AnCan’s Brains Trust Review Very Recent Seminal Prostate Cancer Work
A couple of weeks ago a prospective seminal paper was published in Nature . Of course, you don’t know if a paper is seminal until it is considered and acclaimed, but this paper is already getting plaudits.
It wouldn’t be the first time some of the paper’s authors have been acclaimed. Back in 2018 several of ‘the usual suspects’, Drs. Small, Aggarwal, Feng, Chi et al published a work in ASCO’s respected Journal of Clinical Oncology. I had first heard about that hypothesis some 3 years earlier at a UCSF Prostate Cancer Research Retreat where Eric Small suggested that advanced prostate cancer morphs into a small cell/neuroendocrine like form as the disease progresses. The significance of this current paper brought the earlier one to mind.
So what is the revelation from this new opus. Well first a tip off – it was published in Nature! That immediately indicates that you need a science background, and maybe even a PhD to even understand the abstract. Not surprisingly, it left me cold so I reached out to our AnCan PCa Brains Trust for a better understadning. Herb Geller and Ben Nathanson independently took the time to reveiw and summarize their understanding in easy-to-understand, patient lingo … and that’s what is presented below.
Oh … and the revelation as I understand it – that in time liquid biopsies will allow us to better define and personally tailor hormone therapy for each man.
Prof. Herb Geller sees this paper clearly identifying that the sum of the parts as greater than the whole ….
Current clinical practice depends upon traditional measures such as serum PSA and scans to stage prostate cancer and determine treatment protocols. More recently, liquid biopsies (from analyzing a blood sample) have begun to provide more information about mutations and cancer progression.
A new paper in Nature from a large group of clinicians and scientists takes the use of liquid biopsies to the next level through the use of whole-genome sequencing and samples taken over time to provide a more detailed picture of cancer progression in metastatic castration resistant prostate cancer (mCRPC) and compare that picture with a similar analysis of a biopsied metastatic site.
One result is that the liquid biopsy can provide a more detailed picture than the surgical biopsy. For example, they find, through the use of sophisticated analytical techniques, that the liquid biopsy shows that different metastatic sites have different mutations, and that sequential liquid biopsies can trace the evolution of the cancer within each site and how it contributes to overall progression. This is in contrast to current methods which only look at the aggregate.
Two observations are of particular interest. One is that they can follow the contribution of the individual sites to cancer progression. Given that some sites may have specific mutations, this may suggest precision treatment protocols that are tailored to each mutation, either separately or in combination. The second is that, while there are many different mutations associated with prostate cancer, they reaffirm that the major driver of cancer progression is the androgen receptor, suggesting, in their view, medicine needs to keep finding new ways to suppress AR signalling.
The overall impact of this paper is that it provides methods that can be implemented more generally. The major current impediments are the cost of whole-genome sequencing, which is decreasing exponentially, and the computational power needed to do the analysis. However, given the huge potential for providing clinical insights, we should expect to see these methods get implemented at major cancer centers.
Ben Nathanson thinks this paper will open the door for Game Theory to play a part in treatment strategy …
A new paper in Nature allows us to witness the day-to-day evolution of a patient’s cancer as its mutations grow and shrink. This level of knowledge is unprecedented, and it can change the face of research and treatment.
Cancer’s guessing game
A drug trial may yield dozens of failures and one miraculous remission. Hormone therapy is indistinguishable from a cure — then stops working. Though we can investigate cancer down to the molecular level, help unraveling these cases is limited because the molecular data is only a snapshot.
We can see what’s different in the genes of the one exceptional responder, but we struggle to identify which differences were significant — and more importantly, why they mattered. We can inventory the mutations in our castrate-resistant cancer, but have no clue how they evolved and how they might be countered.
Instead of snapshots, we need live-action footage. This work provides it.
The very different makeup of five patients’ cancers and their responses over time. A color indicates a cell population with a unique set of mutations. Plots show the details of each individual’s response. Circled numbers are times at which liquid biopsies were taken; AE numbers are patient IDs. The researchers were able to project back before the first measurement to the very start of the cancer. A lot of information was gained from a few measurements. From Herberts et al., Deep whole-genome ctDNA chronology of treatment-resistant prostate cancer.
Evolution of five cancers
The figure above shows the kind of information yielded up by the new work. Each plot is from a different patient; rises and falls are changes in his PSA. A color indicates a unique cell population with its own set of mutations.
