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Tackle 2019 AGM & Conference - Prostate Cancer: To Screen or Not to Screen

Members are now invited to register for this year's AGM & Conference taking place on Thursday 13 June 2019 at Hornton Grange, 53 Edgbaston Road, Edgbaston, Birmingham B15 2RS - the same venue as last year.
 
The theme for the Conference this year is Prostate Cancer: To Screen or Not to Screen and we have lined up some excellent speakers.

For full details of the provisional timetable and how to register, click here.

We look forward to seeing you!

Cycle to the Moon launch attracts great media coverage

Our 2019 launch of Tackle's fundraising campaign Cycle to the Moon, now expanded to include bikers using Bike to the Moon, has attracted some excellent media coverage:

The Rooftop News

Bradford Telegraph & Argus

Exquisite Concierge

British Motorcyclists Federation

Dorset Echo

Wheels within Wales

Are you getting on your bike this year? Come on, let's Save a Dad!

European Assoc of Urology propose PSA Screening for Prostate Cancer

Prof. Van Poppel from Belgium discusses the European Association of Urology's policy papers proposing the need to reconsider structured population-based PSA screening for prostate cancer.

Watch the video on YouTube.

Observations on the National Prostate Cancer Audit 2018

Steve Allen, a prostate cancer patient who represents Tackle on various clinical matters eg NICE, reviews the findings of the 2018 National Prostate Cancer Audit in England and Wales.

The Audit is prepared by a team of clinicians, audit experts and cancer information specialists based at the Royal College of Surgeons of England, the British Association of Urological Surgeons and the British Uro-oncology Group.  Its findings are entirely independent and are generally regarded as the most recent and reliable source of information on current practice and outcomes related to the treatment of prostate cancer.

The latest report (NPCA Annual Report 2018) was published in February 2019 and is the fifth year that such a report has been published. At 62 pages, it is very detailed. A patient summary is expected to be published soon.

Below are some of the main facts that come from the Report.  My personal comments are added in italics.

Patient characteristics: (Data for England quoted.  Data for Wales fairly similar)

42,975 men diagnosed with PCa   (41,739 in 2015/16)

12% men aged under 60 yrs

33% men aged 60 – 70

37% men aged 70 – 80

17% men over 80 yrs of age

Great efforts are being made to raise awareness of PCa in men over the age of 50.  However, the statistics above represent the numbers of men actually diagnosed.  What they do not show is how many in each group were actually tested.  It is possible that many men in the lower age range were tested but that no cancers were found. 

Overall, prostate cancer remains a cancer of the older man but one where diagnosis in younger men is increasing – an age group where side effects of treatment and adverse events can have devastating consequences on quality of life.

There is still a large number of men being diagnosed over the age of 80 despite the consensus opinion that PSA testing is not always appropriate in this age group.

The report does not identify the severity of disease diagnosed in each age group.  It would be interesting to know if younger men coming for PSA testing were more likely to present with more aggressive disease than other age groups.  My perception from involvement with many support groups is exactly that:  younger, often asymptomatic, men seem to be diagnosed with more aggressive disease than in older age groups.  But, of course, perception is not always reality.

Stage of cancer at diagnosis:

Data was available in 94% patients diagnosed:

16% had metastatic disease at the time of diagnosis

39% had locally advanced disease

3% mixture of above

35% had intermediate disease

7% had low risk disease

These figures are similar to those in the previous year’s report.

It would appear that men are still not being diagnosed early enough.  Only 7% had low risk disease, 58% had metastatic or locally advanced disease. We cannot afford to reduce our efforts at raising awareness of PCa.

The earlier PCa is diagnosed , the better the clinical outcome.

It has been estimated that the cost of early ‘curative’ treatment is €15,000 compared with €300,000 for the long term treatment of advanced disease.

Use of Multiparametric MRI (mpMRI):

This continues to increase.  58% of all scans performed were mpMRI. 

In England, 80% of all of these mpMRI scan were performed before biopsy.   (Figures for Wales show only 41%)

Tackle, along with other groups, have championed the use of mpMRI earlier in the diagnostic pathway and before biopsy.  This is now undoubtedly coming into routine use.  It is now supported in the recently updated NICE Guideline for PCa.

Use of prostate biopsy:

Trans-rectal ultrasound guided (TRUS) biopsy remains the most common technique used.  There appear to be  differences in practice in England and Wales – however the data for England was only available for 54% of patients diagnosed, 100% in Wales but where the overall total numbers were very much lower

England                                           Wales

88%                TRUS                        96%

12%                Trans-Perineal         4%

Template biopsy giving multiple samples is perhaps the commonest reason for using the perineal approach.  It normally requires a general anaesthetic and may explain the low uptake.

With the increased use of mpMRI and the more accurate localisation of tumour tissue within the prostate, the use of the trans-perineal route for targeted biopsies may well increase in the future.

Arguably the trans-perineal biopsy route may have a lower incidence of adverse events than the trans-rectal route.  In a few centres, trans-perineal sampling (not a full template biopsy) may be performed under local anaesthesia.  The current data for England is split equally between template biopsy and trans-perineal sampling.

Are we improving the treatment of patients?

