Prostate cancer
InsightsIssue 7 | Winter 2016 10-year ultimatum Our plan to beat the disease in a decade
Prostate cancer and me JEFF STELLING
Rise of the biomarkers The new revolution in diagnosis and treatment
Insights | Winter 2016 1 Inbox Would you have Get in touch and Editor’s 3 have your say INBOX a genetic test? note Tell us what you think about the magazine. Prostate cancer news We asked you this question There’s a real sense of All feedback is welcome: we want to hear what you’ve got to say. The latest research in our feature, ‘Unravelling excitement in this issue developments the clues in our genes’, 4 – and it’s not just the predictive value of this the media occasionally and received these irrepressible personality procedure to identify suggests we are. Biomarkers laid bare responses online: of our cover-star, Jeff prostate cancer’, surely Our in-depth guide to p19 Stelling. Nor is it our there should be wider In this case, our Director a new generation of Dear Insights feature about the amazing applause for initiatives and of Research, Dr Iain 6 tests for diagnosis p6 advances researchers are You recently reported on endeavours of this nature, Frame, went to meet Dr and treatment making with biomarkers the trial results of using shortcomings and all? Claire Guest, the CEO Forewarned is forearmed. ONTENTS to diagnose and treat dogs to detect prostate of the Medical Detection I am all in favour of genetic Richard Murphy, Prostate Cancer UK prostate cancer, though cancer from urine samples Dogs charity, and talked to testing. It happens for
C via email update it certainly heralds an (Behind the headlines, her about how to get the families with a history of exciting new era of summer 2015) – a novel most robust data possible breast cancer – rightly so. All the latest from us Dear Richard, 9 individually-tailored and potentially life-saving about what the dogs are Prostate cancer needs treatments. field of medical enquiry. Thanks for getting in actually detecting. While to be treated on the Our 10-year ultimatum It’s so reassuring to know touch. It’s not always it would be great if the same footing. Find out about our It’s our new 10-year that there is no ceasing possible to get the tone of dogs could reliably detect Brett Ennals exciting new strategy to strategy, which commits in the efforts to expand our stories right for every prostate cancer, what 10 beat prostate cancer in a us to beating this terrible upon the means and reader but we certainly we really need is a way decade and the scientists disease within a decade, methods for detection don’t want to lecture. We to distinguish between whose work will make that has got us most of the disease, but how understand and respect aggressive and non- it a reality excited. It’s a bold disappointing to read that everyone will form aggressive tumours to Totally agree with genetic ambition but one that your, at times, patronising their own opinion. But rule out biopsies for men testing as we have had Prostate cancer leading scientists in the critique. While the original it is our responsibility to with no, or very low, risk three men in our family and me: Jeff Stelling field think is realistic. research concludes paint a clear picture of disease. In the meantime, that have had prostate The Soccer Saturday If that’s not worth quite rightly: ‘Further where we really are with we’ll continue to monitor cancer, thankfully all 14 presenter talks about his shouting about, what is? studies are needed to research, rather than the progress of Dr Guest’s in remission, so early epic fundraising walk for us investigate the potential where we hope to be or research with interest. detection can be treated and how you can join him Which is why we’ve got with better results. Jeff Stelling on board Sign up to Insights Viv Price to lead the epic Men The Manual monthly email United March this spring, How healthy eating can newsletter: getting the message out help with prostate cancer Get all the latest news, to as many people as Dear Insights My husband 16 views and events from possible. So get excited, I thought the last edition of I think it is better to know won’t talk about us direct to your inbox – DIY golf challenge spread the word and Prostate cancer Insights and monitor your health. just enter your details How one 12-year-old encourage others to join was great. Very readable, his prostate Hopefully advancement at prostatecanceruk. organised a tournament us, because we need well paced, informative in medicine will treat 18 fundraiser and you can too with the right amount of cancer. Finding org/insights early signs quicker – p14 the support of everyone for our new strategy detail, friendly and with an comfort from perhaps with stem cells? Trekking to the to succeed. excellent tone – neither South Pole talking up or down. others and Tariq Plus Top Dad and Best wishes for all future how they cope 19 thanks to fundraisers editions: I’ll be looking forward to getting them. doesn’t make Get involved Dick Tonkin, me feel so alone. Dates for your diary and South Wales great ideas for spring Editorial team Thank you for 20 Sophie Lutter Sarah Lines your help. Our support Nick Wright and services Penny Eaton Like us on Facebook: Follow us on Twitter: Email the Insights team: p10 22 How we can help you Dominic Bates (Editor) Prostate Cancer UK @ProstateUK [email protected] 2 Insights | Winter 2016 Insights | Winter 2016 3 Second wave of landmark survey of men with PROSTATE CANCER NEWS prostate cancer brings total to 60,000 The second batch of cancer on everyday life hospitals – to make sure The research team NHS England fast-tracks upfront docetaxel after our pioneering ‘Life after by asking the only people they provide the support doesn’t only want to prostate cancer diagnosis’ who really know: men and care men say is know if your experience STAMPEDE trial publication and mounting pressure survey is set to land on who’ve got the disease. important to them. was bad, either. Knowing men’s doorsteps this where and why men have It’s been a frustrating wait The breakthrough followed December to make sure men. Earlier docetaxel month, after more than This is your chance to So if one of these surveys good experiences of care since the astonishing results our tireless influencing the treatment reaches must become standard 20,000 were sent out report your experiences lands on your doorstep, will give us important of the STAMPEDE trial were of NHS England behind men as soon as