We can see what’s happening in each patient’s cancer to cause those changes in PSA.
Based on liquid biopsies
The Nature paper has a lot to be excited about. The molecular information comes from blood samples — “liquid biopsies” — rather than conventional tissue biopsies. Tissue biopsies are impossible when a tumor is too small or inaccessible, and are time-consuming, require high-level medical expertise, and can be painful. Liquid biopsies just require drawing blood.
Convenience aside, a liquid biopsy contains data from every metastasis, not just one.
Samples can be taken again and again during the course of the disease, tracking its evolution in detail.
Liquid biopsies are already used clinically to find treatable mutations in genes like BRCA2. The new results can turn liquid biopsies into the most revealing tool we have ever had to investigate castrate resistance. Ultimately it can make them the tool of choice for assessing patients and monitoring treatment — a requisite for precision medicine.
Real-time results
The work also can strengthen use of game theory and similar novel strategies to head off resistance. Cancer uses Darwin’s playbook: A mutation that improves survival in a hostile environment allows a cell and its children to dominate. If we continuously deprive a tumor of androgens, cells that need androgens will be replaced by mutations that don’t.
Thus one way to prevent resistance may be to modulate treatment so nascent mutations have no chance to grow. Trials are underway that do this, using PSA to monitor the cancer. We gain an advantage if we can lean over and read cancer’s cards. That’s what the research offers: an opportunity to see mutational populations growing and shrinking in real time.
No new equipment
Another exciting aspect of the work is how little it requires. There’s no special assay, no new machinery, no delicate lab procedure. It needs only a state-of-the-art DNA sequencer and public software.
Thus any lab with a good sequencer can join this effort and expand it in countless directions. Part of the software was designed to fit the data in this specific study, but the authors explain their work, and the results are so compelling that other institutions are likely to help generalize the code.
Biological insights
The authors have already made biological discoveries using their methodology, and these dominate the paper. Most require a deeper knowledge of genomics than I can lay claim to, but at least two bear mentioning.
The research confirmed that the DNA in the liquid biopsies showed more diversity than DNA in comparison tissue biopsies – suggesting that tissue biopsies do indeed reveal only part of the story.
And the work sought to determine for the first time whether genes other than the androgen receptor gene change during androgen deprivation. The AR gene was, in fact, the only gene seen to change in every sample. Their conclusion: As long as ADT remains the backbone of prostate therapy, medicine needs to keep finding new ways to suppress AR signaling.
For now this is a tool for insight rather than treatment. Today, although we can see those colors and know exactly what’s in them, we don’t know what to do about them. There’s much we have to learn about cancer dynamics, but we now have a tool that gives us a front-row seat.
Some 200 folks gathered together last Friday, June 24 at the Cold Spring Baptist Church in Mechanicsville, Virginia. to celebrate the life of our dear Advisory Board Member, Jerry Deans, Of Blessed Memory. I was honored to present one of the three tributes … and no surprise, we all said the same thing in different words.
Jerry loved life
Jerry loved to spread love
Jerry lived for the moment
Let’s be honest … there are few, if any, who would not want to be remembered for such wonderful and embracing atttributes. We loved Jerry becasue Jerry loved everyone!
Here first are my words, followed by those of Jim Schraidt that I read on his behalf. Alongside Jim’s eulogy, you see a picture in the church displayed on a carousel showing Jerry and Jim touching hands on their bucket list diving trip to Key Largo 12 months ago together with the original a little further down.
“This disease, (prostate cancer) as well as all cancers, thrusts people into the ‘Belly of the Beast.’ You have to experience it yourselves to know how devastating it can be. But there is help and hope. No matter what you are battling, there are people who have dedicated their lives to help improve yours.”
Not my words … I wish I was so eloquent. These are our beloved Jerry’s words. Mr. Deans was one of those immensely compassionate folks who dedicated his life to helping improve the lives of others who found themselves on the same road he was traveling – whether the loss of a loved one, cancer, or frankly any life experience, Jerry was there to help and support.
Jerry had lived with prostate cancer since 1999, aged 50. Unlike most of you sitting here, I came to know Jerry through prostate cancer. When prostate cancer came into my world it was both a curse and a blessing – Jerry was one of the biggest factors that made it a blessing.
It is also the reason I stand here before you all today. Likely, the majority of you know little about Jerry’s prostate cancer life. Patsi asked if I could do my best in 5 minutes or so to correct that, and it is my privilege to assume that honour. I can’t really even begin without paying tribute to Patsi’s role in how Jerry navigated this 23-year disease path.