Low-risk disease:

4% men ‘over-treated’ 1916 /17

8% men ‘over-treated’ 1915/16

A major cause for concern in raising awareness of PCa and increasing the uptake of PSA testing has always been the possibility of over-diagnosis and over-treatment.  The latest figures show a continuing downward trend of this occurring and demonstrates the accuracy and efficacy of the diagnostic pathway in current use.

Locally advanced disease:

33% men ‘under-treated’ 1916/17

27% men ‘under-treated’ 1915/16

‘Under-treatment’ is suggested here when men with locally advanced disease are treated with ADT (hormone) therapy alone rather than combined with additional radiotherapy or surgery.  Under-treatment’ would appear to be more common in older, otherwise healthy, men.

Surgical techniques used:

As one might expect, robotically assisted surgery is now overwhelmingly the most common type of radical prostatectemy performed.

England                                            Wales

   81%             Robotic                       63%

    9%              Laparoscopic              4%

  10%              Open                            23%

The data were collected from April 2016 to March 2017.  It is likely that more procedures will now be being performed using robotic assistance as surgical experience increases. It is too early to have data comparing the number of procedures performed using the newer ‘Cave of Retzius Sparing’ technique.

However, there will always be patients for whom open surgery is required because of medical or technical reasons.

Radiotherapy:

The vast majority of all external beam radiotherapy now uses Intensity Modulated Radiotherapy (IMRT).

90% (England) and 100% (Wales) patients were treated using IMRT. 

For this Audit, no specific data were recorded for treatment involving brachytherapy.

The older 3D-conformal technique is likely to disappear as older radiotherapy equipment is phased out. This should potentially further reduce the incidence of both short-term adverse events and longer-term ones now being identified from treatment given many years previously. 

The use of shorter courses of treatment which use higher doses at each session (hypo-fractionated radiotherapy) may well be increasing but this is not captured in the Audit.

Estimation of Quality of Life

Information was obtained from a Patient Survey sent by the NPCA to men who were diagnosed with prostate cancer from 1st April 2015 to 30th September 2016.  (This is a slightly different time period to that used for data collection from hospital and other records for other parts of the Audit).

Of 35.162 surveys sent out, results were obtained from 25.490 men – a response rate of 73%

Estimations of quality of life were measured using Patient Reported Experience Measures (PREMs) and Patient Reported Outcome Measures (PROMs).

Overall Experience:

90% men said they were given ‘the right amount of information’ concerning their condition and treatment

72% men felt they were involved as much as they wanted in decision making

83% were given the name of a Clinical Nurse Specialist

89% men rated their overall care as 8/10 or above

These are undoubtedly good results – and perhaps better than some of us closely involved with support groups and their members might have expected.  (But support groups by their very nature will attract more people who have experienced problems than those who have not).

However, we should not become complacent.  23% patients did not complete the survey and the figures are incomplete.  It could, perhaps, be argued that these non-responders overall rated their treatment experience highly.  Are those who have with problems more likely to respond than those who have not and will this subsequently influence the overall results?

Side effects / Adverse events:

No treatment for prostate cancer is without the potential for side effects or adverse events.

Of the 25,490 men who responded: 

23% treated with radical prostatectemy  (at 56 surgical centres)

44% treated with External beam Radiotherapy  (at 55 Radiotherapy centres)

Outcome measures were scored on a 0 – 100 scale  (0 bad to 100 good)

After Radical Prostatectemy:

Mean continence score                71 / 100

Mean sexual function score       23 / 100

After External Beam Radiotherapy:

Mean Bowel function score        85 / 100

Mean sexual function score       17 / 100

These are overall estimations of a few outcome measures and only in two treatments used. They evaluate the current status of the patient and do not specifically compare that with how the patients were prior to their treatment.  One assumes a number of patients would not have always scored 100 / 100 on each measure prior to their treatment. However, the Audit uses a well validated questionnaire giving reliable data which allows comparison to be made from one Audit Report to another, and between different forms of treatment.

In Conclusion…….

The full report contains a vast amount of information and I have only highlighted some of the major points that I feel the most relevant for patients.

 

 

 

 

 

 

Health Secretary Needs Prostate Screening

Matt Hancock, Secretary of State for Health, announced today that he is at a higher risk of developing prostate cancer after taking a DNA test. Chris Booth of Tackle's Clinical Advisory Board commented:

"So, the Secretary of State for Health, Matt Hancock, has discovered he has a genetic predisposition to develop Prostate Cancer (PCa).Without more clinical information, particularly Matt Hancock’s family history of PCa on the male side and breast cancer on the female side, it is difficult to comment on his individual case. However, we do know that about 10% of men presenting with PCa, particularly those presenting at a “younger” age in their 50s and 60s have a familial genetic predisposition to develop PCa. Such men need to know the risk and to be in a screening programme for PCa from their 40s. At present the only freely available NHS test to do this is the simple blood test Prostate Specific Antigen (PSA). Though it is not a perfect test, it is entirely adequate to screen such men and until a better test arrives, men at risk should have a PSA test every year or two from their 40s to age 70.

Unfortunately 90% of men who develop  PCa in the UK have no known risk factors.  In the UK PCa is diagnosed in 47,000 new cases and kills nearly 12,000 men every year – more now than breast cancer where the death rate is falling whilst for PCa it is rising! In all the countries using PSA routinely to screen for PCa the death rate has fallen by about a half  but there has been no comparable fall in the UK where our cure rates for PCa lag well behind our European neighbours. Despite the availability of PSA and  NHS Guidelines that clearly entitle men over 50 to have PSA tests, over a half of newly diagnosed cases in the UK have advanced, incurable PCa.

