Media Articles
December 2012
Canadian Urological Assoc. - Furthering the prostate cancer screening debate (prostate cancer specific mortality and associated risks)
News Release
Public Warned Against Misinterpreting Flawed Research
CALGARY, AB - The Prostate Cancer Institute responded today to newly released European and American studies on the effectiveness of PSA screening. Dr. Bryan Donnelly, Chairman of The Prostate Cancer Institute, applauded the results of the European study, which found that PSA screening has reduced death rates by 20 percent, but condemned as "fundamentally flawed" the conclusions of the American research, which found no decrease in the death rate in men who have annual PSA tests. Dr. Donnelly said the way these studies have been reported is irresponsible.
"The European study clearly showed that PSA testing allows us to diagnose prostate cancer very early, when it is confined in the gland and can be treated," said Dr. Donelley. "To disregard these results is irresponsible," he warned.
Dr. Donnelly said that while the European study is exceptionally positive, reinforcing the message that the PSA saves lives, the American study is seriously flawed. Of the group that was meant to be the control arm (the untested group), at least half of the subjects had already been tested, leading to skewed results. Furthermore, the test only studied men up to ten years following the PSA test. It is not unusual for a majority of men to live with prostate cancer after ten years. Most die in the second decade. The European study is a much bigger study and the untested arm, were truly untested. That study, even with a ten-year control mark, indicated a twenty per cent reduction in mortality, a significant result.
Knowing that men will use any excuse not to have their health checked, Dr. Donnelley worried that the reporting on this issue will only feed into that excuse. Advanced prostate cancer is incurable and the third most common cause of death in North America, one that is miserable, painful, and slow.
"The PSA test is not perfect, but it's the best we've got. When I started in neurology thirty-six years ago, 90 per cent of the men I saw had advanced prostate cancer. Today 90 per cent have treatable cancer. The one and only difference is PSA blood testing," Dr. Donnelly said.
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Dr. Bryan Donnelly is a staff Urologist at the Calgary Rockyview Hospital, and the Tom Baker Cancer Center. He is a Clinical Associate Professor in the University of Calgary. He is chairman of the Prostate Cancer Institute of Calgary, and a founding member of the Prostate Cancer Foundation. He currently holds the Seaman Chair for Clinical Research at the U of C.
The Prostate Cancer Institute aspires to excellence in prostate cancer education, awareness and research. We are a not-for-profit organization and for the last ten years we have provided current information, facilitated diagnosis and research and coordinated community and family support for men who may have prostate cancer and prostate-related disease. Annually, over 6000 men and their families visit the Prostate Cancer Institute to access medically sound information from a Resource Centre lending library, and to receive support from volunteers who have experienced prostate disease.
New clinic reduces wait times for prostate tests - 37 KB
Waiting times for test results to determine prostrate cancer have been cut to a fraction of the time due to a new referral process. Officials with the Calgary Health Region say it now takes two weeks to get results, as opposed to an average of three months.
Cuts to Wait Time - 39 KB
Doug Driediger unravels a stack of small square canvases, one for each day in November. For the past year, he's painted the view outside his front window, but that month's work stands out.
A draft recommendation by the U.S. Preventive Services Task Force calling for an end to routine PSA testing for healthy men age 50 and older goes too far, says a prostate cancer expert at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis.
“Mass screening is not the way to go,” says Gerald Andriole, MD, chief of urologic surgery, who acknowledges that widespread testing has lead many men with slow-growing tumors to be over diagnosed and over treated with aggressive therapies. “We have to take a more nuanced approach to determine which men should be screened in the first place, how frequently they should be tested, and whether their cancer warrants therapy.”
In recommending against routine PSA screening, the task force says that the test does not save lives and, when positive, often leads to invasive biopsies and treatments such as surgery or radiation therapy, with side effects that can include incontinence and impotence.
Andriole
But Andriole, who also is the principal investigator of the National Cancer Institute’s Prostate, Lung, Colorectal and Ovarian (PLCO) screening trial, argues that it would be a mistake to universally dismiss the PSA test. Rather, he says the decision to screen should be left up to patients and their doctors, who should take into consideration a man’s overall health, age and other risk factors.