possible. practice for men with around the UK in October. and influence the future of please don’t throw it examples of what should announced in May last closed doors, who were advanced prostate cancer. prostate cancer care away. The questionnaire be happening elsewhere. year. But now docetaxel stalling until STAMPEDE’s We’re delighted that NHS Funded with support from in the UK. We’ll be taking will only take about half chemotherapy as a first- results had been officially England has ensured an Our Chief Executive, the Movember Foundation the results and using an hour and will help us To find out more about line treatment alongside peer-reviewed and accelerated review of Angela Culhane, says: and led by researchers at them to influence understand how tens of the study or read answers hormone therapy will be published in a medical the evidence, and that “This positive result means the University of Leeds and governments and health thousands of you have to some commonly made available to all men journal. That happened we’ve been supporting men will be accessing Queen’s University Belfast, providers in all UK nations been affected by prostate asked questions, visit in England with newly shortly before Christmas, the development of a the new treatment much the study aims to find out at all levels – from national cancer and what support prostatecanceruk.org/ diagnosed advanced but even before then, commissioning policy for sooner after peer-review the impact of prostate decision-makers to local you’ve had to deal with it. lifeafterprostatecancer prostate cancer. It could NHS England had given upfront docetaxel. We than would normally be the extend lives by an average in to pressure from us now need specialists to case. But we’ll continue of 15 months compared and clinicians wanting to be made aware that this applying pressure until A year in the Movember to the usual pathway of openly prescribe upfront commissioning policy we know that men are FROM THE LAB Centres of Excellence docetaxel only after hormone docetaxel. They have is imminent so that it is actually receiving this treatment stops working. worked with us since prescribed to all eligible treatment in the clinic.” It’s been just over a year since the Movember Centres Meanwhile at the Institute of Cancer Research, they’ve of Excellence opened their doors for business, and recruited staff to run a clinical trial called CTC-STOP. here’s what’s happened since. This trial is based on the idea that the number of cancer BEHIND THE HEADLINES: Does the success of cells that have escaped the tumour to move through Belfast-Manchester the blood stream (known as circulating tumour cells, the Stockholm trial mean an overhaul of prostate The Belfast-Manchester Movember Centre of Excellence or CTCs) gives an indication of how well a treatment set out with a very clear aim: to predict who will respond is working. The trial will investigate whether switching best to treatments for advanced disease, and who’s at treatments based on a change in the number of cancer screening is imminent? risk of their disease returning after initial radical therapy. CTCs in the blood can improve survival for men with What is it? In November, any clinically significant on the basis of a 3ng/ml research team behind the advanced prostate cancer. the trial results of a prostate cancer is PSA level alone. programme The team started by recruiting new research leaders new Stockholm-based present. Only then are to find a way from around the world to head up some of their Both teams have already demonstrated the value screening programme for the men referred to a So when will it be to validate projects, with experts joining them from Boston, of bringing researchers and clinicians with different prostate cancer showed urologist for a digital rectal available? While the these results Oslo, California and Cambridge. scientific and medical expertise a dramatic reduction in examination and prostate results are extremely for the UK together to make a real and These new teams had their work cut out to get up and the number of referrals for volume check – together promising, further population. lasting change for men with running within the year, but they’ve risen to the challenge, biopsy compared to using with anyone who initially trials are needed prostate cancer. And it’s and their projects are all off to a flying start. In fact the a PSA test alone. It spared had a PSA level of 3ng/ to prove that the only going to get better first clinical trials are open to recruitment, and they’ve many men the discomfort ml or more – with a programme works as the results of these already pulled in additional funding from elsewhere to and potential risk of an biopsy performed if any for a more projects start to extend their ambitious research programme. invasive procedure that abnormalities are found. ethnically and come through in socially diverse the coming years. may not find any cancer. London How effective is it? The range of men, The London Centre of Excellence is off to an award- How does it work? Any additional panel of tests and that the For the very latest from the winning start, as the UCH Urology Team won a man’s blood with a PSA reduced the number of costs and Centres and their researchers, visit prestigious Innovation award from the British Medical level of more than 1ng/ biopsies by 27 per cent complexities prostatecanceruk.org/excellence Journal for their pioneering work to improve prostate ml is put through a panel overall, with the number of the additional cancer diagnosis. of further tests looking of negative biopsies blood tests for various genetic and performed also down by are practical and protein biomarkers that 38 per cent compared affordable on a mass If you’d like to comment on this or other news stories, go to prostatecanceruk.org/news can give a more reliable to the current practice of scale like the NHS. We’re and join the conversation. indication of whether referring men for biopsies working with the Swedish