In the UK the previous disadvantages of PSA use (so-called "overdiagnosis and overtreatment") have been virtually eliminated by advances in specialist diagnosis and treatment of PCa over the last 5 years.  GPs need to know this and also be aware that in Europe numerous clinical studies on PSA screening  are showing that when used properly for appropriate and fully informed men, PSA screening can halve the death rate from this thoroughly unpleasant cancer now killing one UK man every 45 minutes!

It is now up to UK men to be aware of the risk this commonest of all male cancers poses and GPs to use PSA proactively according to our existing NHS  entitlement.”

High Peak PCSG promotion during Prostate Cancer Awareness Month

Former Tackle Trustee Mike Harrison, who founded High Peak PCSG in Derbyshire back in 2010, featured in the Buxton Advertiser as part of Prostate Cancer Awareness Month. He also recorded an interview with High Peak Radio.

UK cannot continue to overlook prostate cancer

Janani Krishnaswamy, who attended the recent prostate screening discussion in the House of Commons co-hosted by Tackle, writes in Government Gazette that the UK can no longer continue to overlook prostate cancer. Read the full story.

Shepway Veterans take on the 3 Peaks Challenge in aid of Tackle

Shepway Veterans, a group of men over 45 are taking on the challenge of a lifetime; to climb the 3 highest peaks in the UK, starting with Ben Nevis in Scotland, then onto Scafell Pike in England and finishing with Snowdon in North Wales raising awareness and funds for Tackle Prostate Cancer.

Back in August 2017 Alistair Hammond from Folkestone - founder of Shepway Veterans - lost his father-in-law, Graham, to prostate cancer. This left a huge hole in his family’s life, but it also made his family so much more aware of the issues that face men and the very real need to do something to help and make a difference.

Alistair decided he wanted to help so, after talking to some close friends, he hatched a plan to form a group of over 45-year-olds who all live in or around the Shepway area and "Shepway Veterans" was created. Made up of a group of seven men  from all walks of life, all have a connection with men’s cancers, loved ones lost and battling the disease and one of the team is a survivor.

Alistair said: “After my father-in-law was diagnosed with Prostate Cancer and sadly lost his fight in 2017, I formed a group of friends called the 'Shepway Veterans' who all have similar stories - one is a survivor -t o do something to support the ongoing search for a cure for all cancers. We recognised Tackle Prostate as the perfect charitable partner to support because it helps dads, families and friends and is one of the smaller national charities that help raise awareness of men's cancer, so everyone gets the help they need. The team are determined to raise as much money and raise awareness in the fight to save men’s lives.”

Alistair’s wife and sister took part in The National 3 Peaks Challenge - 3 Peaks in 24 hours - back in 2018. This inspired him and his fellow Shepway Veterans to endeavour to complete each climb in a fast time (comparable to the 24 hour times), but they will tackle each mountain on a new day, so 3 Peaks in 3 days.

Alistair commented: Well, it might not be over 24 hours, but we will climb each peak with speed and the endurance required for a fast ascent/descent and then contend with the aching limbs each day thereafter. It is a challenge nonetheless and each of the Shepway Veterans wants to achieve the climb as a personal journey and to challenge mind and body. Some of us are scared of heights and the thought of climbing not 1, not 2 but 3 of the highest peaks in the UK is quite scary and daunting.”

Roger Wotton chairman of Tackle Prostate Cancer said: "We know how devastating the diagnosis of prostate cancer can be.  By raising awareness and funds we will hopefully see more men being tested earlier, and help accelerate a reduction in mortality figures. Prostate cancer doesn’t just affect the man diagnosed – it affects his whole family. Shepway Veterans are a true inspiration to others and deserve all our support."

The group has received fantastic support from local company LIFElabs.io (LIFElabs) a Fintech blockchain company who will provide a facility for donations to be accepted in digital currencies, such as Bitcoin, Ethereum and LIFEtoken. LIFElabs have agreed to help sponsor aspects of the challenge and will match fund donations received up to £5,000. The Shepway Veterans hope they will raise £5,000 early on through fundraising support.

LIFElabs’ CMO, David Pugh-Jones commented: “We are extremely proud to sponsor Alistair and the Shepway Veteran’s team, supporting them in raising funds for the inspirational Tackle Prostate Cancer charity. As a company that has philanthropy and pioneering technology at its heart, it was a perfect opportunity for us to match fund donations and help build awareness of Prostate Cancer. We wish them the very best of luck in their endeavours later this year.”

Shepway Veterans are looking for additional sponsorship for equipment and help towards the costs of this expedition.

Alistair Hammond added: “We researched carefully and have decided to support Tackle Prostate Cancer. Through your support, our hard work and LIFElabs support, we will be able to track exactly where your donations will be going and what support takes place.”

To sponsor the Shepway Veterans, click here.

Tackle Co-hosts Prostate Cancer Screening Discussion at House of Commons

Tackle co-hosted a discussion on whether we should be screening for prostate cancer in the Churchill Room at the House of Commons on 27 February. The evening was organised by Chris Booth, a member of our Clinical Advisory Board, and sponsored by Lord Bernie Ribeiro, Sir Bernard Jenkin MP and Mrs Ian Hunter. Co-hosts were CHAPS and Orchid.

