Prostate Cancer Awareness

How a Month of Moustaches May Be the Key to Beating Prostate Cancer

Sonya Friesen

Men’s health charity Movember kicks off its annual fundraising campaign every November 1st, encouraging participants to grow moustaches throughout the month in the name of men’s health. While the cause has evolved from its humble beginnings, Movember continues to be rooted in prostate cancer awareness. To some, the charity may seem like just a bit of fun — something to ward off the winter blues while supporting a good cause. But Movember has played a significant role in not only driving global awareness for prostate cancer, but elevating the quality of treatments, increasing the diversity of research, and making prostate cancer one of the most widely-known cancers in men.

Movember has been the catalyst for unparalleled global collaboration within the prostate cancer space over the last 10 years, leading to important scientific breakthroughs

in treatment and research that have quite literally been made possible by the annual moustaches. In 2015, Movember established a global network of researchers from Canada to Australia, working to find more accurate, less invasive tests for prostate cancer. Current tests — like the PSA blood test — help diagnose the disease but can be unreliable, allowing for unnecessary biopsies or for some men’s cancers to go missed. By bringing the scientific community’s brightest minds together and enabling them to work in conjunction, Movember is hoping to find effective tests that allow clinicians to make better-informed decisions about their patients’ treatment.

Sharing knowledge of what works and what doesn’t not only reduces duplication of effort, it also allows scientists to build on each other’s learning. Thanks to this unique strategy, there are now some promising developments on the horizon. These include the results from a Canadian study, published earlier this year, and built on the findings of a European study, which found compelling evidence in favour of using MRI-guided biopsies. And in Calgary,

a local physician's office has signed up to act as a pilot site for a Movemberfunded urine test developed in the U.K. that tells clinicians whether their patient is likely to need active treatment within the next five years.

And it’s not just in the bio-medical world that Movember-funded projects are changing the lives of prostate cancer patients. True North is a global website that aims to guide those living with prostate cancer through the experience, providing helpful information that allows users to make informed decisions, receive care, manage symptoms, and share lived experiences.

It’s easy to get caught up in the excitement of Movember. But so often we forget that these moustaches, miles moved, and unique fundraising feats are not done in vain, but are making a real difference in the lives of men living with prostate cancer all around the world.

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Designer: Kylie Armishaw Content & Web Editor: Karthik Talwar Content Strategist: Emma Yordanov All images are from Getty Images unless otherwise credited. This section was created by Mediaplanet and did not involve Maclean’s magazine or its editorial departments. Send all inquiries to ca.editorial@mediaplanet.com.

When It Comes to Prostate Cancer, Awareness and Early Diagnosis Save Lives

After adopting a healthy lifestyle and losing over 50 pounds, Charlie Taylor was in the best shape of his life — but then he was diagnosed with prostate cancer. We chatted with Charlie to learn about his prostate cancer journey and his advice for others going through a similar experience.

Tell us a bit about yourself, your health journey, and your diagnosis.

I’m 58 years old and have been married to my wife Kelly for 34 years. We have two adult children and with their partners, we have three awesome grandsons. I’ve worked in the automotive industry for 40 years. I officiated basketball in Canada for 35 years. I love spending time outdoors and summers on Washademoak Lake.

When I was 49 years old, I was diagnosed with an elevated prostate-specific antigen (PSA), and I was sent to a urologist by my family doctor. More testing was done and just after my 50th birthday, I was diagnosed with prostate cancer. Twelve months prior to my diagnosis, I worked hard on becoming healthier by changing my lifestyle through diet and exercise. I was in the best shape I had been in for a long time. I had dropped 50 pounds and had no symptoms. Two weeks after my diagnosis, I had a radical prostatectomy and was then sent to an oncologist for further treatment. My oncologist tested my PSA every six months and it was undetectable — and it still is. To this day, I have not needed further treatment.

I have one side effect from surgery, and I deal with this by taking medication. On a positive note, I’ve won the battle against prostate cancer and am now here celebrating with my family and friends.

