MEDIWATCH: July 2013

Wednesday 17 July 2013

Prostate Cancer UK

Prostate Cancer UK--The Summer issue of Progress: prostate cancer news and views is out now featuring an interview with athletics legend Colin Jackson, a feature on the PSA test and much more

Tuesday 16 July 2013

Canada-PSA still a powerful test

Re: Study finds prostate cancer to be far more widespread, July 15
Published on Mon Jul 15 2013

The PSA is the only test we currently have to help diagnose prostate cancer. While there are controversies amongst the medical community over its value, a controversy that also exists for mammography, elevated PSA readings still serve as a powerful red flag for physicians to further investigate.

Recent stats by the Canadian Cancer Society estimate that in 2013, approximately 23,600 Canadian men will be diagnosed with prostate cancer, and about 3,900 will die from the disease. Prostate cancer is 90 per cent curable when detected early, so what, or who, are we missing?

Perhaps an informed patient-physician discussion that may lead to the decision to perform a PSA test and digital rectal exam (DRE) could prevent many of the estimated 3,900 deaths this year — we don’t know.

We do know that the early warning signal provided by the PSA can’t happen if men choose to ignore their health and avoid doctors’ visits. An informed discussion with a patient’s family doctor is essential because it is based on individual medical history and personal risk factors for prostate cancer.

In an age of informed health care, this is one of the most powerful tools we have. Worried about prostate cancer? Know your risk. Talk to your doctor. Get informed.

Rocco Rossi, President and CEO, Prostate Cancer Canada

http://www.thestar.com/opinion/letters_to_the_editors/2013/07/15/psa_still_a_powerful_test.html

Monday 15 July 2013

Australia-Secure Future for Prostate Cancer Nurses

July 14th 2013

Federal Government helps secure future of prostate cancer nurses

Following the announcement that cancer funding is a priority for the 2013-2014 Federal Budget, Prostate Cancer Foundation of Australia (PCFA) is delighted that $7 million is being allocated to the Prostate Cancer Specialist Nursing Program.

Federal Minister for Health Tanya Plibersek announced the additional funding this morning at the Kinghorn Cancer Centre in Sydney which will ultimately help to expand the specialist nursing program in the coming years.

PCFA, with the generous support of The Movember Foundation, launched the specialist service in May 2012 to address the needs of people living in metropolitan and regional Australia who have been affected by prostate cancer.

The Movember Foundation generously contributed $3.6 million to secure the program and recruit its first nurses.
The program has now placed twelve nurses in major metropolitan and regional hospitals in Queensland, New South Wales, ACT, Victoria, South Australia, Tasmania, Western Australia and the Northern Territory.

Dr Anthony Lowe, Chief Executive of PCFA, commended Minister Plibersek for recognising the needs of prostate cancer survivors and delivering additional resources for Australia’s only prostate cancer specialist nursing program.

“This is a significant day for the Prostate Cancer Specialist Nursing Program. PCFA is enormously grateful to The Movember Foundation for having the vision to support the pilot program which has enabled us to lay the foundations for the service. And we applaud the Federal Government for its tremendous efforts to help sustain such an important program. This will allow the recruitment of more nurses to help meet the needs of prostate cancer patients,” said Dr Lowe.

According to PCFA’s Director, Health & Education Programs, Julie Sykes, the program has shown promising results in its first year with many families already benefiting from the free service.
“A diagnosis of prostate cancer causes significant anxiety for men and their families. Men not only face the prospect of treatment, but also may have to live with long term side effects, and face prolonged surveillance programs requiring ongoing hospital visits, sometimes involving multiple specialists. The Prostate Cancer Specialist Nurses are a central point of contact to help men navigate this process.”
"We are very excited about having these much-needed additional resources to take the program to the next level. The need for expert advice and ongoing support for those affected by a cancer diagnosis is well-recognised in all types of cancer," said Mrs Sykes.
Jason Hincks, Movember’s COO, has expressed his excitement over the Federal Government’s latest contribution.

"Movember is proud to be catalytic funder of initiatives that improve the lives of men, such as the Prostate Cancer Specialist Nurses Program. We are delighted that the Federal Government has taken the decision to invest in the program, thereby dramatically increasing the number of men with access to such a vital service. This is a proud day for the Movember movement and reinforces the power of the humble Mo," said Mr Hincks.

For further information about the Prostate Cancer Specialist Nursing program or to see which hospitals are hosting specialist nurses, visit www.prostate.org.au or call 1800 22 00 99.

Tuesday 9 July 2013

USA-What has your doctor told you about PSA testing?

This is taken from The "New" Prostate Cancer InfoLink:

Posted on July 9, 2013 by Sitemaster

According to a recent article in the Annals of Family Medicine, about 64 percent of 3,400 men aged between 50 and 74 years of age who participated in a survey conducted in 2010 stated that they had never had a conversation with their doctor about the pros and cons of PSA testing.
There is already a nice summary of this paper available on the HealthDay web site, and we see little point in repeating the same information here. The full text of the original paper by Han et al. is also accessible on line.
The bottom line is perhaps best encapsulated in some comments made by Dr. Robert Ferrer, the vice chair for research in the department of family and community medicine at University of Texas Health Science Center at San Antonio, as follows:

Doctors have “a duty to help patients understand in situations where there are competing benefits and harms.”
“The PSA decision is no more complex than many other health care decisions.”
The medical profession needs to find ways to educate patients even if doctor visits are brief and cluttered with other tasks.
Clinicians have a responsibility to help patients make decisions consistent with their preferences.

Now that sounds like one of the most sensible sets of comments we have heard about PSA testing in the past 20+ years!
The article by Han et al. is, in fact, just one of four articles dealing with PSA testing that are available in this issue of the Annals for Family Medicine. They are, probably, all worth reading together as a group:

Han PJK, et al. “National evidence on the use of shared decision making in prostate-specific antigen screening” is the article previously referred to above
Feng B, et al. “Physician communication regarding prostate cancer screening: analysis of unannounced standardized patient visits” is another study looking at the use of how physicians used a web-based tool to discuss PSA testing with their patients.
Wilkes MS,. et al. “Pairing physician education with patient activation to improve shared decisions in prostate cancer screening: a cluster randomized controlled trial” provides data from a study designed to assess one way to improve the shared decision-making process between doctors and patients.
Ferrer RM, Gill LM “Shared decision making, contextualized” is an editorial that offers insights into whether the primary care community is really convinced that “shared decision making” is an operating principle that must be fully accepted and acted on by most primary care doctors today.

There is a real value to the patient community of being well aware of research and discussion like this that is going on within the primary care community. It can be balanced against the more dogmatic “guidelines” issued by everyone from the U.S. Preventive Services Task Force to the American Urological Association.

Link to website

Monday 8 July 2013

The 100th Tour de France

The route

Running from Saturday June 29th to Sunday July 21th 2013, the 100th Tour de France will be made up of 21 stages and will cover a total distance of 3,404 kilometres.