4 Insights | Winter 2016 Insights | Winter 2016 5 Below is a roundup of some of the biomarkers being urine, and so the relative protein levels within it, varies It’s possible that multi-parametric MRI (mpMRI) will be tested in each of these categories. A few tests, like depending on how much water you’ve had to drink. able to rule out not only men with no prostate cancer, the PSA test, are already in use, while many are still in This means that any test has to be able to take that but also men with non-aggressive prostate cancer from development and showing promising results. into account when interpreting the results. needing a biopsy. A clinical trial called PROMIS looks Biomarkers set to help us answer some of these questions when it Risk biomarkers Two urine markers in particular – tests for which are reports later this year. available in some private clinics in the UK – have come SNPs under scientific scrutiny. The first is called prostate The most common type of risk biomarkers are genetic Prognostic biomarkers cancer antigen 3 (PCA3). This is expressed specifically markers called Single Nucleotide Polymorphisms or Prolaris laid bare in the prostate and at especially high levels in prostate SNPs (pronounced snips). These are where a single Developed by a company called Myriad Genetics, Prolaris cancer. The second is TMPRSS2-ERG. This is a ‘letter’ of the DNA code is different between groups is probably one of the most talked-about treatment common genetic change in prostate cancer cells of men at average and higher than average risk of decision tools and is available in some UK private where two genes (TMPRSS2, which is activated prostate cancer. So far, researchers have clinics. This test measures the activity of 31 different by testosterone, and ERG, a cancer- found over 100 SNPs that can indicate genes to determine how fast the cells are dividing and promoting gene) fuse together. When higher risk of prostate cancer, but growing as a marker of how aggressive the cancer is. this happens, ERG starts to be only around 20 that suggest activated by testosterone and a higher risk of aggressive Prolaris seems to be most useful for men with a It’s the latest buzzword in cancer promote cancer growth. research, but what exactly is a disease. This type of Gleason score of seven or higher, who are considering active surveillance. A Prolaris score (called a cell biomarker? Sophie Lutter finds biomarker is usually These markers both cycle progression, or CCP score) of two or higher out and explains how they could detected in blood or seem to be more may indicate that it’s worth thinking about treatment revolutionise the diagnosis and tissue samples. accurate than to control the cancer. This is because there’s a link treatment of men with prostate cancer. PSA at indicating BRCA1 and between a score of two or more and death from prostate the presence BRCA2 cancer in men with a Gleason score of seven or more. If you’ve read anything at all about prostate cancer of prostate Sometimes a research in the last few years, you’ve probably heard cancer single gene More recent research suggests that Prolaris could the word ‘biomarker’ bandied about like the latest and some can contain also be used to help guide a decision about whether trendy buzzword in a Silicon Valley start-up. But scientists more than or not active surveillance is appropriate for men with how many of us really know what it means? think that one type of a Gleason score of seven or lower. But these results testing for The definition of the word biomarker is ‘a measureable mutation, haven’t yet had the ‘stamp of approval’ that comes TMPRSS2- characteristic that highlights a difference between two some of from publication in a peer-reviewed journal, so the ERG and biological states’. It can be any number of things: a which may jury’s still out on this one. PCA3 gene, a protein, a chemical structure, a part of a cell be more together can or a ribonucleic acid (RNA) molecule – literally anything harmful than help decide that changes in response to a biological transition. others. So far, which patients we only really need to have a As for the transition, this could be any number of things know about biopsy. Others too. Like the change between a healthy cell and a two genes where think that these We hope we’ll soon not only cancer cell, an aggressive cancer and a non-aggressive harmful mutations tests still aren’t cancer, or a cancer cell before effective treatment and a increase prostate good enough to rule understand every dilemma a cancer cell after effective treatment. cancer risk – the out non-aggressive ‘breast cancer’ genes man might face but have the prostate cancers, or In prostate cancer, there are four main categories of BRCA1 and BRCA2. to make sure that all the biomarker that are defined by the type of information Mutations in these genes biomarker tools to resolve them aggressive cancers are caught. they give: can either be inherited or Oncotype DX occur spontaneously. Risk biomarkers: Those that reveal whether a man Imaging Oncotype DX looks at 12 cancer genes involved in four One very promising way to rule out is at higher or lower than average risk of developing PSA different biological processes and gives what’s called a unnecessary biopsies could be through imaging the prostate cancer, or aggressive prostate cancer. The best known biomarker for prostate cancer risk is genomic prostate score, or GPS, from zero to 100. prostates of men with a raised PSA before they have a the prostate specific antigen protein, more commonly biopsy. An enhanced form of MRI scan allows clinicians It was tested in two different groups of men who Diagnostic biomarkers: Indicate whether a man has known as PSA. If you have a higher than expected level to not only examine the anatomical structure of the had their prostates removed. In both studies the prostate cancer or not. of PSA protein in your blood, it indicates that you’re at prostate, but also to measure changes to the tissue investigators found that there was a link between increased risk of having a prostate problem. Prognostic biomarkers: Used to give doctors an idea within it. For example, changes in the pattern increasing GPS and the prostate tissue showing a of what the most likely outcome would be for a man if of blood flow or the movement of water molecules more serious cancer than was predicted from the he wasn’t treated at all. Diagnostic biomarkers in a tumour compared to normal prostate tissue biopsy. Oncotype DX hasn’t yet been tested on men PCA3 and TMPRSS2-ERG are biomarkers that indicate the presence of a with prostate cancer who aren’t being actively treated, Predictive biomarkers: Can predict how a man will One difficulty with developing a successful urine test prostate tumour. so we don’t know if GPS can predict the likelihood of respond to treatment for prostate cancer. for prostate cancer is that the concentration of your dying from prostate cancer.