What’s the biggest misconception about prostate cancer?

My father lost his battle with prostate cancer at the age of 68, only six weeks after his diagnosis back in 2000.

One thing I hear a lot is, “Well, if you’re going to get cancer, this is the one to get.” Cancer is cancer. If detected early, prostate cancer has a 90 percent survival rate, but I’ve known a lot of people who have lost the battle.

I'm a big believer in the PSA test. There’s a lot of controversy

over a PSA test because an elevated PSA doesn’t mean that you have prostate cancer, but it does tell you that there’s something wrong and that more investigation is needed. As men, we only have two tests to detect prostate cancer. One is the PSA test and the other is the digital rectal exam.

What advice would you give to Canadians who have recently been diagnosed with prostate cancer or who have a loved one who has recently been diagnosed?

The advice I’d give to men and their families would be to listen to your doctors and do what they suggest. If I hadn’t listened to my doctors, I may not be here today. If you’re not comfortable with what your doctor tells you, seek a second opinion.

How did you get involved with the former Prostate Cancer Canada and the Canadian Cancer Society, and what role did they play in your experience?

I attended a prostate cancer support group in Moncton just after my surgery as it helped me in my recovery and a couple of years later, I took over the group as the leader.

I found that for many, more personal one-on-one meetings with newly-diagnosed men and their families were better received. That’s how and why I volunteer as a peer support person if needed.

Do you have any additional thoughts that you’d like to share?

I recommend that men over the age of 50 get tested for prostate cancer, and if there’s a history of the disease in your family, then start getting your PSA checked at the age of 40. I started at the age of 42 and if I hadn’t, I may not be here today to share my story. Early detection saves lives. It did in my case.

The advice I'd give to men and their families would be, to listen to your doctors and do what they suggest.

This article was brought to you by one of Canada’s leading research-based pharmaceutical companies.

Photos Courtesy of Charlie Taylor

Taking Control of Prostate Cancer

How well do you know your body?

Knowing what’s normal for you helps you notice changes. When you notice something different about your body — like a new growth or lump, increased fatigue, or dramatic weight loss — it needs to be checked out. There are also tests that help find different types of cancer before you’ve even noticed symptoms.

If you have a prostate, you may want to consider the benefits and limitations of testing for prostate cancer.

When prostate cancer is found and treated early, the chances of successful treatment are better. Get regular health checkups and see your doctor if you have any symptoms or are worried about your health.

PSA testing

The prostate-specific antigen (PSA) test is a key step in detecting prostate cancer early. It’s a blood test that can determine if a person’s PSA levels are higher than they should be — this can indicate that something might be wrong before symptoms are noticed.

The Canadian Cancer Society recommends talking to your doctor about the PSA test, considering your personal risk factors, and then making an informed decision about whether the PSA test is right for you.

• If you’re at average risk of developing prostate cancer, consider testing from age 50.

• If you’re at high risk of developing prostate cancer, consider testing from age 45.

Black men and those with a family history of prostate cancer are considered to be at high risk.

Deciding whether to choose PSA testing

Almost every test or procedure has benefits and limitations. You might think of these as pros and cons. Before having any test, it’s important to be aware of them so that you’re making an informed decision that’s right for you. Testing for prostate cancer early — before you have any symptoms — is your choice.

There are a number of benefits and limitations that come along with PSA testing. For

example, some benefits include potentially finding prostate cancer early before you have symptoms, and if the result is normal then you might feel reassurance. Limitations could include false positives and negatives, or test results could potentially lead to unnecessary treatment that may have side effects.

It’s your decision Still trying to decide about the PSA test? Research hasn’t yet clearly shown if the benefits of testing for prostate cancer outweigh the limitations. Deciding whether to be tested for prostate cancer can be confusing. You may assess the benefits and limitations of doing a PSA test differently than someone else based on your values and preferences.