As evident in all aspects of their marriage, Patsi was Jerry’s rock and support along with his faith. From keeping him on the right track with exercise and diet, to helping maintain his medical records – especially in recent months, attending appointments, providing continuous nurture, maintaining the household through emotional swings caused by the never-ending hormone therapy …. and what does that mean – living life for the past 20 odd years with no testosterone in your body. Yup Gents – you heard right!!
No T messes you up good! All those symptoms you hear the wife complaining about when she hits menopause – hot flushes, fatigue, brain fog, weight gain, emotional instability. Our men complain of the very same! All down to zippo testosterone each and every day. Who knew?? Well Patsi did, and she was one of the biggest reasons Jerry weathered the storm better than almost anyone else we have ever know living with advanced prostate cancer.
Jerry was truly amazing …. As far back as 2006, he was found to have metastatic lung nodules. These nodules were a bit like a spiritual epiphany … REALLY. They would repeatedly appear and disappear over many years, but we knew that they were prostate cancer cells in Jerry’s lungs. NO ONE LIVES 16 YEARS WITH LUNG METS.
And some of you may recall Jerry knocking off a bucket list item this time last year. He and our good buddy Jim Schraidt went diving in Key Largo. What you may not have known is that Jerry was already having some cognition issues. Why? …. brain mets!! NO ONE LIVES 15+ MONTHS WITH PROSTATE CANCER BRAIN METS. Even his neurosurgeon told him that.
In fact, Jerry continued to defy medical science for 23 years., He experienced almost every prostate cancer treatment known to man and his disappointment was that there was no more to roll out … but more of that later.
Jerry was always immensely grateful to his medical team – as I reflect, I don’t ever recall him badmouthing his docs …ever! More often he was calling to tell me how graciously and compassionately they had received him! That reflected Our Man!
Right now, I want you to hear directly from Jim Schraidt in Jim’s own words – the dear friend with whom Jerry went o Key Largo last year. Jim cannot be with us today as his wife Jane is undergoing cataract surgery in Chicago, but as they say – this message is endorsed by all Jerry’s UsTOO colleagues. UsTOO, btw, is no more and has been merged into ZERO; Jim now sits on their Board.
Jim Schraidt’s tribute below inserted here.
To borrow a term from one of our Pfizer colleagues, Jerry was a LEGEND of support for prostate cancer patients. Somewhere around 2006, Jerry started attending Peter Moon’s UsTOO Support Group here in Richmond. Peter – I feel sure you are here – please stand up.
Peter was one of the very few local folks who knew and understood Jerry’s condition. He has been a member of Jerry’s inner support circle longer than anyone except Patsi. Meanwhile, Jerry loved what UsTOO was doing and before very long he was offered a seat on the UsTOO Board where he could evangelize for support in the same way he evangelized for his faith. Indeed, he was a legend, and under his navigation UsTOO expanded and grew its loose network of physical, mainly peer-led support groups across the nation and the globe.
By the mid 20-teens, Jerry was Vice Chair and ready to step into the chair when his advanced prostate cancer made him think twice about assuming those responsibilities. Instead he took to the sidelines to support, coach and guide from the wings.
It was around 2014 that I came to meet Jerry. We knew of each other – I had been a bit of a rebel when it came to UsTOO as we engineered a scheme to replace the ineffective Chief Exec. Nonetheless, in 2014 the Board voted to give me and one of my accomplices-in-crime, dear Dominic Marrese Of Blessed Memory , national recognition awards. In my case it was for the work I was doing virtually in prostate cancer support. I continue to be active in virtual patient support for several diseases and conditions through AnCan Foundation. Jerry became a member of our Advisory Board when he stepped down from UsTOO in 2018, 2 years after we formed AnCan.
Jerry was a true confidant and advisor, both on personal and AnCan issues. I sought Jerry’s counsel when I was in a pickle, listened carefully and closely to his words of wisdom and heeded them. He was never afraid to tell me I stepped over the mark or should back off … and frankly, I can’t ever remember doing anything against his advice. Jerry guided me with great care and compassion; I will always hear him in my inner ear as I continue to ask for guidance.