Discouraging men with a high risk of dying from prostate cancer – particularly African-Americans and those with a family history of prostate cancer – from getting a PSA test would be misguided, he adds.
For men who choose to have a PSA test, Andriole urges caution if the test is abnormal. Doctors, he says, often do not need to rush to perform biopsies or recommend aggressive treatments because most prostate tumors grow slowly. In many cases, “active surveillance” may be practical, which involves periodic PSA tests and biopsies to monitor tumor growth rather than opting for immediate aggressive treatment.
Ending PSA screening all together would mean a return to the “pre-PSA” era when about a third of prostate cancers were advanced and incurable at the time of diagnosis.
Preliminary results of the PLCO trial, published in 2009 in the New England Journal of Medicine, indicated that routine PSA screening does not reduce deaths from prostate cancer among men ages 55-74 who had been followed for up to 10 years.
But Andriole says that a close look at younger, healthy men in the study showed an improvement in prostate cancer mortality among those who had PSA tests and digital rectal exams. With longer follow-up, there may be additional benefit to screening for younger men and men who are known to have a high risk of dying from the disease. Updated results of the study are expected to be published later this year.
“Routine annual PSA screening is not necessary for most men,” Andriole says. “But men with a high risk of dying from prostate cancer – particularly African-Americans and those with a family history of prostate cancer – should still be screened.”
Prostate cancer is the second most common cancer among men, after skin cancer. In 2010, nearly 220,000 U.S. men received a diagnosis of prostate cancer and an estimated 32,050 died of the disease.
Prostate Cancer Screening vsProstate Cancer Treatment
CALGARY, AB- October 7th,2011
Todaythe U.S. Preventive Services Task Force group announced that they are recommending men donot get screened for prostate cancer.
Dr. Bryan Donnelly, Chairman of the Prostate Cancer Centre in Calgary isconcerned about the confusion this task force may be creating around thedifference between screening someone suspected of prostate cancer and treatingthem once they have a definite diagnosis of prostate cancer.
Helikens the comparison to checking the oil in your vehicle. This is doneregularly to prevent damage to the engine.Sometimes all you need to do is add more oil but on occasion, furtherinvestigation may be required to prevent the engine from malfunctioning.
Dr. Donnellyand other physicians have produced a paper that will be released this fall inthe Canadian Journal of Urology that analyses the recent PSA screening studiesand have concluded that the PSA screening does save lives.
"A European study clearly showed that PSA testing allows us to diagnoseprostate cancer very early, when it is confined in the gland and can betreated," said Dr.Donnelly. "To disregard these results is irresponsible," he warned.
Knowing that men will use any excuse not to have their health checked, Dr.Donnelly worried that the reporting on this issue will only feed into thatexcuse. Advanced prostate cancer is incurable and the third most common causeof death in North America, one that is miserable, painful, and slow.
"The PSA test is not perfect, but it's the best we've got. When I startedin urology thirty-six years ago, 90 per cent of the men I saw had advancedprostate cancer. Today 90 per cent have treatable cancer. The one and onlydifference is PSA blood testing," Dr. Donnelly said.
AMERICAN UROLOGICAL ASSOCIATION RESPONDS TO NEW RECOMMENDATIONS ON PROSTATE CANCER SCREENING
Association urges men to speak with their physicians about the value of prostate cancer testing
LINTHICUM, MD, October 7, 2011–The American Urological Association (AUA) today released the following statement in response to the U.S. Preventive Services Task Force draft recommendations on the use of the prostate-specific antigen (PSA) test. The statement is attributed to AUA President Sushil S. Lacy, MD:
The American Urological Association (AUA) applauds the U.S. Preventive Services Task Force for its interest in reviewing the use of the prostate-specific antigen (PSA) test. However, we are concerned that the Task Force’s recommendations will ultimately do more harm than good to the many men at risk for prostate cancer both here in the United States and around the world. The AUA’s current clinical recommendations support the use of the PSA test, and it is our feeling that, when interpreted appropriately, the PSA test provides important information in the diagnosis, pre-treatment staging or risk assessment and monitoring of prostate cancer patients.