To set the scene, Monique Roobol-Boots, a Dutch researcher in the Urology Department at Erasmus University in Rotterdam, gave a very informative and thought-provoking presentation. Her conclusion was clear: that targeted screening for prostate cancer was beneficial.

From the floor, Jim Davis - Chairman of PCaSO Dorset - made an impassioned plea for the immediate introduction of prostate cancer screening based on the results of the many thousands of PSA tests that PCaSO has carried out which, he said, clearly demonstrated the need.

Alphonso Archer then recounted his personal story. He had been diagnosed with prostate cancer so recommended his brother to have a PSA test. However, as his brother was under 50, this was refused him even despite the clear family connection increasing the risk and that he was of black ethnicity which doubled the risk from 1 in 8 to 1 in 4.

Sir Mike Richards, an oncologist who was National Cancer Director in the UK from 1999 to 2013, then gave an overview of the development of prostate cancer research over the years, recognising the great advances that have been made but he stopped short of recommending screening.

Rounding up the evening, Sir Bernard thanked everybody and said that he would take a lot away from the evening and in particular from the personal stories. Lord Ribeiro commented on the evening "the keynote speech struck just the right chord and will send many home appreciating the need for targeted screening, a powerful message".

Tackle wins Best Patient-Led Support Charity Award

We are delighted to win the Best Patient-Led Support Charity in the 2019 Social Care Awards.

Feb 2019 Prostate Matters published

The latest edition is now available on our website and, if you normally receive a printed version, this will be with you shortly. Please do let us know if you would like more or fewer copies.

This edition has articles about the following:

  • Kidderminster & Worcestershire PCSG set up a Men's ShedThe Big White Bus in Oxford
  • Prostate Cancer Survival in EnglandSpinning on Father's Day in Stratford-on-Avon
  • How Best to Use a Beer Mat

  • Keith Cass Raises Awareness of Prostate Cancer with his Unorthodox Funeral Plans
  • Letters to the Editor
  • Proton Beam Therapy Comes to the UK
  • Prostate Radiotherapy can Benefit Men whose Cancer has Spread
  • The Issue of Incontinence Pad Disposal

Researcher calls for national screening programme to tackle prostate cancer

Dr Sylvain Ladame, from Imperial College's Department of Bioengineering, presentshis research on how to diagnose and treat prostate cancer more effectively at the Imperial College Academic Health Science Centre (AHSC) seminar.

To find out more and see the presentation, click here.

Urgent action on prostate cancer screening needed

Europa Uomo - the organisation that is the voice of prostate cancer patients across Europe and which Tackle is a member of - has joined with European urological associations, scientific experts, policy makers and other patient organisations to call for national screening programmes for prostate cancer across Europe.

In a new policy paper, launched in the European Parliament with support from MEPs, the organisations say that the European Parliament and EU member states should ensure that the European Commission considers whether PSA-based screening should be implemented at European level.

The paper was issued jointly by Europa Uomo, Cancer Control Joint Action, the European Cancer Patient Coalition and the European Association of Urology (EAU) at a special event to mark European Prostate Cancer Awareness Day (EPAD). “The European Union can no longer continue to overlook the most common cause of cancer in men in Europe,” says the policy paper.

Chris Booth from our Clinical Advisory Group reports on the findings.

NICE Recommends MRI Scans for Suspected Prostate Cancer BEFORE Biopsy

The National Institute for Health and Care Excellence (NICE) have issued Guideline CG175 stating that men with a raised PSA blood test who require further investigation to diagnose or rule out underlying prostate cancer (PCa) with a view to radical treatment should no longer  proceed directly to an invasive prostate biopsy but instead should be offered a multi-parametric MRI scan.

Clinical trials comparing mpMRI with standard ultrasound guided (TRUS) biopsy have shown that mpMRI is much more accurate in detecting PCa and that PCa seen on mpMRI is significant and usually needs treatment.  On the other hand when the mpMRI is normal, it is much less likely that a significant PCa is present.  Such patients can then safely wait on a closely supervised “Active Surveillance” programme.  About a third of patients presenting with a raised PSA but normal-feeling prostate can thus avoid an invasive TRUS biopsy.

There are however still some problems to overcome.

Firstly, GPs cannot order mpMRI scans and not all UK urology departments have appropriate MRI scanners.

Secondly, there is a shortage of radiologists trained to report mpMRI scans and reporting criteria have only just been standardised.

Thirdly, if a scan is normal, there may still be an underlying cancer present as it has been shown that half of such men placed on “Active Surveillance” subsequently develop signs of cancer progression and require active treatment.

Despite these caveats, this is a major step forward which virtually nullifies the argument that PSA screening for PCa leads to “over-diagnosis”.  Furthermore, now that Active Surveillance has become the standard UK management of insignificant, non-aggressive PCa, the “over-treatment” argument no longer carries much weight.  These historical arguments against screening now have to be weighed against the latest PCa screening evidence showing a 64% fall in PCa mortality in a screening programme involving over 400,000 men just reported from Northern California! ref

Although the UK has no formal screening programme, the Prostate Cancer Risk Management Programme entitles UK men over the age of 50 to have a PSA test.  It also flags up those men who are at higher risk of PCa and who should unquestionably be in a screening programme from their 40s until at least their mid 70s:  men with a family history of PCa, or breast cancer on their female side, and black men of African or Caribbean heritage.

