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--></style></head><body lang=EN-CA link=blue vlink="#954F72" style='word-wrap:break-word'><div class=WordSection1><p class=MsoNormal><span class=DefaultFontHxMailStyle>Interesting publication wrt Active Surveillance vs. PCa treatment.<o:p></o:p></span></p><p class=MsoNormal><span class=DefaultFontHxMailStyle><o:p> </o:p></span></p><p class=MsoNormal>Sent from <a href="https://go.microsoft.com/fwlink/?LinkId=550986">Mail</a> for Windows</p><p class=MsoNormal><span class=DefaultFontHxMailStyle><o:p> </o:p></span></p><div style='mso-element:para-border-div;border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0cm 0cm 0cm'><p class=MsoNormal style='border:none;padding:0cm'><b>From: </b><a href="mailto:healthbeat@mail.health.harvard.edu">Harvard Medical School</a><br><b>Sent: </b>June 23, 2022 1:37 PM<br><b>To: </b><a href="mailto:glen46nor@gmail.com">Glen</a><br><b>Subject: </b>Active surveillance over prostate cancer treatment: Is it right for you?</p></div><p class=MsoNormal><span class=DefaultFontHxMailStyle><o:p> </o:p></span></p><div id=PreHeader><p class=MsoNormal><span style='font-family:"Arial",sans-serif;display:none'>The reason for choosing active surveillance is to defer immediate surgery or radiation.<o:p></o:p></span></p></div><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><img border=0 width=1 height=1 style='width:.0104in;height:.0104in' id="_x0000_i1037" src="http://www.ne16.com/do/3811851/20302661/1000401/1.gif?x=a792a6b8"></span><span style='font-family:"Arial",sans-serif'><o:p></o:p></span></p><div align=center><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;background:#E5E5E5;border-collapse:collapse' id=body-wrapper-table><tr><td width="100%" style='width:100.0%;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%' id=body-wrapper><div align=center><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=640 style='width:480.0pt;border-collapse:collapse' id=outer-wrapper-table><tr><td style='padding:0cm 3.0pt 0cm 3.0pt;-webkit-text-size-adjust:100%' id=outer-wrapper><table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 style='border-collapse:collapse;border:none' id=inner-wrapper-table><tr><td style='border:solid #CCCCCC 1.0pt;background:white;padding:0cm 0cm 0cm 0cm'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 style='border-collapse:collapse'><tr><td style='background:white;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=640 style='width:480.0pt;border-collapse:collapse'><tr><td width=320 valign=top style='width:240.0pt;padding:0cm 0cm 0cm 0cm'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width=320 style='width:240.0pt;border-collapse:collapse'><tr><td style='background:white;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%' id=logo-block><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=320 style='width:240.0pt;border-collapse:collapse'><tr><td style='padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%'><p class=MsoNormal><a href="http://www.ne16.com/t/3811851/20302661/2465843/0/1000401/?f5d63f87=SEIyMDIyMDYyMy1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=9d3415f8"><span style='text-decoration:none'><img border=0 width=320 height=74 style='width:3.3333in;height:.7708in' id="_x0000_i1036" src="https://domf5oio6qrcr.cloudfront.net/images/email/healthbeat_masthead_mobile-2@2x.png" alt=HEALTHbeat></span></a><o:p></o:p></p></td></tr></table></td></tr><tr><td style='background:white;padding:6.0pt 24.0pt 6.0pt 24.0pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial",sans-serif;color:black'><a href="http://www.ne16.com/t/3811851/20302661/2465644/0/1000401/?f5d63f87=SEIyMDIyMDYyMy1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=d2954f22"><span style='font-family:"Calibri",sans-serif;color:#3D5D8F'>Subscribe</span></a> | <a href="http://www.ne16.com/t/3811851/20302661/2465836/0/1000401/?f5d63f87=SEIyMDIyMDYyMy1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=1f464e76"><span style='font-family:"Calibri",sans-serif;color:#3D5D8F'>Shop the Bookstore</span></a><o:p></o:p></span></p></td></tr></table></td><td width=320 valign=top style='width:240.0pt;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=320 style='width:240.0pt;border-collapse:collapse'><tr><td style='background:white;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%' id=icon-block><p class=MsoNormal style='line-height:15.0pt'><span style='color:black'><a href="http://www.ne16.com/t/3811851/20302661/2465843/1/1000401/?f5d63f87=SEIyMDIyMDYyMy1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=ef3073df"><span style='font-size:10.5pt;font-family:"Georgia",serif;text-decoration:none'><img border=0 width=320 height=107 style='width:3.3333in;height:1.1145in' id="_x0000_i1035" src="https://domf5oio6qrcr.cloudfront.net/images/email/logo-harvard_medical_school_mobile@2x.png" alt="Harvard Medical School"></span></a></span><span style='font-size:10.5pt;font-family:"Georgia",serif'><o:p></o:p></span></p></td></tr></table></td></tr></table></td></tr></table></td></tr><tr><td style='border-top:none;border-left:solid #CCCCCC 1.0pt;border-bottom:solid #CCCCCC 6.0pt;border-right:solid #CCCCCC 1.0pt;background:white;padding:24.0pt 24.0pt 24.0pt 24.0pt;-webkit-text-size-adjust:100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left style='border-collapse:collapse'><tr><td style='background:white;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%'><h1 style='mso-margin-top-alt:0cm;margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm'><span style='font-size:21.0pt;font-family:"Tahoma",sans-serif;color:black;font-weight:normal'>Active surveillance over prostate cancer treatment: Is it right for you? <o:p></o:p></span></h1><table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 style='border:solid #AAAAAA 1.5pt'><tr><td style='border:none;padding:6.0pt 6.0pt 6.0pt 6.0pt;-webkit-text-size-adjust:100%'><p class=MsoNormal align=center style='margin-bottom:12.0pt;text-align:center'><img border=0 width=556 height=371 style='width:5.7916in;height:3.8645in' id="_x0000_i1034" src="https://domf5oio6qrcr.cloudfront.net/medialibrary/12670/6c5326bb-21d0-4a68-91ae-0253271cb821.jpg" alt="Doctor showing tablet to patient in medical practice."