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</o:shapelayout></xml><![endif]--></head><body lang=EN-CA link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='color:#1F497D'>Hi all:<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>See below for the PCCN Oakville/Mississauga e- newsletter.<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Thx.<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Glen <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0cm 0cm 0cm'><p class=MsoNormal><span lang=EN-US style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><br><b>To:</b> PC Support Group<br><b>Subject:</b> PC Information Newsletter - November<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><i><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Hello to all. FYI for new folks, this is my summary of anything interesting or educational that I picked up in my reading over the past month. <br>Enjoy your weekend. Feel free to comment and/or ask questions. Next Support Group meeting Wednesday Dec 18<sup>th</sup>.<o:p></o:p></span></i></p><p class=MsoNormal><i><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Walter<o:p></o:p></span></i></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>A Common Sense Approach to the PSA Test<o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Dr. Larry Goldenberg is a well-respected urologist and scientist at the Vancouver Prostate Centre and author of The Intelligent Patient Guide to Prostate Cancer (copy in our Wellspring library). Here he tells it like it is on the PSA test</span><span lang=EN-US style='font-size:12.0pt;font-family:"Verdana","sans-serif"'> “</span><i><span lang=EN-US style='font-size:11.5pt;font-family:"Arial","sans-serif";color:black;background:white'>PSA is not stepping onto a slippery slope to inevitable biopsies, surgery, radiation and chemotherapy; it is just a single decision point”. </span></i><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Well worth reading and sharing.</span><span lang=EN-US style='font-size:12.0pt;font-family:"Verdana","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US><a href="https://vancouversun.com/opinion/op-ed/larry-goldenberg-checking-psa-is-not-stepping-onto-a-slippery-slope-to-inevitable-biopsies">https://vancouversun.com/opinion/op-ed/larry-goldenberg-checking-psa-is-not-stepping-onto-a-slippery-slope-to-inevitable-biopsies</a><o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US><o:p> </o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Surgery or Radiation?<o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>I had my surgery almost 9 years ago. I have said in meetings that, if it were today, I would give radiation more serious consideration because of the advances that have taken place. In this short video, Dr. Mark Scholz makes a similar case for radiation.<o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US><a href="https://www.youtube.com/watch?v=Pya8N78bR7s&feature=youtu.be&fbclid=IwAR2DsJFeEvktgh60bYWBATMfFPGCaA0nK_0jIfBJcMdDZgnywtHGpxSd9ZM&app=desktop">https://www.youtube.com/watch?v=Pya8N78bR7s&feature=youtu.be&fbclid=IwAR2DsJFeEvktgh60bYWBATMfFPGCaA0nK_0jIfBJcMdDZgnywtHGpxSd9ZM&app=desktop</a><o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>LINAC at Sunnybrook<o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Back in August, I reported on Sunnybrook starting up their new MRI-Linac radiation equipment. The first prostate cancer patient has now been treated. </span><span lang=EN-US><a href="https://sunnybrook.ca/media/item.asp?c=1&i=2002&f=first-prostate-patient-mr-linac">https://sunnybrook.ca/media/item.asp?c=1&i=2002&f=first-prostate-patient-mr-linac</a><o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Think of it this way – what’s the use of having new techniques such as SABR that can direct radiation within a millimeter or two if the prostate itself moves more than that from one treatment to the next? That’s where ‘real-time’ MRI guidance comes in. </span><span lang=EN-US><a href="https://sunnybrook.ca/content/?page=occ-radonc-cancer-mr-linac">https://sunnybrook.ca/content/?page=occ-radonc-cancer-mr-linac</a></span><span lang=EN-US style='font-family:"Verdana","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Germline Testing<o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Germline Testing checks a person’s DNA for genetic mutations, including those that may increase their lifetime risk of developing cancers such as prostate cancer and others. Here is an indication of how germline testing may soon be incorporated into diagnosis and treatment<o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US><a href="https://www.renalandurologynews.com/home/expert-perspectives/brian-t-helfand-md-phd/">https://www.renalandurologynews.com/home/expert-perspectives/brian-t-helfand-md-phd/</a><o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US><o:p> </o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Survival vs. Quality of Life<o:p></o:p></span></p><p class=MsoNormal><i><span lang=EN-US style='font-size:11.5pt;font-family:"Arial","sans-serif"'>“<span style='color:#212529;background:white'>Although men with prostate cancer are living longer, they are not necessarily living well, with symptom burden increasing and quality of life declining over time”.</span></span></i><i><span lang=EN-US style='font-family:"Verdana","sans-serif";color:#212529;background:white'> <br></span></i><span lang=EN-US style='font-family:"Verdana","sans-serif";color:#212529;background:white'>This Australian study highlights what is becoming an ever-increasing issue in the care of PC patients. More and more new drugs, new chemo treatments, radio nucleotide treatments, combination therapies, third-line treatments after second-line treatments, etc. may add to survival but at what cost to QOL? </span><span lang=EN-US><a href="https://www1.racgp.org.au/newsgp/clinical/prostate-cancer-survival-rates-at-all-time-high-bu">https://www1.racgp.org.au/newsgp/clinical/prostate-cancer-survival-rates-at-all-time-high-bu</a><o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US><o:p> </o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>When Treatment Stops Working<o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>This is a short, straightforward explanation of the steps in the evolution of prostate cancer and the treatments for it.<o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US><a href="https://www.pcf.org/c/when-treatment-stops-working-blame-resistance/?utm_source=PCFlist&utm_medium=email&utm_campaign=2019EOYE6d">https://www.pcf.org/c/when-treatment-stops-working-blame-resistance/?utm_source=PCFlist&utm_medium=email&utm_campaign=2019EOYE6d</a><o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US><o:p> </o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Treatment of Advanced PC<o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>Not so short or straightforward but, if you are interested enough to get into the details of new treatments and emerging treatments for advanced PC, you will want to read this summary </span><span lang=EN-US><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441973/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441973/</a><o:p></o:p></span></p><p class=MsoNormal><i><span lang=EN-US style='font-family:"Verdana","sans-serif"'><o:p> </o:p></span></i></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif";background:white'>Optimal sequencing of Enzalutamide and Abiraterone Acetate </span><span lang=EN-US style='font-family:"Verdana","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US style='font-family:"Verdana","sans-serif"'>In treatment of metastatic PC, ADT stops working at some point, PSA goes up and the patient is ‘castrate resistant’ (mCRPC). Next comes abiraterone acetate (Zytiga) or enzalutamide (Xtandi) and when one of these stops working the oncologist might then try the other. This article suggests that </span><i><span lang=EN-US style='font-size:11.5pt;font-family:"Arial","sans-serif";background:white'>using a sequencing strategy of abiraterone acetate followed by enzalutamide provides the greatest clinical benefit.</span></i><i><span lang=EN-US style='font-size:11.5pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></i></p><p class=MsoNormal><span lang=EN-US><a href="https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(19)30688-6/fulltext?rss=yes#.Xdb1lKgQbdU.twitter">https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(19)30688-6/fulltext?rss=yes#.Xdb1lKgQbdU.twitter</a><o:p></o:p></span></p><p class=MsoNormal><span lang=EN-US><o:p> </o:p></span></p><p class=MsoNormal><span lang=EN-US><o:p> </o:p></span></p></div></body></html>