It’s important to talk to your doctor about what is right for you, so that you can make an informed decision. Visit cancer.ca to learn more.

Elizabeth Holmes

If you have a prostate, you may want to consider the benefits and limitations of testing for prostate cancer.

Elizabeth Holmes Senior Manager of Health Policy, Canadian Cancer Society

This article was brought to you by one of Canada’s leading research-based pharmaceutical companies.

Advances in Prostate Cancer Treatment Are Giving Men New Hope

Tania Amardeil

Advances in prostate cancer treatment have burgeoned in the past decade, giving new hope to patients and their loved ones. Today, a prostate cancer diagnosis is bad news, but it’s not always bleak. Thanks to new treatment options, patients can expect to continue enjoying their active lives for longer than before, even during treatment.

New research and recent advances “It has been a busy 10 years,” says Dr. Sebastien Hotte, a medical oncologist at the Juravinski Cancer Centre. “There are a lot more prostate cancer treatment options than there used to be.”

Prostate cancer patients’ treatment route depends on the state of their disease. Some prostate cancer is localized or non-metastatic, meaning it hasn’t spread beyond the prostate. Prostate cancer can sometimes be slow-growing and the decision to treat, and with which method, should be discussed with their doctor.

“Generally if patients require treatment, the two conventional modes are surgery or radiation,” says Dr. Stanley Flax, a urologist at North York General Hospital. “Now, numerous new modalities are being developed.” Dr. Flax notes that the trend is toward more targeted focal therapies, such as high-intensity focused ultrasound and cryoablation, which could potentially reduce the risk of incontinence or erectile dysfunction in some patients.

This

The more traditional treatments have also seen promising advances. “Surgically, we’ve developed more robot-assisted surgery,” says Dr. Thierry Lebeau, Chief of Urology at CIUSSS de l’Est-de-l’Ïle-de-Montréal. “We’ve also seen improvements in radiation therapy, with more focused treatments.”

Delaying time to metastasize with new treatments

Prostate cancer can grow and spread (metastasize) to other parts of the body, including the lymph nodes or bones. Castration-sensitive prostate cancer still responds to medical or surgical treatments that lower testosterone, whereas castration-resistant prostate cancer no longer responds to these treatments. Triple therapy for metastatic Castrate-Sensitive Prostate Cancer (mCSPC) is a promising new development affording patients prolonged survival. Non-metastatic Castrate-Resistant Prostate Cancer (nmCRPC) is a type of prostate cancer that hasn’t spread to other parts of the body but is no longer responding to the testosterone-lowering therapies. nmCRPC has traditionally been difficult to treat, but early treatment and new treatment options, including next-generation testosterone-lowering therapies, are extending patients’ lives. “This has been a huge advance,” says Dr. Flax.

Dr. Hotte notes that new hormonal therapies are making a big difference for nmCRPC

patients’ quality of life and delaying the time their cancer takes to overtly metastasize.

The importance of collaborative decision-making Making the decision of which treatment to pursue is often a joint decision-making process between men, their loved ones, and their health care practitioners. While treatment recommendations depend on medical diagnostics, individual factors also come into play. Men’s varying wishes, values, and preferences about quality of life and maintaining their activity levels makes reviewing the different treatment options and their side effects essential.

“Although we can recommend preferred options, it’s not us who will be taking the treatment,” says Dr. Hotte. “It’s important to get a good sense of the patient. With prostate cancer, we have the advantage of having a few choices for these men.”

“Since prostate cancer isn’t often a very aggressive disease, we have time to discuss the different options and to give patients information,” says Dr. Lebeau. “I direct my patients to good sources of information, like the PROCURE website.”

Support along the patient journey PROCURE is a charitable organization that educates and supports people affected by prostate cancer. Laurent Proulx, PROCURE’s

article was brought to you by one of Canada’s leading research-based pharmaceutical companies.

President and CEO, had prostate cancer himself and discovered that men didn’t want to talk about it. As a result, he was motivated to get involved with PROCURE.