><o:p></o:p></p></td></tr></table><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'>More men are choosing active surveillance for their low-risk prostate cancer diagnosis. While this "wait and see" approach may appear passive, it can provide opportunities for men to get more active about their overall wellness.<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'>There is a good chance men will live a long time with low-risk prostate cancer, and they should do everything they can to ensure their life is the healthiest and the highest quality it can be.<o:p></o:p></span></p><table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 style='background:#FEFEFE;border-collapse:collapse;border:none'><tr><td style='border:solid #AAAAAA 1.0pt;padding:12.0pt 12.0pt 12.0pt 12.0pt;-webkit-text-size-adjust:100%'><p class=MsoNormal style='margin-bottom:12.0pt'><span class=like-h3><b><span style='font-size:11.5pt;font-family:"Tahoma",sans-serif;color:black'>Get your copy of </span></b></span><em><b><span style='font-size:11.5pt;font-family:"Tahoma",sans-serif;color:black'>2022 Annual Report on Prostate Diseases</span></b></em><span style='font-size:10.0pt;font-family:"Tahoma",sans-serif;color:black'><br>  <o:p></o:p></span></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left style='border-collapse:collapse'><tr><td width=113 valign=top style='width:84.75pt;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 style='border-collapse:collapse'><tr><td style='background:#FEFEFE;padding:.75pt .75pt .75pt .75pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='color:black'><a href="http://www.ne16.com/t/3811851/20302661/2486644/0/1000401/?f5d63f87=SEIyMDIyMDYyMy1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=ea659980"><span style='color:#3D5D8F;text-decoration:none'><img border=0 width=100 height=126 style='width:1.0416in;height:1.3125in' id="_x0000_i1033" src="https://domf5oio6qrcr.cloudfront.net/medialibrary/12189/Prostate_PA0122_3d-cover.png" alt="2022 Annual Report on Prostate Diseases"></span></a></span><o:p></o:p></p></td></tr></table></td><td valign=top style='padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma",sans-serif;color:black'>Most men eventually develop some type of prostate problem, and when they do there are usually no easy solutions. More than a primer on prostate conditions, this Special Health Report, the <em><span style='font-family:"Tahoma",sans-serif'>Annual Report on Prostate Diseases,</span></em> includes roundtable discussions with experts at the forefront of prostate research, interviews with men about their treatment decisions, and the latest thinking on complementary therapies. This report will provide you with the information you need to understand the current controversies, avoid common pitfalls, and work with your doctor to make informed choices about your prostate health.<br><br></span><a href="http://www.ne16.com/t/3811851/20302661/2486644/1/1000401/?f5d63f87=SEIyMDIyMDYyMy1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=a8072f5a"><span style='font-size:10.0pt;font-family:"Tahoma",sans-serif;color:#3D5D8F;text-decoration:none'><img border=0 width=176 height=26 style='width:1.8333in;height:.2708in' id="_x0000_i1032" src="https://domf5oio6qrcr.cloudfront.net/media/images/landing_page_offers/button-read_more-2@2x.png" alt="Read More"></span></a><span style='font-size:10.0pt;font-family:"Tahoma",sans-serif;color:black'><o:p></o:p></span></p></td></tr></table></td></tr></table><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'>The choice to follow active surveillance begins after a prostate biopsy, which provides information needed to predict how fast the cancer is growing and the probability of spreading.<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'>Generally, active surveillance is an option for men with low-grade cancer that hasn’t spread, who have a PSA level of less than 10 nanograms per milliliter and a Gleason score of 6 or less.<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'>(The Gleason system assigns 1-to-5 rankings to the two most common types of cancer cells in a man’s biopsied tissue. The two rankings are added together to get a Gleason score, with 10 being the highest. The higher the number, the greater chance the cancer will quickly grow and spread.)<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'>The reason for choosing active surveillance is to defer immediate surgery or radiation, since low-grade prostate cancer is unlikely to progress. That also means avoiding possible side effects of treatment, such as erectile dysfunction, urinary incontinence, and bowel problems.<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'>Men on active surveillance regularly follow up with their doctor for PSA tests, MRI scans, and prostate biopsies. If there is evidence the cancer has progressed, such as a higher Gleason score or cancer in a greater number of biopsies, then treatment should be considered.