6 Insights | Winter 2016 Insights | Winter 2016 7 This means that overall, Oncotype DX might be useful to help men with a Gleason score of six or seven decide Movember Award for between active surveillance and treatment. But since we don’t yet know how well this reflects overall survival, moves make work with we can’t be too confident about its usefulness just yet. Oncotype DX is currently only available privately in the We hardly know a difference volunteers UK for breast cancer. The annual month of facial Our 2,000 volunteers are where to start! hair and fundraising saw vital to our work, so we’re tens-of-thousands of delighted to have been Predictive biomarkers Dr Hayley Whitaker is people taking part across awarded the Investing in Decipher working to combine UPDATE the UK. Our own network Volunteers accreditation Decipher is another panel of genetic biomarker tests, biomarkers with prostate of MoBros and MoSistas in July – the UK quality with a twist. In this case, it looks at the activity of 22 imaging at University managed to raise an standard for good practice different genes involved in various cancer processes. College London. But the twist is that it was developed specifically to Go shopping Thousands astonishing £53,000. in volunteer management. predict the likelihood of the prostate cancer spreading “When I first started out, PSA was the be-all-and- Superb work everyone! We try to make the outside the prostate even after a prostatectomy. This end-all of prostate cancer biomarkers and there for the cause enjoy a Lads This year, as well as volunteer experience as rich has been tested in a number of different trials and wasn’t anything else on the horizon. We thought You asked for it. And now, impressive moustaches, and fulfilling as possible. – in every case – has proved strongly predictive for the key to a new diagnostic test would be to find a after much anticipation, Night In On 25 September, Movember folk were also This award reflects our developing additional tumours after a prostatectomy. single new biomarker that could do everything. we’re delighted to At the moment, Decipher is only available in the US announce that our online thousands of homes getting active with a new volunteer team’s efforts to and we don’t know when the company that makes it “Now, of course, we have nearly the opposite problem: shop is open for business! throughout the UK held initiative called MOVE, produce a new volunteer will ask for, or be given, marketing approval in the UK. we’ve got so many potential new biomarkers With t-shirts, hoodies, a Lads Night In – our encouraging 30 moves in handbook, run regular we hardly know where to start! This is, in large pin-badges and a range new poker fundraiser 30 days. Movember’s UK training days, and AR-V7 part, because of the advances in technology – of accessories all nattily in partnership with country director, Sarah promote and celebrate the In September 2014, scientists announced the first clue particularly around genetics – that mean we now branded with our logo, PokerStars. We also held Coghlan, said: “Being work of volunteers to all as to why abiraterone and enzalutamide don’t work have ways to analyse large numbers of DNA and there are myriad ways to our own event at London’s active is one of the best Prostate Cancer UK staff. for some men with advanced prostate cancer. They tissue samples quickly and cheaply. show the world that you’re Hippodrome Casino. things you can do for your found that some men have a mutated version of the part of Men United – the health, so the addition You can read more about androgen receptor (AR) in their cancer cells, called AR- “Biomarkers will make a huge difference to men movement that believes So far we’ve raised a of MOVE makes it even our work with volunteers V7. This version is not only turned on all the time but with prostate cancer over the next few years in a men are worth fighting for. fantastic £42,000, with easier to do something fun at prostatecanceruk.org/ also lacks the part of the receptor that abiraterone and couple of ways. Firstly in diagnosis: we’re already more donations rolling in that’s good for you and volunteers enzalutamide stick to. Because the drugs can’t bind to making massive headway in how we diagnose With 100 per cent of all the time. We’ve also men’s health.” the receptor, they can’t do their job of blocking cancer prostate cancer. Now we need to get better at only profits from every sale heard from a number of growth in men with this mutation. diagnosing aggressive prostate cancer. And that’s going towards our work pubs and sports clubs Harry’s knack not too far off. I think that probably within the next to beat prostate cancer, who want to hold future If these results can be confirmed in a bigger clinical five years, we’ll be diagnosing far more aggressive you’ll be saving lives while events for us too. on the blower trial, this may be a really useful test to help men cancers, and not even offering biopsies to men who you shop. Visit the website As a further thank you consider their options when other treatments don’t have cancer or who have a harmless cancer. now and get kitted out at raises £40k are no longer working. prostatecanceruk.org/ from PokerStars, everyone Former football manager “This is the area that my research focusses on. shop who raised £100 on Harry Redknapp and Promising conclusions I’m really excited about the potential of combining the night was entered Sky Sports presenter into a prize draw for an Hayley McQueen took Overall, the word ‘biomarker’ is a bit misleading. It traditional blood or urine based biomarkers with awesome trip to the to the trading floor at the sounds like we’re talking about a single subject, when new imaging technologies like multiparametric