Personally, it was an immense privilege to navigate Jerry through the recent maze of prostate cancer approvals and developments. And while the grief and bereavement support group that he led in Richmond, often coincided with our meetings, whenever Jerry attended our Advanced PCa virtual group, he was a rock star. None the least, when Jerry joined from his hospital bed a couple of months back to show us his battle scar from removing the brain mets.
It was ALWAYS an honor to explain developments. I navigated and guided Jerry on his medical journey as we developed the questions for him to ask at his upcoming appointments. He was fearless …. and always wanted to do more. right before entering hospice Jerry was still asking Patsi what else we could do …. what a surprise!!
“Not Today”
I can truly say in Jerry’s case it was never out of fear of death but love of his family, friends, church, colleagues, mentees … in fact humanity in general. He wanted to be around to do more good and spread more love.
Jerry was a man of great faith … not my Jewish faith, but he respected that in his conversations with me which I always appreciated. We all hope that faith is rewarding him now. All of us have lost a true friend and an immense human being …. may you all receive much comfort as the pain of recalling Jerry subsides, and may Jerry’s memory always be a true blessing.
Let me close as I started … with Jerry’s own words ….
“One of these days this cancer might get me, but it might not be today and probably not tomorrow. Since it is NOT THIS DAY … Today we fight, and live and love and do everything we can to help others along the way. “
Onward & upwards …
Jim Schraidt’s Eulogy
I first met Jerry when I was appointed to the Us TOO International Board of Directors in 2015, but I really got to know Jerry better when we both were selected to attend a week-long retreat for non-profit leaders in San Francisco in 2017.
It was there that we spent hours talking about our dreams for the prostate cancer community and our personal journeys with prostate cancer. Although our journeys have been very different, Jerry was always interested in and respectful of my issues. He truly helped me in my journey and in turning my negative emotions into positive energy and concrete plans for supporting and advocating for the prostate cancer community.
During the retreat, I was amazed by Jerry’s ability to communicate with and support all of the other participants, most of whom were women. His extraordinary communication skills came from a sincere interest in the people around him, his ability and willingness to listen, and his positive non-judgmental and hope-filled approach to life and problem solving. He has spent countless hours using those skills for the benefit of the prostate community.
On a more personal note, last June, Jerry graciously invited me to join his bucket list diving trip. My son Brian had died about three weeks earlier, and Jerry knew that Brian and I loved diving together. Besides rejoicing with Jerry as he fulfilled this bucket list wish, he and Patsi helped me cope with my grief and remember good times with Brian.
Jerry, I miss you brother, but I know you will always be with me.
By the way, I was not the only AnCan’r present. Super-Volunteer aand Moderator Rich (and Brenda) Jackson drove up 100 miles from Norfolk, Va to keep me company. I was very grateful to see a familiar face. Boardie and Moderator,Herb Geller would have been present too, but was sailing in Scotland.
Onward & upwards, Jerry … your memory will forever be a blessing to all of us.
Going back many years, there has been debate around what is and what is not considered to be cancer. As an old-timer in the field of cancer advocacy I recall this debate ignited by UCSF breast cancer surgeon extaordinaire Dr. Lara Esserman when she spoke about IDLE in a Lancet article. IDLE stands for Indolent Lesion of Epithelial Origin. Early blogger Mike Scott latched onto this since the concept was supported by her UCSF prostate cancer colleagues, Drs. Peter Carroll and Matthew Cooperberg. Mike’s “new” Prostate Cancer Infolink article,New Terminology, IDLE threats, and human behavior (about cancer)from May 5, 2014 is defintiely worth a read!
Fast forward 8 years, and we are back in the midst of the same debate as to whether some suspect lesions should or should not be considered cancer. And who is that at the heart of this …. none othre than our own Advisory Board member, Howard Wolinsky stirring up the pot yet again along with urologist buddy, Dr. Scott Eggener from University of Chicago. Howard and Dr. Scott got to talking and rekindled this debate as to whether calling a suspicious lesion cancer too early can result in more harm than good. Howard, for example, had a life insurance policy application rejected in 2010 becasue of his prostate cancer diagnosis that has only produced one diagnosed Gleason 3+3 lesion in multiple screenings and biopsies over almost 13 years!. Dr. Eggener was motivated to write an journal article; he leads leads an illustrious group of authors that includes Matt Cooperberg … and of course Howard representing the patient voice in a controversial piece that appears in ASCO’s Journal of Clinical Oncology this month titled Low Grade Prostate Cancer: Time to Stop Calling It CancerLow Grade PCa – not cancer HW JCO 0422 .