<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'>Men should see their cancer diagnosis as a wake-up call to make lifestyle changes that could not only improve their long-term cancer outcome, but also protect against other serious health issues like heart attacks and strokes. That means eating a Mediterranean or similar healthy diet, exercising more, and shedding pounds if you are overweight.<br><br><strong><span style='font-family:"Tahoma",sans-serif'>To learn more about active surveillance and other treatment options, read the </span></strong><a href="http://www.ne16.com/t/3811851/20302661/2486644/2/1000401/?f5d63f87=SEIyMDIyMDYyMy1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=a1a22e77"><em><span style='font-family:"Tahoma",sans-serif'>Annual Report on Prostate Disease</span></em></a><strong><span style='font-family:"Tahoma",sans-serif'> from Harvard Medical School.</span></strong><o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%'><strong><span style='font-size:8.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'>Image: Westend61/Getty Images</span></strong><strong><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'> </span></strong><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:#4D4D4F'><o:p></o:p></span></p><table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 style='background:#EFEFEF;border-collapse:collapse;border:none'><tr><td style='border:solid #CCCCCC 1.0pt;border-right:none;padding:2.25pt 2.25pt 2.25pt 12.0pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span class=rbi-text><b><span style='font-size:10.0pt;color:black'>Share this story:</span></b></span><o:p></o:p></p></td><td style='border:solid #CCCCCC 1.0pt;border-left:none;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><table class=MsoNormalTable b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border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse' id="feature-inject_details"><tr><td width="3%" valign=top style='width:3.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>•<o:p></o:p></span></p></td><td width="97%" valign=top style='width:97.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>A year of progress in prostate research<o:p></o:p></span></p></td></tr><tr><td width="3%" valign=top style='width:3.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>•<o:p></o:p></span></p></td><td width="97%" valign=top style='width:97.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>An introduction to the prostate gland<o:p></o:p></span></p></td></tr><tr><td width="3%" valign=top style='width:3.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>•<o:p></o:p></span></p></td><td width="97%" valign=top style='width:97.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>Inflammation of the prostate (prostatitis)<o:p></o:p></span></p></td></tr><tr><td width="3%" valign=top style='width:3.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>•<o:p></o:p></span></p></td><td width="97%" valign=top style='width:97.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>Prostate enlargement (benign prostatic hyperplasia)<o:p></o:p></span></p></td></tr><tr><td width="3%" valign=top style='width:3.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>•<o:p></o:p></span></p></td><td width="97%" valign=top style='width:97.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>Prostate cancer<o:p></o:p></span></p></td></tr><tr><td width="3%" valign=top style='width:3.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>•<o:p></o:p></span></p></td><td width="97%" valign=top style='width:97.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>A patient's perspective: One man’s experience with radiation cystitis following treatment for prostate cancer<o:p></o:p></span></p></td></tr><tr><td width="3%" valign=top style='width:3.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>•<o:p></o:p></span></p></td><td width="97%" valign=top style='width:97.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'>SPECIAL SECTION: Biomarkers and genetic testing: Aids to diagnosis and treatment<o:p></o:p></span></p></td></tr></table><p class=MsoNormal style='line-height:15.0pt'><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif;color:black'><br><a href="http://www.ne16.com/t/3811851/20302661/2486644/5/1000401/?f5d63f87=SEIyMDIyMDYyMy1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=2cdc7589"><strong><span style='font-family:"Tahoma",sans-serif;color:#3D5D8F'>Click here to read more »</span></strong><span style='color:#3D5D8F'> </span></a></span><span style='font-size:10.5pt;font-family:"Tahoma",sans-serif'><o:p></o:p></span></p></td></tr></table></td></tr></table></td></tr></table></td></tr><tr><td style='border-top:none;border-left:solid #CCCCCC 1.0pt;border-bottom:none;border-right:solid #CCCCCC 1.0pt;background:#EEEEEE;padding:24.0pt 24.0pt 15.0pt 24.0pt;-webkit-text-size-adjust:100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td style='background:#EEEEEE;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%'><p class=MsoNormal style='line-height:14.4pt'><span style='font-size:8.5pt;font-family:"Arial",sans-serif;color:black'>Harvard Medical School offers special reports on over 60 health topics.<br>Visit our website at <a href="http://www.ne16.com/t/3811851/20302661/2465843/3/1000401/?f5d63f87=SEIyMDIyMDYyMy1Qcm9zdGF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