It’s fair to say receiving a prostate cancer diagnosis, particularly the advanced incurable variety, throws your world into a spin...

In a highly competitive field, one of the more alarming side effects of hormone therapy is a gradual decline in cognitive function. This is not ideal for anyone but is particularly suboptimal for a career writer...

Long-time readers of this column (stretching back, oh, what is it now, three weeks?) may recall that my own cancer self-care mantra is a simple one: Remember to take your M.E.D.S – Meditation, Exercise, Diet, Sleep. And that ticking each of these boxes each day, alongside conventional therapies, helps us withstand the rigours of cancer treatment and enhance quality of life...

Any diagnosis of cancer can trigger a range of emotions and put one into an anxious state. These feelings may wax and wane through the various stages of the cancer journey and may persist. Wondering whether you have cancer; waiting for the results of diagnostic tests; going for treatment; dealing with the after effects of treatment and the fear of recurrence are just some of the potential triggers...

I love food. I love eating it. I love cooking it. I love shopping for it. I love planning a meal or discovering a new restaurant.

So, since I was diagnosed, on July 7, 2015, with metastatic prostate cancer, one of the most vexed questions I’ve faced is a remarkably basic one. What should I eat?

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?

Hi, I’m Tim.

Diagnosed with stage 4, metastatic prostate cancer on July 7, 2015. PSA 120. Gleason score 9. Lesions in right femur (thigh bone) and left seventh rib. Those of you with a maths brain might have already calculated that was nearly seven years ago. In that time, I’ve had early chemotherapy with concurrent hormone therapy, targeted radiation, ongoing intermittent hormone therapy, and have undergone a TURP...

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... 

In this article, we consider the risks of prostate cancer for people who have transitioned from being assigned male at birth to female in later life, who have a prostate gland which may predispose them to prostate cancer. This may be the case for people who were born with a prostate gland and have had gender affirming surgery (GAS), as well as those who identify as female, but have not had GAS.

The concept of intermittent androgen deprivation therapy (IADT) is well established. After a patient has been initiated on ADT for an induction period of between 6-12 months, they may then be offered a treatment holiday. The benefit of this treatment approach is to minimise treatment related side effects (such as compromised sexual function, hot flushes, depression, fatigue and cardiovascular risk) and improve quality of life. It may also ...

Neoadjuvant therapy usually refers to chemotherapy administered prior to definitive treatment such as surgery or radiation. In the context of prostate cancer neoadjuvant treatment can include androgen deprivation therapy (ADT) (also known as testosterone blockade). Although usually given in the context of a clinical trial, neoadjuvant ADT (nADT) may be used to reduce the size of locally advanced tumours, facilitating surgical resection. It has also been shown to ....

The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group was formed in 2008, and is comprised of a multidisciplinary team of doctors, nurses, allied health care professionals, scientists, researchers, and community representatives, all working in areas related to urogenital cancer. Their aim is to .....

Nuclear medicine studies such as PSMA PET scans can guide prostate cancer staging prior to surgery but are also used after surgery to search for disease recurrence or evidence of disease spread. These studies involve intravenous injection of radioactive tracers which are then tracked using specialised cameras to detect the cancer which lights up in various colours. It may be useful to pick up disease not seen on conventional CT scans or MRI. For those patients with intermediate and high-risk disease the surgeon may also .....

SBRT is a form of radiotherapy that is delivered at a higher radiation dose per day but over a shorter period of time, 4-6 sessions versus 20-45 sessions (conventional external beam radiation therapy). The radiation dose is precisely targeted to the area containing cancer in a small number of fractions (hypofractionation) thereby avoiding surrounding structures and reducing toxicity. In the initial session a team of ...

Despite recent research advances, metastatic castration-resistant prostate cancer continues to be fatal. Prostate-specific membrane antigen (PSMA) is highly expressed in metastatic castration-resistant prostate cancer. Lutetium-177 (177Lu)–PSMA-617 is a radioligand therapy that distributes beta-particle radiation to PSMA-expressing cells and the adjacent microenvironment. It is capable of

Metastatic prostate cancer is initially treated with androgen deprivation therapy (ADT) by inhibiting the cancer cells growth through blockade of testosterone (androgens). Despite a high initial response rate, most patients become castrate-resistant within 3 years from the start of treatment. As discussed in previous blogs castration resistance is not only due to ADT resistance. Despite the reduction of .....

Immunotherapies as a single agent have not been shown to be effective for treating advanced prostate cancer till now. In this research blog we will try find out why they are not effective and what the potential alternatives are. Numerous blogs in the past have addressed the concept of immunotherapy and the types available. The premise of immunotherapy is ...

Like the ageing woman develops menopause due to the waning levels of oestrogen so too does the ageing man develop andropause or testosterone deficiency. Some men remain symptom free despite this change while others develop significant symptoms. These symptoms may include mood changes (depression), memory and sleep disturbances and lower energy levels. This condition may result in osteoporosis (increased risk of fractures), anaemia, loss of libido, sexual dysfunction and increased risk of metabolic syndrome (diabetes, cardiovascular disease, stroke, high cholesterol). Many other conditions can cause......

A previous blog addressed the different focal therapies for prostate cancer and brachytherapy is classified as another treatment modality. It is the implantation of radioactive sources directly into the tumour, also known as interstitial brachytherapy. Brachytherapy is used to...........

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.......

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 .....

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.