CHAPS Charity has contributed positively to this NICE guideline updated recommendation which will be published in April 2019.

Reference:    Alpert PF.  Urology. 2018; 118: 119-126

Tackle Trustee Keith Cass explains why he is selling tickets to his own funeral

Tackle Trustee Keith Cass' funeral will be different to most people's. He's selling tickets for it to raise awareness and funds for research into prostate cancer.

Read more about this and listen to Keith talk about his idea on ITV.

Blue November in Italy is a new prostate cancer awareness campaign

Europa Uomo is promoting Blue November, Italy’s first prostate cancer awareness campaign, with the slogan: “Shine a light on yourself”.

They have decided to use art as a powerful means of instantly getting a message across about men’s health, by shining blue lights on male nude statues.

To find out more about the numerous initiatives, please take a look at www.novembreazzurro.it which is available in both English and Italian.

Tackle supports Stephen Fry Appeal for more research into advanced prostate cancer

BBC Radio 4 Appeal

Here is a note for your listening diary!  On Sunday 16th December at 07.55 repeated on Thursday 20th December at 15.27  please tune in to hear the Stephen Fry and Martin Dallison appeal asking for more research into advanced prostate cancer.   This is being organised by the Prostate Cancer Research Centre, with whom we will be working more closely going forward. 

The attached pdf gives more details.  If you would like paper copies of the appeal please email Sonja at slawrence@prostate-cancer-research.org.uk

Prostate cancer: A wake-up call for men

Tackle Chairman Roger Wotton has an article published on the Open Access Government website discussing whether men should be screened for prostate cancer.

Read it here.

From death's door to the all-clear from Prostate Cancer

Michael English is living evidence that we may finally have discovered a powerful secret to beating cancer. Astonishingly, this long-sought answer lies hidden inside our own bodies.

Read the full story in the Daily Mail.

Prostate breakthrough with simple blood test could spare thousands of men from surgery and radiotherapy

Necrotising Fasciitis (flesh-eating bug) after routine Prostate Surgery

Gel implant can spare prostate patients the side-effects of radiotherapy

A new treatment for prostate cancer uses a gel implant to stop healthy cells being damaged by radiotherapy. Gordon Robinson, 70, a former electrical wholesaler, from Dungannon, Co. Tyrone, was one of the first UK patients to be given it.

Read the full report in the Daily Mail.

New drug that unleashes the body's immune system could eradicate 'ultra-mutant' tumours in men with drug-resistant prostate cancer

Men with aggressive drug-resistant prostate cancer could see their tumours eradicated by a new treatment.

Read the full report in the Daily Mail.

Inspirational Woman From Yorkshire Dales Raises over £400 at a Bag Packing Day at Tesco Store in Skipton

29 year-old Kayleigh Davies from Skipton is one determined lady. To raise awareness for Tackle Prostate Cancer, she organised a bag pack day at the Tesco store in Craven Street in Skipton last weekend raising over £400.

In total she has now raised over £2,122 and still has lots more fundraising events and swims to go as well as organising a Charity Ball on 13 October in Skipton. Kayleigh has been inspired by two of her father's friends who have prostate cancer to raise awareness.

Tackle Prostate Cancer is a patient-led charity addressing the real issues people face when they are diagnosed with prostate cancer, and helping people to cope with their diagnosis and treatment. As a National Federation, Tackle has 90 support groups across the country, representing some 15,000 members.

Kayleigh said: "I am organising a ball and doing swims for Tackle Prostate Cancer because I have seen the effects of this disease. Men are dying daily because they are not routinely checked by GPs for prostate cancer."

In June Kayleigh attempted to swim the English Channel as part of a four person relay team. Up until two years ago Kayleigh could hardly swim as she suffers from an auto-immune condition, which means she is in constant pain as well as making her prone to chest infections. Kayleigh was diagnosed with sarcoidosis when she was eight years old which can affect any part of the body.

Kayleigh has taken part in open water swims throughout the summer including a 5K swim in London and the Dee swim.

Kayleigh added: "I have personally seen the effects of this devastating disease as it has affected friends and family and believe that it is important that we do everything that we can to fight and 'tackle' the illness."

Tackle have recently launched their inaugural national cycling event ‘Cycle to the Moon, Save a Dad’ – a major fundraising initiative that will encourage people of all ages to get on their bikes and raise awareness and  money for the fight against prostate cancer.

Cycle to the Moon is a chance for members of the public to show their support through their cycling miles either on the roads, in the gym, at home or on outdoor trails. The event is open to all ages regardless of ability. It is designed to be a fun, healthy activity raising funds on behalf of Tackle Prostate Cancer as well as encouraging the next generation to participate. It also aims to raise awareness and encourage men at risk of prostate cancer to get tests and earlier diagnosis. The campaign’s target is £250,000 –  £1 for every mile between Earth and the Moon.

Prostate cancer is now a bigger killer than breast cancer, making prostate cancer the third biggest cancer killer in the UK. Every penny Kayleigh raises will make a difference, lives will be saved and more people will be aware of the need to be tested. The money will help the charity continue to meet its objectives of campaigning on behalf of patients and raising awareness in the community.