Not all prostate cancers require active treatment and not all prostate cancers are life threatening. The decision to proceed to active treatment is one that men should discuss in detail with their urologists to determine whether active treatment is necessary, or whether surveillance may be an option for their prostate cancer.
The AUA is currently preparing a new clinical guideline on this topic, and has convened a panel of experts to review not only the use of the PSA test, but also early detection of prostate cancer overall, taking into account the new tests and diagnostics that are becoming available. Until there is a better widespread test for this potentially devastating disease, the USPSTF – by disparaging the test – is doing a great disservice to the men worldwide who may benefit from the PSA test.
For more information about the AUA’s position on the early detection of prostate cancer, or to arrange an interview with an expert urologist, please contact the AUA Communications Office at 410-689-3932.
About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is the pre-eminent professional organization for urologists, with more than 18,000 members throughout the world. An educational nonprofit organization, the AUA pursues its mission of fostering the highest standards of urologic care by carrying out a wide variety of programs for members and their patients.
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October 14, 2010 – eCanadaNow
British researchers have created a urine test that is said to be twice as accurate in determining the risk of prostate cancer than the current PSA blood test.
The urine test is said to be a cheap and simple way to detect and predict cancerous changes in the prostate. The test is believed to be available to doctors in four years.
For full article: Breakthrough in Predicting Prostate Cancer http://www.ecanadanow.com/science/2010/10/14/breakthrough-in-predicting-prostate-cancer/
November 6, 2010
Pictures: Calgary men get naked for Cancer research!
Saturday was a sunny, beautiful and just a little chilly morning here in Calgary. But I had no right to complain about the cold weather, not when there were over forty guys lined up on 9th avenue for the first ever #nakedespy. The prostate cancer fundraiser saw that the first thirty guys to show up at Espy in their underwear get a $400 wardrobe for free. All they had to do was make a donation to the Prostate Cancer Centre here in the city.
It was the brainchild of Megan Szanik, the store’s owner whose father and father in law have both been effected by the disease. Before the doors opened, Calgary’s very own Brett Wilson showed up to support the unique event. A prostate cancer survivor himself, Wilson encouraged all the guys and thanked them individually for helping bring attention to the prostate cancer research.
The final tally raised for the event was more than $3500!!!! Such an amazing event that the neighborhood of Inglewood will be talking about for a very long time!
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Man Van takes cancer fight to streets
By JENNA McMURRAY, Sun Media
Last Updated: 22nd July 2009, 2:22pm
Despite the initial screening for prostate cancer being a simple 15-minute blood test, many men don’t bother taking the time to get checked, a problem the Prostate Cancer Centre in Calgary say they hope to conquer with the launch of the Man Van.
The 25-ft. motor home equipped with leather recliners and flat screen televisions was rolled out Wednesday and will travel around the city and eventually, the southern half of the province, to screen men for prostate cancer.
“Men are not as good as women are for taking care of themselves so we thought, if they aren’t going to come to us, we’ll go to them,” said Tom Kenny, the centre’s executive director.
“We’re trying to promote men over the age of 40 getting their prostate specific antigen (PSA) tested.”
The mobile unit is the first of its kind in Canada and is expected to screen approximately 4,000 men in and around Calgary this year, making PSA tests accessible to those who may not have time to schedule an appointment with a doctor.
“We thought if we presented the test in a way that was easy to get to it would help,” said Kenny, noting blood test results are available to patients the day after their screenings.
Approximately 2,400 Alberta men will be diagnosed with the disease this year and 430 will die.
It is estimated that one in every six men will develop prostate cancer in their lifetime, though there are no early warning signs.
Males over the age of 40 are encouraged to get an initial screening and those over the age of 50 should be getting checked at least once a year, said Kenny.
The Man Van is currently looking for a main sponsor to help cover the daily cost of $2,500 to run the system, he said.
Currently it is being funded through donations to the Prostate Cancer Centre.