of the urethra inside the pelvis. When the prostate is removed there is a gap between the opening of the bladder and the end of the urethra...

Following a radical prostatectomy one of the potentials complications is a slight shortening of the length of the penis. This is because where the prostate is taken out a gap remains. The surgeon has to close the gap by reconnecting the urethral stump, which runs through the penis, to the bladder. Pulling the urethra internally towards the pelvis, pulls on the penis as well, potentially resulting in a relative shortening of the penis. Toussi et al and team at the Mayo Clinic in the United States have conducted a trial investigating the value of a penile traction device to assist patients with penile lengthening after surgery.

ADT blocks the production and effect of testosterone through various mechanisms (discussed in previous blogs). The main impact of reduced testosterone is low libido (reduced desire for sexual activity). However, it has also been demonstrated that low testosterone may affect erectile function both within the penis and the spinal cord. Read more... 

Penile rehabilitation is a well-established concept and is thought to counter the effects of hypoxia (oxygen deprivation) in the penile tissue and cavernous nerve neuropraxia (damage to penile nerve supply) after a radical prostatectomy (RP) which leads to fibrosis (scarring) and atrophy (shrinkage) of the smooth muscle cells of the corpora cavernosum (erectile chambers) of the penis. The variations to tissue cause veno-occlusive dysfunction and lower the probability of long-term recovery of erectile function. Techniques utilised include .....

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 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........

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?

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. 

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.