Kayleigh has set up a Just Giving page and Facebook page for her swims.

Roger Wotton chairman of Tackle Prostate Cancer says: "We know how devastating the diagnosis of prostate cancer can be. Raising awareness will hopefully see more men being tested earlier, and help accelerate a reduction in mortality figures. Prostate cancer doesn’t just affect the man diagnosed – it affects his whole family." Kayleigh is a true inspiration to others she and she deserves all our support. Go girl!"

Kayleigh added: "I would swim all around the world to make a difference and help raise awareness."

To sponsor the Kayleigh's swimming challenge visit http://www.justgiving.com/kayleigh-davies6?utm_id=124

Exploring prostate cancer key issues

Roger Wotton, Chairman of Tackle Prostate Cancer explores the key issues around prostate cancer, the most common cancer in men.

Read the full article.

Clinical Advisory Board Member Chris Booth Update on Prostate Cancer Screening

AN UPDATE ON PROSTATE CANCER SCREENING

Bad News - Good News 

First, the bad news.

An update is necessary because the UK still has unacceptable Prostate Cancer statistics with over 47,000 new cases and over 11,800 deaths each year, which now exceed deaths from breast cancer.  Our cure rates languish below most of our European neighbours despite us having one of the richest economies in the world.   Despite this there is no central impetus towards better screening for this cancer which is eminently curable if caught early.  This is because the so-called “harms” of screening for early, curable prostate cancer - ”over-diagnosis” of insignificant non-aggressive cancer and its attendant risk of unnecessary ”over-treatment” – continue to be cited as reasons for discouraging men from having PSA tests.  This advice is now outdated and italso overlooks the serious risk of “under-diagnosis” of aggressive and potentially lethal prostate cancer.

Furthermore, in the USA the death rate from prostate cancer has fallen by about 4% a year since the introduction of PSA testing in the 1990s – until now!   Since the US Preventive Services Task Force (USPSTF) controversially discouraged the use of PSA screening in 2012, this steady reduction in mortality has levelled off and, more worrying, the incidence of incurable late stage disease and metastatic spread is now rising in the USA.

Now, the good news.

Pioneering studies in the UK on the use of mpMRI scanning for suspected prostate cancer in men with an elevated PSA have demonstrated a marked superiority over the traditional TRUS biopsy pathway. The PROMIS trial has confirmed that an initial mpMRI reduces by at least 25% the need for biopsy and hence over-diagnosis of insignificant cancer whilst increasing the detection of significant prostate cancer when combined with targeted biopsies.  Consensus guidelines are now establishing the criteria for the reliable use of mpMRI as the optimum diagnostic test prior to possible biopsy in men with an elevated PSA.

As well as mpMRI new biomarkers are being used to predict the need and likelihood of finding significant prostate cancer on biopsy.

PSA is present in the blood in multiple forms, some of which are more cancer-specific.  For instance, our charity CHAPS routinely uses the ratio of Free PSA to Total PSA to flag up the likelihood of significant prostate cancer in men with PSAs of 4-10ng/ml.

The Prostate Health Index and Prostate Cancer Antigen 3 already have approval in the USA for prediction of high risk prostate cancer on biopsy and at least 4 other biomarkers are under study with similar objectives.

Regarding “over-treatment” of non-aggressive, insignificant prostate cancer, the UK rate for this is down to 8% and continues to fall.  Active surveillance has now replaced over-treatment which can no longer be considered a major obstacle to screening.

What are the messages for the UK if we accept that our current outcomes for prostate cancer management are unacceptably poor for a wealthy western nation?

Firstly, the above information makes it clear that we cannot accept at face value statements from authoritative bodies such as the USPSTF which highlight the “harms” of screening but fail to mention the benefits;  long term European PSA-based screening programmes are showing falls in mortality of over 40% and GPs should be made aware of this.

Secondly, UK men need to know the risk posed by prostate cancer in exactly the same way as women and breast cancer.  When men request a PSA test, GPs need to know about the advances the UK has made in diagnosis and the reduction of over-treatment through active surveillance.  Only then can they provide balanced counselling that allows individual men to make an informed decision on when to have a first PSA test, how often to repeat the test and when it is safe to stop screening.  It should be noted that a single PSA is of little value and does not constitute a programme.  Most current programmes now recommend screening from  40s -75 with frequency of testing based on risk.

For the moment PSA remains the only simple, cheap screening test.  If we are to make any immediate inroads into our unsatisfactory death rate from this most pernicious cancer, it is essential that we increase PSA-based screening and learn how to use this valuable marker properly.

Chris Booth, MBBS, FRCS
Consultant Urologist (retired)

Inspirational Woman from Yorkshire Dales has raised over £1000 For Tackle and has more planned

29 year-old Kayleigh Davies from Skipton is one determined lady to raise awareness for Tackle Prostate Cancer. She has raised over £1000 to date and still has lots more fundraising events and swims to go. Kayleigh has been inspired by two of her father's friends who have Prostate cancer to raise awareness.

Tackle Prostate Cancer is a patient-led charity addressing the real issues people face when they are diagnosed with prostate cancer, and helping people to cope with their diagnosis and treatment. As a National Federation, Tackle has 90 support groups across the country, representing some 15,000 members.

