Representing CPCN from the local support group: Bob Shiell, president CPCN and ProstAid Calgary

1. Representing CPCN from the local support group: Bob Shiell, president CPCN and ProstAid Calgary

2. If women got prostate cancer…. …everyone would know about it! • Breast cancer and prostate cancer have the same rate of incidence, yet breast cancer receives much more press! • Women are motivated to talk about their health concerns, and rally for support. • Men are motivated to find excuses to ignore their health concerns, and hide.

3. The difference between women and men

4. Where is the prostate, anyway? • Surrounds upper part of urethra • Size and texture of a small ripe plum

5. Lymph Node Other organs Tumor PROSTATE GLAND Systemic Spread Tumor CAPSULE Possible levels of prostate cancer at diagnosis Local-regional disease spread

6. The risk is bigger than you think… • 1 in 6 Canadian men will be diagnosed with prostate cancer in their lifetime. • It is the most common cancerin Canadian men - an estimated 22,300 were diagnosed in 2006. • Only lung cancer takes more lives: an estimated 4,300 Canadian men died from prostate cancer in 2006.

7. It’s not an old man’s disease… • Men in their forties are at risk. • Risk increases with age: 30-39 . . . . . . . . . . 5 40-49 . . . . . . . . 340 50-59 . . . . . . . 3500 60-69 . . . . . . . 8000 70-79 . . . . . . . 7000 80+ . . . . . . . . 3400 • A man over 50 is 3x more likely to die from prostate cancer than be killed in a car accident. Not just this guy! Breakdown of estimated 22,300 cases (some figures rounded off)

8. The trick is catching it early… • 95% of prostate cancer is curable if detected and treated in the early stages. • There are no symptoms in the early stages so it’s essential to check the prostate every year via two tests available through a doctor. To ignore the risk of prostate cancer is equivalent to…

9. Things you don’t learn from the Discovery Channel • A man is 1,200 times more likely to die from prostate cancer than be killed by lightning. • Men who have actually been struck by lightning – and lived to talk about it – will say it took them “by surprise.” So will men who are diagnosed with prostate cancer.

10. Things you don’t learn from the Discovery Channel • A man is 108,000 times more likely to die from prostate cancer than be lunch for a shark. • Sharks are what they eat and so are humans. Men who choose to eat less red meat/dairy and more vegetables/fruit may reduce their risk of developing advanced prostate cancer.

11. Things you don’t learn from the Discovery Channel • A man is 900 times more likely to die from prostate cancer than be killed in a mountain climbing accident. • To have your prostate checked takes only 10 minutes, far lesstime than it takes to climb a mountain.

12. This is too easy. Things you don’t learn from the Discovery Channel • Unlike a snake bite, prostate cancer doesn’t give you blurred vision and a rapid pulse. • In fact, prostate cancer has no symptoms in its early stages. That’s why early detection is so important.

13. Prostate Cancer Survival Checklist • See your doctor once a year to have your prostate checked. • See your doctor sooner, if you have symptoms of prostate trouble! • Eat more nutritious foods. • Take a multi-vitamin daily. • Watch your weight. • Exercise. • Know your PSA score!

14. Prostate Cancer Survival Checklist • Don’t wait to see a doctor if you experience prostate trouble e.g.,* • Changes in urination habits or flow • Erectile difficulties • Pain in the pelvis, hips or lower back • Prostate trouble is a warning sign but not confirmation of prostate cancer! *Not a complete list of symptoms!

15. Oh, you’re fine. *The meaning of a PSA score depends on many factors, so don’t compare your score to anybody else’s – only your own benchmark! Prostate Cancer Survival Checklist • What is the right age? • Start talking to your doctor about your prostate at age 40. • Take a single PSA test at age 40 to establish a benchmark for comparison. • Continue to have your prostate checked once a year. • Know your PSA score!Ask your doctor for a number even if he says you’re “fine”!

16. Prostate Cancer Survival Checklist • What are the risk factors? • Age: risk increases with age. • Race: men of African or Caribbean descent are more likely to be diagnosed than Caucasians. • Family history: the risk doubles if one close relative (i.e, father, brother) has it. With two close relatives, the risk increases 5 to 10 times. • Diet: some studies suggest that a high-fat diet, particularly red meat and dairy products, stimulates the growth of prostate cancer cells. Me, too, Dad

17. What to say to opponents of the PSA test… • Yes, we need a better test! • The PSA test is not perfect. There are “false positives” and “false negatives,” meaning it can say you have prostate cancer when you don’t, and say you don’t have prostate cancer when you do. • Still, it works, it saves lives and countless prostate cancer survivors are thankful.

18. What to say to opponents of the PSA test… • Since widespread use of the PSA test began in 1991: • 5-year survival rates have risen from 75% to 99%. • The incidence of advanced prostate cancer at the time of diagnosis has decreased by 75%.

19. Prostate Cancer Survival Checklist • Eat 5 servings of fruit and veggies per day. • More richly coloured fruits and vegetables • More “cruciferous” vegetables – broccoli, cauliflower, cabbage, brussel sprouts • More tomatoes and cooked tomato products (e.g. sauce) • More garlic,onions, shallots • Key words: phytochemicals, anti-oxidants,lycopene, glucosinolates, allyl sulphides

20. Prostate Cancer Survival Checklist • Other diet tips: • More fibre - at least 25 grams per day • Less red meat and less saturated fat • No 2% or whole milk; only skim or soy milk • More omega 3 fatty acids e.g. nuts and fish (not fried!) such as salmon • More soy protein (25 grams/day) and ground flaxseed (1-2 tbsp/day) • More green tea • Key words: Isoflavones (soy), Polyphenols (tea)

21. Prostate Cancer Survival Checklist • Take a multivitamin daily. • While it’s better to get essential nutrients through food, vitamins can help bolster your daily intake. Focus on: • Vitamin C and E • Vitamin D (supplements are essential in the winter season when sunlight is minimal) • Selenium

22. What’s wrong with this picture?

23. What to know about treatment • The right treatment for each man depends on the individual case. For early cancer that has not spread outside the prostate gland or nearby area, the options are: • “Active surveillance”: defer treatment and watch closely for signs of progression. • Surgery: remove the prostate via a radical prostatectomy or laparoscopic surgery. • Radiation: kill cancer cells with external beam radiation, or by implanting tiny radioactive seeds. • Other: freeze cancer cells with cryotherapy or heat them with HIFU (High Intensity Focused Ultrasound).

24. What to know about treatment • Depending on the treatment and the individual, side effects can range from short to long term incontinence or impotence, to other effects such aspain and depression. • Untreated, prostate cancer is fatal.Side effects, although a concern, donot outweigh the benefits of treatment.

25. What to know about treatment • For prostate cancer that returns after initial therapy, the options depend on the case. • Some may require observation, some ‘salvage’ radiation treatment and some may proceed to hormone therapy.

26. What to know about treatment • For advanced or metastatic prostate cancer, the options include: • Hormone Therapy: starve the cancer cells of testosterone with drugs that inhibit testosterone production. • Chemotherapy: take medications that are toxic to cancer cells. Generally used to treat cancers that have become resistant to hormone therapy.

27. What to know about treatment • All patients have these options: • Complementary and alternative medicines • Some patients try treatments in addition to, or instead of conventional treatments. • Investigational treatment • Some patients enroll in research studies known as clinical trials, to try promising new therapies or techniques.

28. Get checked, get educated • For more information: • www.cpcn.org • www.prostaid.org • Our prostate cancer support group meets • Time: 7:30 PM on the 2nd Tuesday of the month • Place: Foothills Hospital Auditorum • It’s free and everyone is welcome!