AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostics.
WELOME all to our newly recorded Low/Intermediate Prostate Cancer Group. To receive notice when new recordings are posted, either follow us on this YouTube Channel or sign up to our Blog via https://ancan.org/contact-us/ – check New Blog box.
If you missed any recent recordings, you’ll find a full list either on our YouTube Playlist (click above) or visit our Blog Post https://ancan.org/our-recent-blog-posts-in-case-you-missed-them/ Sign up for our Blog by checking the New Blog box at https://ancan.org/contact-us/
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s Pick: You rarely get out of cancer Scott-free; and treatment decisions complicated by other chronic conditions (rd)
Topics Discussed
Evaluating treatment plan options (radiation, surgery, and hormone therapy) and quality of life issues associated with treatments; Participating in the RTIRE trial for treatment; Understanding different medical reports and tests for prostate cancer; Getting a third opinion to decide between surgery and radiation while seeking the best quality of life outcomes; Life after treatment and having the right mindset; Choosing a treatment option when other chronic conditions/diseases exist; What makes focal treatment a good option.
Chat Log
Jim Stewart Reno, NV sent: 6:25 PM
have to pick up grandkids so signing off….see you all next time!!
AnCan and The Marsh (well renown, long-established theater company with a large following in the Bay Area and venues in San Francisco and Oakland) collaborateevery 4th Wednesday of the month for Solo Arts Heal.
We were so happy to welcome AnCan’s own, Dan Dressen!
Dan is a moderator for our Active Surveillance Prostate Cancer support group, and also a talented musician from Southern Idaho, with a passion for Americana music. With roots in Minnesota and a stint in both Southern and Northern California, Dan has honed his skills on the guitar since the age 14.
In 1975, while at the University of Minnesota, he filled in as student coordinator at the Whole Coffeehouse. The Whole, as it was know, brought in music that attracted audiences locally, regionally and nationally and he still follows the music and musicians from that time period.
Now today and for over a decade, he has been entertaining at open mic nights, sharing his unique blend of country-inspired tunes with audiences in various venues on West Coast. Married to his wife Lila for 35 years, Dan is joined by their two feline friends Willow and Webster. Drawing inspiration from songwriters such as Guy Clark, Tom Russell, John Prine, and Robin & Linda Williams, Dan brings his own distinct voice to the Americana genre.
You’ll hear warm songs, fantastic stories, and great conversation. Dan has learned the importance of being “active” when taking charge of one’s health journey, and will also share the importance of being your own best advocate. (an AnCan favorite!)
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostics.
WELOME all to our FIRST recorded Low/Intermediate Prostate Cancer Group. It proved to be an excellent and lively session with about half our time devoted to radiation therapy and half to radical prostatectomy/ surgery. To receive notice when new recordings are posted, either follow us on this YouTube Channel or sign up to our Blog via https://ancan.org/contact-us/ – check New Blog box.
If you missed any recent recordings, you’ll find a full list either on our YouTube Playlist (click above) or visit our Blog Post https://ancan.org/our-recent-blog-posts-in-case-you-missed-them/ Sign up for our Blog by checking the New Blog box at https://ancan.org/contact-us/
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s Pick: With seminal vesicles positive for cancer in post-surgical pathology, what’s next?(rd)
Topics Discussed
PROSTOX test determines longer term sensitivity to radiation; SBRT vs hypofractionation; Dr. Greco is the go-to RO in the DC are; what does your Rad Onc do for you between sessions?; MIRAGE RT trial to report soon – how effective is MRI Guidance?; does cancer in your SVI post-surgery require follow up treatment?; MSKCC nomograms help guide decisions; with 3+4, when to follow up post-RP; 3+4 man decides to treat with RT; can you get a consult out of state.
Chat Log
sent: 5:14 PM
Dr. Mark. I cannot talk now. My question is not important. I can ask it at our next meeting.
sent: 5:18 PM
Rick. Can you please provide the link to that study you’ve mentioned.
Transperineal Biopsies – AnCan’s favorite Standard Bearer explains!
If you’ve been around AnCan’s prostate cancer programming, and for sure our Active Surveillance and Low/Intermediate Groups, you are certain to know AnCan moderator and medical journalist Howard Wolinsky. He has campaigned on many issues impacting men like him with very low, low and intermediate risk prostate cancer. The list is long – and included below!
Howard has three signature campaigns. He has worked ceaselessly to expand the number of men diagnosed with very low, low and low/intermediate risk prostate cancer who are treated with the active surveillance protocol. He is a founding member of the medical group advocating to rename very low grade prostate cancer something other than cancer. It recently dawned on us that AnCan, one of Howard’s ever present platforms, had never blogged on TPs.