Kayleigh said: "I am organising a ball and doing swims for Tackle Prostate Cancer because I have seen the effects of this disease. Men are dying daily because they are not routinely checked by GP's for prostate cancer."

In June Kayleigh attempted to swim the English Channel as part of a four person relay team. Up until two years ago Kayleigh could hardly swim, she suffers from an auto-immune condition which means she is in constant pain as well as making her prone to chest infections. Kayleigh was diagnosed with scarcodosis when she was eight years old which can affect any part of the body.

Kayleigh has taken part in open water swims throughout the summer including a 5K swim in London and the Dee swim.

Kayleigh added: "I have personally seen the effects of this devastating disease as it has affected friends and family and believe that it is important that we do everything that we can to fight and 'tackle' the illness."

Tackle have recently launched their inaugural national cycling event ‘Cycle to the Moon, Save a Dad’ – a major fundraising initiative that will encourage people of all ages to get on their bikes and raise awareness and  money for the fight against prostate cancer.

Cycle to the Moon is a chance for members of the public to show their support through their cycling miles either on the roads, in the gym, at home or on outdoor trails. The event is open to all ages regardless of ability. It is designed to be a fun, healthy activity raising funds on behalf of Tackle Prostate Cancer as well as encouraging the next generation to participate. It also aims to raise awareness and encourage men at risk of prostate cancer to get tests and earlier diagnosis. The campaign’s target is £250,000 –  £1 for every mile between Earth and the Moon.

Prostate cancer is now a bigger killer than breast cancer, making prostate cancer the third biggest cancer killer in the UK. Every penny Kayleigh raises will make a difference, lives will be saved and more people will be aware of the need to be tested. The money will help the charity continue to meet its objectives of campaigning on behalf of patients and raising awareness in the community.

Kayleigh has set up a Just Giving page and Facebook page for her swims.

Roger Wotton chairman of Tackle Prostate Cancer says: "We know how devastating the diagnosis of prostate cancer can be. Raising awareness will hopefully see more men being tested earlier, and help accelerate a reduction in mortality figures. Prostate cancer doesn’t just affect the man diagnosed – it affects his whole family." Kayleigh is a true inspiration to others she and she deserves all our support. Go girl!"

Kayleigh added: "I would swim all around the world to make a difference and help raise awareness."

To sponsor the Kayleigh's swimming challenge visit

http://www.justgiving.com/kayleigh-davies6?utm_id=124

Passengers and Crew of the Saga Sapphire ship hold a ‘beat the ship’ cycling event for Tackle

Officers, Crew and passengers of the Saga Sapphire participated in a charity bike ride raising £6,000 for Tackle's inaugural national cycling event Cycle to the Moon, Save a Dad a major fundraising initiative that will encourage people of all ages to get on their bikes and raise awareness and  money for the fight against prostate cancer.

Cyclists participated in the charity bike ride called 'Beat the Ship' by the Kiel Canal in Germany.

The cyclists disembarked at the Holtenau locks near Kiel and then headed off for the 110km ride to try and beat the ship to the Brunsbuttel Locks at the western end of the Kiel Canal. Guests were out on deck to watch the race start whilst 30 from the ships company and 7 guests also participated in The Verandah bike ride.

Captain Julian Burgess Master Saga Sapphire said: " A couple of cruises ago one of our guests shook my hand as he entered the Britannia lounge for a party and I noticed his lapel badges and particular a little grey/black mottled man. Having asked what is was he told me it was called "Men United" and was associated with the charity Prostate Cancer UK.  During that "warm" discussion he told me about a National Federation called "Tackle Prostate Cancer" which only exists due to the work of the Volunteer support groups which represent about 15,000. The Federation achieved charity status in 2008 and in 2013 the Tackle Prostate Cancer campaign was launched. What has impressed me is that this small charity relies completely on volunteers and this has really "resonated" such that I am very keen to support "tackle". I have since been given permission by the Saga Charitable Trust to include Tackle as one of their recognized charities."

Cycle to the Moon is a chance for members of the public to show their support through their cycling miles either on the roads, in the gym, at home or on outdoor trails. The event is open to all ages regardless of ability, it is designed to be a fun, healthy activity raising funds on behalf of Tackle Prostate Cancer as well as encouraging the next generation to participate. It also aims to raise awareness and encourage men at risk of prostate cancer to get tests and earlier diagnosis. The campaign’s target is £250,000 –  £1 for every mile between Earth and the Moon.

Captain Julian Burgess Master Saga Sapphire added: "I have been thinking about some charity work for several years but nothing had quite "grabbed me" until now. One of the key things I like about this charity is that it is run by volunteers with no-one taking large salaries, and we've all heard of those!! The ladies have been very good in raising awareness for breast cancer, but us men don't like talking about personal things like prostate. Well I am now on a mission to raise awareness and what better place to start than Saga Sapphire. The Kiel Canal challenge fits in perfectly with the "Tackle" campaign  "Cycle to the Moon - Save a Dad", with myself being a father to two beautiful girls aged 12 & 14. "Tackle are trying to raise £250,000, to raise awareness of prostate cancer and encourage more men to have the PSA blood test."