MRI. Bahamas. Congratulations Bloomberg Tradebook in fact this one word covers pretty much every aspect I think putting these two technologies together will to the lucky winner, Alex event in November to of cancer biology, diagnosis and treatment. Ultimately, have amazing results, and I can’t wait to see what MacVicar, and his four raise money to help beat we hope we’ll soon not only understand every dilemma happens over the next few years. friends from Glasgow! prostate cancer. a man might face as he contemplates prostate cancer “The other area where biomarkers are going to Their night was inspired risk, diagnosis and treatment, but also have the make a massive difference is in working out which by Alex’s dad, who was The pair answered phones biomarker tools to help him resolve them. We’re not men should be given what treatment. I think diagnosed with prostate and made deals at the there yet, but the sheer volume of work going into everyone accepts that there just isn’t going to be cancer two years ago. annual charity event, this area – from non-invasive alternatives to biopsies a one-size-fits-all solution for prostate cancer and which sees the financial at diagnosis, to tailoring treatment to match a man’s that individual treatment options are the future. Read Alex’s story software giant donate one individual cancer – should give us real hope that this We’re only just starting to get to grips with this.” and find out more day’s commission to 15 is an achievable goal. about Lads Night In at charitable causes. Thanks prostatecanceruk.org/ to Harry and Hayley’s hard Read more about some of the exciting research we’re funding into prostate cancer biomarkers on poker work, Prostate Cancer UK Sophie’s blog at prostatecanceruk.org/biomarkers received over £40,000 on the day – a great result.
8 Insights | Winter 2016 Insights | Winter 2016 9 Our 10 year ultimatum
With the launch of our new strategy, we’re giving ourselves a decade to beat prostate cancer. Sounds ambitious? We hope so. Unrealistic? We think not – and neither do our scientists and supporters over the page. Because over the next 10 years we’ll be investing heavily in research, focusing on three areas: better diagnosis, better treatments and better prevention. But we haven’t forgotten the importance of supporting men with prostate cancer now, which is why it’s the fourth pillar of our new strategy. #1 Better diagnosis #3 Better prevention It’s not often a CEO proudly promises to put We’ll fund research that will pick up on aggressive We’ll prioritise understanding what makes a cancer cell their organisation out of business within 10 prostate cancer sooner, predict and manage the impact tick, so we can stop it from starting and block it from years, but that’s exactly what I’m doing with it will have, and reduce today’s number of biopsies and returning after primary treatment. our new strategy. Because by 2026, we at unnecessary treatments for cancers that are harmless. Prostate Cancer UK plan to have defeated the HOW? By using a man’s genes to assess his disease we were founded to fight 25 years ago. HOW? By developing and establishing a risk-based likelihood of being diagnosed with prostate cancer, we screening tool that can be available to all men and is can understand how to prevent it from killing him. In This isn’t just a pipe dream or another marketing more accurate and reliable than the PSA test alone. particular, we’ll look at the genetic changes that make plan. We think that beating prostate cancer is We have already started an international project prostate cancer aggressive and cause it to spread (read a realistic proposition. And we’re not alone. with the leaders in this area of research, and we are more about this in our biomarkers feature on p6). We Leading researchers in the field – including those determined to push ahead to get the benefits of this also need firmer evidence on whether a man really can quoted below – are optimistic that the science work to all men over 50 as soon as possible. usefully do anything to control his risk through diet, and technology to really target and destroy the exercise or drugs, and what role environment may play. disease aren’t far away. We’ve already seen radical advances in prostate cancer’s diagnosis, #2 Better treatments treatment and prevention in the last 10 years. We’ll invest in putting effective treatments, with fewer #4 Better support Imagine what will be possible in another 10. side effects, into the hands of the men who need them, We’ll continue supporting men directly ourselves, but wherever they live in the UK. we’ll also demand that other organisations meet their This doesn’t mean we’re abandoning men responsibilities. We’ll work with health professionals and living with prostate cancer now. We’ll continue to HOW? By understanding more about how prostate the country’s health services to pinpoint and implement provide services and help champion men’s health cancer progresses, we can make better and truly the changes necessary to deliver innovative care. so long as there are men who need us. We’re personalised treatments a reality. And the more effective just recognising that to get the medical care – and tailored a treatment is to a man’s individual cancer, HOW? As well as continuing our award-winning and cure – we so desperately want for men with the more likely unpleasant side effects – such as Specialist Nurse and fatigue services and information, prostate cancer, we need to commit as much incontinence and erectile dysfunction – can be reduced. we’ll be urging health services across the UK to pick up money as possible into groundbreaking research Critically, we need to make sure these treatments are the baton when innovative care that makes a difference to find them. made available to everyone