“We have over 100,000 visitors on our website each month,” he says. “We’re going beyond the boundaries of Canada, helping patients and caregivers all around the world.”

PROCURE offers webinars, help phone and chat lines, and well-referenced resources. It also helps connect men with prostate cancer with others who have gone through a similar patient journey — something that’s invaluable when it comes to support and decision-making. “It’s good for patients to speak to one another,” says Dr. Lebeau. “PROCURE has events where men can meet and they tend to speak freely about their experiences. That’s mostly where I orient my patients.”

A promising outlook Canada’s researchers and health care practitioners — along with the valued patients who participate in clinical trials — are working diligently with industry partners and academic cooperative groups like the Canadian Cancer Trial Groups (CCTG) to bring the newest treatments and technologies to Canadian patients.

“Most of my research involves looking into new therapies,” says Dr. Hotte. As a surgeon, Dr. Flax focuses on developing new biopsy techniques, while Dr. Lebeau is involved in clinical research on surgical outcomes. “It’s a very active research field in which things are always changing for the better,” Dr. Hotte says.

Patients can also play an active role in their care. Monitoring prostate-specific antigen (PSA) and understanding the role of PSA doubling time can be helpful. Patients should speak with their health care professional to learn more.

Thanks to new advances, patients with advanced prostate cancer can expect to live longer and with a better quality of life than before. They have many new treatment options, giving patients more choice and the opportunity to continue doing the things they enjoy.

Addressing the Top Questions Men with Prostate Cancer Ask

Men diagnosed with prostate cancer face many challenges. Here are some of their most frequently-asked questions.

What are the signs and symptoms of prostate cancer?

Common signs and symptoms of prostate cancer include urinary problems, blood in the urine or semen, erectile dysfunction, and weakness or numbness in the legs or feet. However, these signs and symptoms can all be indicative of other problems as well, so getting tested for prostate cancer is essential, especially for men over the age of 50. Not all men with prostate cancer will experience signs or symptoms and should discuss prostate cancer screening with their physician.

What are the treatment options available for prostate cancer? Depending on the type and progression of the disease, a variety of treatment options are available. These include procedures like surgery, high-intensity focused ultrasound, and radiation, as well as prescription medicine given as a pill or intravenously. Patients should speak to their doctor for the best treatment options available for them.

What are the side effects of treatment?

Side effects vary depending on the treatment route, but may include urinary or sexual problems, fatigue, bone loss which may lead to fractures, cognitive or memory impairment, and rashes. New treatment advances can reduce major side effects and allow prostate cancer patients on treatment to maintain an excellent quality of life.

Are there any holistic treatment options I can explore?

Clinical trials have shown that vigorous exercise on a regular basis has a number of positive effects on men with prostate cancer. Eating a well-balanced diet and addressing emotional needs may also be beneficial.

What is PSA, and what does this marker mean?

Prostate-specific antigen (PSA) is a protein made by the prostate gland and found in the blood. PSA blood levels may be higher than normal in men who have prostate cancer, benign prostatic hyperplasia (BPH), or infection or inflammation of the prostate gland. PSA is often a good marker of prostate cancer disease burden. Talk to your doctor to learn more about tracking your PSA levels.

Where can I go for support?

Friends and family are often great supports to lean on, and patient associations like PROCURE (www. procure.ca and 1 855 899-2873) are also excellent options.

Thanks to new treatment options, the life expectancy of prostate cancer patients has increased dramatically, and patients can expect to continue enjoying their active lives, even during treatment.

Laurent Proulx President & CEO, PROCURE

Dr. Stanley Flax Urologist, North York General Hospital

Dr. Thierry Lebeau Chief of Urology, CIUSSS de l’Est-del’Ïle-de-Montréal

Dr. Sebastien Hotte Oncologist, Juravinski Cancer Centre

This article was brought to you by one of Canada’s leading research-based pharmaceutical companies.