TPs avoid the germy rectum and virtually never cause infections or potentially deadly and disabling sepsis, although nothing is 100%. The biopsy needle is placed through the perineum, the space between the rectum and the testicles. This is not only patently more hygienic avoiding all fecal material, but also allows access to posterior areas of the prostate that cannot be reached with the TR protocol. Here’s an excellent short video to better explain.
Over 800 people—fellow patients and some leading physicians—have signed his petition to phase out transrectal biopsies. Wolinsky called on Medicare and Congress to intervene after a scandal in Norway caused the European Association of Urology to take on the issue in 2021 when a Norwegian died from sepsis following a prostate biopsy. The policy head of EAU told Wolinsky that transrectal biopsies were tantamount to “malpractice” in Europe. Wolinsky moderated a debate on TP vs. TR at AnCan in 2022 AnCan also ran two webinars on the topic in 2022:
So what did the American Urological Association do?
You might expect some resistance to a major change in practice that’ would cost urologists time to be trained and up to $40,000 in equipment to set up this new approach. That’s what happened. Wolinsky, representing AnCan, as a consumer reviewer, told the AUA Early Detection Guidelines in 2023 that they should recommend transperineal biopsies as the preferred method. He said men were dying while they were debating which end of the egg is better to break first.
AUA still put TP on par with TR in its guidelines. A small step for men, as Neil Armstrong said on the first moon landing. The AUA is conservative and says it requires high levels of evidence from research before changing its guidelines—even though EAU counterparts consider TP their preferred method. Daniel Lin, MD, vice chair of the AUA committee, said in 2023 that randomized clinical trials would be the key to resolving the issue and several were coming in the next year.
Dr. Badar Mian’s single-center RCT at the University of Albany showed TR and TP essentially had the same results in terms of infections. It was widely criticized for not having enough patients to reveal rates for sepsis.
Dr. Jim Hu’s multi-center study based at Weill-Cornell “almost” showed a statistical benefit to TP in a paper presented last January. But no cigar. The study was expanded and it is clear that TP wins in this research. Hu told the recent AUA meeting about it, but won’t talk about the results until the study is published.
But TP, meanwhile, is in increasing demand. A poll of 145 AS-educated readers of TheActiveSurveillor.comfound that 36% had undergone a TP biopsy – far above the national average of 15% now and 10% two years ago. 54% of respondents expect to undergo transperineal procedures in their next biopsies.
None of this is say biopsies should be eliminated, just that they should be done as necessary and as infrequently as possible. A decade ago, urologists recommended annual biopsies. As their confidence in AS has increased, the frequency varies by practice: from every other year to three to five years as in Dr. Klotz’s practice in Toronto. Wolinsky’s own care as a peer in this Active Surveillance cohort has de-intensified with annual visits to his doctor, Dr. Brian T. Helfand | NorthShore He has not had an MRI or biopsy in eight years–though his doctor still considers Wolinsky on AS. At age 76, he is considering hopping off the AS train.
Just in case you think Howard is a one-track (or even three-track) pony, here are a few other issues he has undertaken on behalf of men living with very low, low and intermediate prostate cancer.
If you were walking down E. Luray Avenue in Alexandria, Virginia, maybe you saw this house ….
In front of that house was a table…..
… not, just any table but one bedecked with a white tablecloth, candle, red rose in a vase, wineglass, empty chair and more …
As you may have guessed, this is not just any house. Captain Jim Marshall (USAF Rtd) lives here with his good wife, Gail. It was Gail who came up with the idea to set up this symbolic table
On This Memorial Day We Honor The Fallen Soldier ★★
This table is reserved to honor our brave and selfless American military members who have perished on the battlefield, those who have not been returned to us after being taken prisoner on foreign soil, and for those who went missing and have not found their way back home.
The table is round- to show our everlasting concern for our fallen and our missing, and set for one, it is small, symbolizing the frailty of one prisoner alone against his or her suppressors.
The white tablecloth – symbolizing the purity of their intentions to respond to their country’s call to arms.
The single red rose– reminds us of the life of each of our fallen, and the loved ones and friends who miss them each and every day.
The vase is tied with a red ribbon – a symbol of our continued determination to remember our fallen and find our missing.
The slices of lemon – on the plate is to remind us of the bitter fate of those who will never return.
A pinch of salt– symbolizes the tears endured by the friends and families of those who have fallen and of those who have not returned.
The inverted wine glass– they cannot toast with us at this time.
The empty chair– they are no longer with us.
The candle – is reminiscent of the light of hope which lives in our hearts to illuminate their way home from their captors, to the open arms of a grateful nation.
Thank you Jim and Gail from all of us at AnCan Foundation on this National Memorial Day holiday!