and not withheld on the is discovered. We’ll make sure that prostate cancer is grounds of cost, politics or bureaucracy. right at the top of the priority list for decision-makers But we can’t do this alone. We need your help and we’ll hold them to account when they block men and support to crack this disease once and for getting the best care available. all. Working together, as Men United, we’ll make prostate cancer a disease the next generation of men need not fear. 25 years of research, lobbying and support... Angela Culhane Chief Executive Prostate Cancer UK 1991 1993 1996 1998 2002 2003 The Prostate Prostate UK and First call taken Prostate cancer Docetaxel We join the Cancer Charity Prostate Cancer by our Specialist becomes the chemotherapy government’s founded in a room Research Nurses. most common approved for new Prostate Read the full strategy and find out more about its creation at prostatecanceruk.org/10yearstrategy at Hammersmith Foundation cancer in men. use on the NHS. Cancer Advisory hospital. (PCRF) founded. Group.
10 Insights | Winter 2016 Insights | Winter 2016 11 THE SURVIVOR THE DRUG SPECIALIST THE GENETICS PIONEER
But don’t Ian Liston, Professor Johann Professor actor and trialist de Bono, Institute Charlotte Bevan, of Cancer Research Imperial College just take and Royal London Marsden Hospital When I was first diagnosed with prostate cancer in I’ve been pursuing research now for over 20 years, and I’ve been working in prostate cancer research for our word 2003, it was ‘not knowing’ that was the hardest thing most of that has been funded by charity. The British the last 20 years, and the way that technology has to bear. The internet was still in its formative years and public has been very generous. We depend on that advanced in that time is remarkable. When I first there were no trustworthy sites to rely on for information support. Without it, we couldn’t do what we do. I want started out, sequencing and quantifying the entire about the disease – although there were plenty of to say thank you, and I want to tell you that your money genome (working out the order of all the DNA ‘snake-oil’ remedies on offer. Once my initial hormone has been very carefully and well used. Through your molecules in a cell, and how much of each section for it... therapy stopped working in 2005, my consultant support we’re already making a difference, not only in of DNA there is) was inconceivable for a single cell offered me palliative care or possible participation in the UK but worldwide. And now we’re trying to make a line or clinical sample. Now there are labs that routinely a clinical trial for a new drug at the Royal Marsden. bigger difference every day for every one of our patients. do this for tens or hundreds of samples in one study. It’s not just us saying we can beat prostate cancer in 10 years. Behind us are a whole host of leading experts, health professionals, scientific researchers, specialists and survivors who believe that imminent advances in understanding and treating the disease make our 2026 deadline Advances in genetics and Through your support we’re We’re making real progress entirely possible. Here are just three of our prostate cancer treatment already making a difference, not now, and new therapies will growing army of supporters and the reasons why they’re backing our new strategy. are coming thick and fast only in the UK but worldwide continue to result The trial drug kept my cancer in check for almost a My work has led to multiple new treatments becoming Of course, this brings its own ‘big data’ problems – year. Over the next decade I took part in six further drug standard care for this disease: abiraterone, cabazitaxel, how to store and analyse all that information. We’ve trials (including abiraterone, radium-223 and olaparib) enzalutamide, and recently some very exciting work probably only just scratched the surface so far, and that all, to a greater or lesser degree, continued to on a drug called olaparib. But overall my focus is on we’ve already learned so much. stabilise my condition and give me a new lease of life – developing better, more precise care for each man with which continues to this day. these diseases. Prostate cancer is not one disease, it’s What will probably make the most difference to men many. That means not only being careful to treat each with prostate cancer in the near future will be the use of In 2003, I would have given anything for the aid and man differently depending on what cancer he has, but biomarkers to understand a man’s disease and assign assistance that is now available from Prostate Cancer also making sure that if a treatment is not working, that him the right treatment for his particular cancer. That type UK for men, their partners and families. They offer vital drug is stopped promptly and a different drug given if of personalised treatment will also include knowing what helplines and cover all the basic problems relating to necessary, or a combination. combinations of drugs work better than single therapies. diagnosis and treatment, tackling difficult issues such as incontinence and erectile dysfunction. Advances in We’re making real progress now, and new therapies I am extremely confident that we’re going to make genetics and prostate cancer treatment are coming will continue to result. Our work really benefits from progress in this decade. The challenge for us is to thick and fast, but I’m confident that the charity your involvement at every level – fundraising, awareness accelerate that to really make a difference for men can keep up to date with the new and hopefully raising, clinical trials and giving permission for samples suffering from these diseases. life-saving developments. to be used in research. We can’t do it without you.