While Dr. Cooperberg maintains his opinion, Peter Carroll may no longer wholly endorse that view. He and another of our Advisory Board members, Dr. Jonathan Epstein, are preparing rebuttals. Another well respected medical professional went as far as to say privately,”Unfortunately I really struggle with this. Why do we need to infantilize patients. We don’t call metastatic cancer the ‘monster'” There are definitley two sides to the coin ….. from the anxiety the ‘C-word’ provokes and repurcussions that Howard found out can be financial; to failing to properly acknowledge the gravity and treatment of precancerous lesions medically and otherwise.
Read the Chicago Sun Times report here; and Howard Wolinsky’s own take posted on his blog here. To see Howard and Scott Eggener speak about this yourself, listen to them on Chicago NBC news …. then you decide!!
Hi-Risk/Recurrent/Advanced PCa Video Chat, Mar 21, 2022
Apologies to all this week as the Reminder did not go to the full distribution list. My error whilst on the road! Nonetheless, you can catch up now … (rd)
Next meeting will be on Apr 4, 2022
All AnCan’s groups are free and drop-in – join us in person sometime! You can find out more about this and our other 10 monthly prostate cancer groups at https://ancan.org/prostate-cancer/ Sign up to receive a weekly Reminder/Newsletter for this Group or others at https://ancan.org/contact-us/
Editor’s Pick: Peter K says “We have to strategize our own treatment!” And how can we fail to mention Jerry Dean’s incredible courage and attitude?!? (rd)
Topics Discussed
Prostate Cancer brain mets and Tx; new de novo Mx man discusses his Tx path; pembro will bve next Tx for MSI-H gent; what’s next – darolutamide, Provenge??; we have to strategize our own treatment; metformin; Orgovyx; super-broccoli; AUA Summit; Lu177 PSMA in Phoenix
Chat Log
Peter Kafka – Maui (to Everyone): 5:38 PM: Was the brain cancer Prostate cancer? I might have missed that.
William Franklin (to Everyone): 5:41 PM: He saiid it was unrelated.
Peter Kafka – Maui (to Everyone): 5:53 PM: IMUDX swab test provides info about whether Keytruda will be tolerated.
Pat Martin (to Everyone): 5:57 PM: Thanks to all.
Peter Kafka – Maui (to Everyone): 6:09 PM: What about Provenge at this point?
Julian Morales-Houston (to Everyone): 6:44 PM: I eat roasted brocolli along with brussel sprouts on a regular basis.
George Rovder Arlington VA (to Everyone): 6:45 PM: Thanks Rick.
Frank Fabish – Ohio (to Everyone): 6:47 PM: Got to go guys.
Len Sierra (to Everyone): 6:48 PM: That PCF site said eating broccoli had the anti-inflammatory effect of one Advil. So, take an Advil and call me in the morning.
Jeff Marchi (to Everyone): 6:48 PM: can’t take advil, on blood thinners
On September 1st, we had Aurora Esquela Kerscher, PhD (Associate professor of microbiology and molecular cell biology and a prostate cancer researcher at Leroy T. Canoles Jr. Cancer Research Center) offered strategies to help laypeople understand medical research articles.
Laypeople may want to read medical journals to find out the latest research in the media, including findings that might impact their care. Dr. Kerscher said it can be hard to track down and expensive to obtain papers. She said Google Scholar at https://scholar.google.com/ and PubMed.gov can lead to pertinent papers. ResearchGate.net can help link people to authors, who might be willing to send interested parties their papers.
In this presentation, Dr. Kerscher gave an anatomy of a research paper, focusing on a new study on how exercise can help prostate as well as cardiac health in men on active surveillance.
She also provided a step-by-step guide on how to quickly read/skim a research paper.
“Ask yourself – WHAT IS THE BIG QUESTION?”
–What problem is being addressed?
–Then ask yourself – Why should I care?
Her final helpful tips were:
• Read slowly, take notes as you read,
• Question assumptions, the importance of the problem.
• Write questions to track what you don’t understand. Write down and translate jargon in Google.
• Sometimes what is not in the paper is more important than what is in it.
• Is there something the authors have overlooked?
• Don’t let ideas or design details pass until you understand them.
• Do not assume the paper is correct, even if published in a prestigious peer-reviewed venue
Watch this extremely information presentation here:
To view the slides from this presentation, click here.