Roger Wotton chairman of Tackle Prostate Cancer says: "We know how devastating the diagnosis of prostate cancer can be.  Raising awareness and funds through this  campaign will hopefully see more men being tested earlier, and help accelerate a reduction in mortality figures. Prostate cancer doesn’t just affect the man diagnosed – it affects his whole family."

Leicester Black Community talk about prostate cancer - see the video

The risk in the UK of being diagnosed with prostate cancer is 1 in 8. For black men, the risk increases to 1 in 4.

Tackle member PROSTaid based in Leicester has produced a video in consultation with the local African and African-Caribbean community to underline the importance of black men having regular checks for prostate cancer. 

Watch the video.

New Saliva Test does not supersede PSA Testing

Tackle's Clinical Advisory Board has reviewed the new saliva test announced last week and concluded that we still need PSA testing at the moment. The full statement is:

Articles in the press and broadcast on 12 June 2018 suggested this was an exciting new test for Prostate Cancer (PCa) that could “revolutionise how men are screened” and “lead to a national screening programme on the NHS within 3 years”. Whilst the test clearly helps predict future risk of PCa, the actual conclusions drawn in the research paper itself are more realistic (Nature Genetics, accessed on line 15 June 2018).

In summary, the authors claim the test “can be used to improve the identification of men at high risk for PCa and therefore inform PSA guidelines for screening and management to reduce the burden of over-testing”. Two issues immediately arise:

  1. The above quote suggests the authors clearly see the saliva test working in tandem with PSA. This is logical as we are already able to use PSA as a useful risk predictor when used in men in their forties and fifties.
  2. The vast majority of men presenting with PCa in the UK have no known risk factors, either racial or familial. It therefore remains for future studies to demonstrate how the test can best be fitted into pragmatic, simple, cheap screening protocol, especially if it is to be used like PSA in primary care.

In conclusion, for the moment we have to remain committed to raising awareness and increasing the utility of PSA-based screening if we are to reduce the UK’s unacceptable 11,800 annual death rate from this most pernicious cancer.

Inspirational Woman from Yorkshire Dales Swims English Channel to raise awareness for Tackle

29 year-old Kayleigh Davies from Skipton is getting ready to swim the English Channel to help a cause close to her heart. Kayleigh has been inspired by two of her father's friends who have Prostate cancer to raise awareness for Tackle Prostate Cancer. Kayleigh is also putting on a ball on 13th October in Skipton.

Kayleigh said: "I am swimming the channel and organising a ball for Tackle Prostate Cancer because I have seen the effects of this disease. Men are dying daily because they are not routinely checked by GP's for prostate cancer."

Despite suffering from Auto Immune Disease Kayleigh has been training daily for the last two years to undertake the swim of her life time. It is anticipated swimming the Channel will take 17-20 hours to complete. As a warm up Kayleigh took part in the Lake Windermere 5k Race on 10th June and will also be taking part in the One Way Windermere on 2nd September. Kayleigh is prone to chest infections and gets sick in the sea which makes this even more challenging. She will be doing further sponsored open water swims over the summer culminating in swimming the English Channel as part of a 4 person relay team called North Yorkshire Dolphins on 20th June. Accompanying Kayleigh will be Adrian Hawley from Huddersfield, Mark Seddon from Ilkley and Zobair Hussain from Skipton.

Kayleigh added: "I have personally seen the effects of this devastating disease as it has affected friends and family and believe that it is important that we do everything that we can to fight and 'tackle' the illness."

Tackle Prostate Cancer is a patient-led charity addressing the real issues people face when they are diagnosed with prostate cancer, and helping people to cope with their diagnosis and treatment. As a National Federation, Tackle has 90 support groups across the country, representing some 15,000 members.

Tackle have recently launched their inaugural national cycling event ‘Cycle to the Moon, Save a Dad’ – a major fundraising initiative that will encourage people of all ages to get on their bikes and raise awareness and money for the fight against prostate cancer.

Cycle to the Moon is a chance for members of the public to show their support through their cycling miles either on the roads, in the gym, at home or on outdoor trails. The event is open to all ages regardless of ability. It is designed to be a fun, healthy activity raising funds on behalf of Tackle

Prostate Cancer as well as encouraging the next generation to participate. It also aims to raise awareness and encourage men at risk of prostate cancer to get tests and earlier diagnosis. The campaign’s target is £250,000 – £1 for every mile between Earth and the Moon. Prostate cancer is now a bigger killer than breast cancer, making prostate cancer the third biggest cancer killer in the UK. Every penny Kayleigh raises will make a difference, lives will be saved and more people will be aware of the need to be tested. The money will help the charity continue to meet its objectives of campaigning on behalf of patients and raising awareness in the community.
Kayleigh has set up a Just Giving page and Facebook page for her swims.

Roger Wotton chairman of Tackle Prostate Cancer says: "We know how devastating the diagnosis of prostate cancer can be. Raising awareness will hopefully see more men being tested earlier, and help accelerate a reduction in mortality figures. Prostate cancer doesn’t just affect the man diagnosed – it affects his whole family. This is a fantastic challenge Kayleigh has set herself. A true inspiration to others she and she deserves all our support. Go girl!" Kayleigh added: "I would swim all around the world to make a difference and help raise awareness."

To sponsor Kayleigh's swimming challenge, visit her fundraising page.

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