2006 2006 2007 2008 2010 2010 2012 2012 2014 2014 2015 2016 Our ground- Our volunteers Movember NICE publishes All 129 new Prostate UK We merge with Successfully Men United First Movember We achieve We launch our breaking Tool begin their first launches its UK first clinical MSPs sign our merges with Prostate Action make abiraterone launches, with Centres of Investing in new 10-year Kit for newly prostate cancer campaign and guidelines for ‘Pledge for PCRF to form to form Prostate available on the 100,000 people Excellence open Volunteers strategy to beat diagnosed men awareness talks our partnership prostate cancer. Prostate Cancer’ Prostate Action. Cancer UK. NHS to whole of signing up by in London and accreditation. prostate cancer is first published. in Scotland. begins. in Scotland. the UK. March. Manchester. within a decade.
12 Insights | Winter 2016 Insights | Winter 2016 13 PROSTATE CANCER AND ME Jeff Stelling
Famed for his unique You’re planning to call at friends – but it does. It getting involved earlier. funding is and exuberant presenting 32 football clubs along affects so many people With all due respect, obviously style, the Soccer the route. Have you and when somebody I’m hoping to help put absolutely Saturday and former been surprised by their really close gets it, it just everyone at Prostate essential for Countdown enthusiasm for the walk? brings home to you how Cancer UK out of work research to frontman is real it is. In the case of Bill in the next few years happen. Thinking joining Men I’ve always had a fantastic and Eddie, it also brings because there won’t be about that will United for an rapport with clubs and home how treatable a cause to be fought help me put my epic 262-mile their fans – probably prostate cancer can be. anymore. That’s the future best foot forward walk over 10 because I’m a Hartlepool That’s important too. we’re hoping for and it’s a on the walk. days, raising fan and they don’t see great cause to be part of – both money us as a threat! But also, Were you shocked even in just a small way. How are preparations for Prostate it’s a cause that everyone by the prevalence of for the walk going so far? Cancer UK and can relate to. The majority the disease? awareness of the of fans are still male and OK. I go on regular walks disease. He tells may get prostate cancer Yes. I certainly wasn’t with the dogs of three or us how he was at some stage in their life. aware of the numbers of four miles at a time, and inspired by the The more we can raise people who get prostate I’ve done some training diagnoses of two awareness of it, the more cancer. One man in eight The more walks as well. I’m relatively close colleagues we can help beat it. is absolutely staggering. we can raise fit for my age, so fingers and why he’s We sat in a thousand- crossed. I think it’s the proud to be How have you been seater stand at awareness of repetition that will be backing our new affected by prostate Hartlepool United, so the problem. Everybody strategy to beat cancer? you’re looking at 125 it, the more we can walk 26 miles in one prostate cancer empty seats. It’s a day, but can you do it on I haven’t personally, nor within 10 years. haunting figure really. can help beat it the second, third and fourth have my family. But I’ve got So we need to get the day? We’ll find out. How did you come up friends and colleagues who message out there that You’ve just visited My biggest concern with the challenge? have been. Bill Arthur and people should go to the some of our scientists is the weather! Eddie Hemmings [Sky’s doctor if they’re worried, in Newcastle. What I had 10 days available rugby league presenters], because we can beat it. did you think? and I wanted to do who I’ve known longer That’s the message we something where people than I care to remember, want to get out there: we It was fantastic to see could see I was feeling have both suffered from can beat prostate cancer. the work that goes on the pain. Then somebody prostate cancer. There in the lab and meet alerted me to the fact that are others as well, who Our new strategy aims the people who are Hartlepool [Jeff’s boyhood are prominent on TV to do just that within 10 doing the research. Talk club] had never played and haven’t talked years. Are you excited about dedication; I was at Wembley. By pure about it publicly. to be helping us absolutely in awe of coincidence, the distance promote that? them. The vast amount of between the two was 260 Did their diagnoses equipment that’s required miles – a marathon a day shock you? I’m very proud to be part and the numbers of staff for 10 days. Ten in ten. of it. I only regret not that you need means It did. You never really Jeff meets our Director of Research, Iain Frame It all just fell into place think it will hit someone like a jigsaw. you know – your dad, Find out more and how you can support or sponsor Jeff at MenUnitedMarch.org brother, son, or best