For information on our peer-led video chat ACTIVE SURVEILLANCE PROSTATE CANCER VIRTUAL SUPPORT GROUP, click here.
To SIGN UP for the Group or any other of our AnCan Virtual Support groups, visit our Contact Us page.
Hi-Risk/Recurrent/Advanced PCa Video Chat Support – Men & Caregivers Recording, May 03, 2021
Editor’s Pick: An 80 yr old man tolerating docetaxel is an inspiration to all. Later on, practically ,do you stop treatment to allow PSA rise for screening purposes? (rd)
Topics Discussed
80+ yr old man undergoes chemo, but rash stops it; reluctant patient faces recurrence; Grade 4 Radiation Cystitis; more recurrence w. pelvic girdle RT; NGS reveals MSI-H; getting an Axumin scan thru MSKCC; In Memory of Scott Hogan; ARV110 trial fails BRCA2 patient; swollen legs leads to coming off abi; melanoma Dx to add to PCa; continuing Tx vs allowing PSA rise to see source of recurrence; bowel and bladder maintenance during salvage RT
Chat Log \
John Ivory (Private): 5:22 PM: https://www.dignityhealth.org/ourdoctors/1699772210-russell-gollard
Carlos Huerta (to Everyone): 5:25 PM: Extravasation is when a medication gets out of the vein and under your skin.
Jake Hannam (to Everyone): 5:26 PM: Extravasation is the leakage of a fluid out of its container into the surrounding area, especially blood or blood cells from vessels. In the case of inflammation, it refers to the movement of white blood cells from the capillaries to the tissues surrounding them (leukocyte extravasation, also known as diapedesis). Extravasation injury is defined as the damage caused by the efflux of solutions from a vessel into surrounding tissue spaces during intravenous infusion. The damage can extend to involve nerves, tendons, and joints and can continue for months after the initial insult.
Bruce Bocian (to Everyone): 5:37 PM: Try lavender oil
Eileen Murphy (to Everyone): 5:37 PM: How about Sarna lotion with menthol or Aveeno products?
Bruce Bocian (to Everyone): 5:38 PM: I got the lavender oil tip from the essential oil book
Bob McHugh (to Everyone): 5:57 PM: A shrink or social worker for this guy?
Herb Geller (to Organizer(s) Only): 6:03 PM: I just searched his hospital and there are no GU oncologists
William Franklin (to Everyone): 6:27 PM: I don’t want to take up time we can use to talk to you guys so I’ll put my plug in here. If you feel like ANCAN has helped you and you’d like to say something nice about us, please hop over to greatnonprofits.org, search for ANCAN, and make a comment. We would greatly appreciate it.
Rick Davis (to Everyone): 6:31 PM: You can go ot our website and just click on Testimonials too
Bruce Bocian (to Everyone): 6:42 PM: Bill, just posted my review!
Frank Fabish (to Everyone): 7:15 PM: need to sign off. Thank you all.
Carlos Huerta (to Everyone): 7:17 PM: Dont forget the old standard. Castor Oil.
Joe Gallo (to Everyone): 7:20 PM: Senakot is brand of Sena
Some 200 folks gathered together last Friday, June 24 at the Cold Spring Baptist Church in Mechanicsville, Virginia. to celebrate the life of our dear Advisory Board Member, Jerry Deans, Of Blessed Memory. I was honored to present one of the three tributes … and no surprise, we all said the same thing in different words.
In fact, Jerry continued to defy medical science for 23 years., He experienced almost every prostate cancer treatment known to man and his disappointment was that there was no more to roll out … but more of that later.
I first met Jerry when I was appointed to the Us TOO International Board of Directors in 2015, but I really got to know Jerry better when we both were selected to attend a week-long retreat for non-profit leaders in San Francisco in 2017.
During the retreat, I was amazed by Jerry’s ability to communicate with and support all of the other participants, most of whom were women. His extraordinary communication skills came from a sincere interest in the people around him, his ability and willingness to listen, and his positive non-judgmental and hope-filled approach to life and problem solving. He has spent countless hours using those skills for the benefit of the prostate community.
By the way, I was not the only AnCan’r present. Super-Volunteer aand Moderator Rich (and Brenda) Jackson drove up 100 miles from Norfolk, Va to keep me company. I was very grateful to see a familiar face. Boardie and Moderator,Herb Geller would have been present too, but was sailing in Scotland.