14 Insights | Winter 2016 Insights | Winter 2016 15 For example, some research has found that vitamin How can I eat more healthily? E from food might help to protect against advanced cancer. But vitamin E supplements don’t seem to lower Food is an important and enjoyable part of the risk of prostate cancer and might even be harmful. THE MANUAL everyday life and it’s important to remember this if You do need vitamin E in your diet as it’s important for Your questions answered about you decide to change or improve your diet. A healthy good health. But you should be able to get enough eating healthily with prostate cancer diet doesn’t need to be boring. In fact, it’s good to eat from foods, such as vegetable oils, nuts, seeds, lots of different foods to make sure you get a range of avocados and cereals without taking supplements. nutrients. Try and include plenty of fruit and vegetables. Some men, though, may need to take specific Set yourself realistic goals and start by making small supplements. For example, if you’re on hormone changes that you feel comfortable with. Trying to make therapy, your doctor might recommend calcium and If you’ve been diagnosed lots of big changes at once can be difficult, and you vitamin D supplements to help avoid bone-thinning. with prostate cancer, the may find it hard to keep them going over time. last thing you might want to think about is changing Try to cut down on unhealthy foods, such as those Is there any food I should avoid? your eating and drinking high in sugar or saturated fat, and those with added habits. But following a flavouring or preservatives. There is some evidence that eating a lot of certain healthy diet can really foods may be harmful for men with prostate make a difference. Our If you want help to improve your diet, ask your doctor cancer. These include dairy foods and calcium, Specialist Nurse, Laura, to refer you to a dietitian. They can help if you’re making red and processed meats, and meat cooked at answers some of your big changes to your diet or if you have other health very high temperatures. diet-related questions. problems that could be affected, such as diabetes. You can also find out more at www.nhs.uk/livewell We don’t recommend avoiding them completely, as we need more research to fully understand their effects, Why is it important to eat healthily if you’ve got and you may still want to eat moderate amounts of prostate cancer? bladder Is there anything I can eat to stop my cancer these foods as part of a healthy, balanced diet. coming back after treatment? We all know that following a healthy diet is Whether men with prostate cancer should eat dairy important for general health. It can help you stay You’ve probably seen stories in the papers about foods and calcium is something we get asked a lot a healthy weight and lower your risk of some health foods that either cause or cure cancer. It’s sensible about. Calcium is important for strong bones and problems, such as heart disease, diabetes and some prostate to be a bit cautious about these because the evidence overall health, so you need some in your diet. Normal gland other cancers. behind them is often very patchy or not there at all. amounts of calcium and dairy foods – which are high in urethra calcium – won’t increase your risk of advanced prostate But eating healthily and staying a healthy weight is However, there is some evidence that certain foods cancer. But we don’t know enough about the effect of also important for men with prostate cancer. Why? may help slow down the growth of prostate cancer or large amounts of calcium or dairy foods. penis Well, firstly because there is strong evidence that being reduce the chance of it coming back after treatment. overweight or obese increases the risk of aggressive or These include soy and other pulses, green tea, tomatoes, Some studies suggest that eating more than 2,000mg advanced prostate cancer. pomegranate juice and cruciferous vegetables of calcium per day (the amount in about 1.6 litres of testicle (like cauliflower, cabbage and Brussels sprouts). milk) may increase the risk of advanced prostate cancer Staying a healthy weight may also mean your several years later. But other studies have found no prostate cancer is less likely to spread after surgery or But it’s also important to say that the evidence is limited link so we can’t say for certain either way. Non-dairy radiotherapy. And if you’re having hormone therapy to and we do need more research before we can say for sources of calcium, such as soy milk with added treat your prostate cancer, your treatment may be less certain whether any single food can help slow down calcium, are widely available in supermarkets and effective if you are very overweight. the growth of prostate cancer. Read more about the health food shops. current evidence at prostatecanceruk.org/diet If you’re experiencing side effects from your treatment, If you’re on hormone therapy, you’ll need extra calcium such as weight gain, hot flushes or urinary problems, to protect your bones. This is because hormone thinking about your eating habits may also help you Should I be taking supplements? therapy can cause bone thinning, which may increase manage them. your risk of bone fractures. Men on hormone therapy Some people like to use dietary supplements or should aim for 1,200-1,500mg of calcium each day. herbal remedies, but there’s little evidence that This is still a safe amount. supplements are helpful for men with prostate cancer. If you don’t think there’s Some supplements may also interfere with your enough calcium in treatment for prostate cancer, so let your doctor or your diet, speak nurse know if you’re taking any. to your doctor or nurse about Most people should be able to get all the nutrients taking calcium Find out more about how diet can affect prostate cancer on our they need by eating a healthy, balanced diet without supplements. website at prostatecanceruk.org/diet taking supplements.
16 Insights | Winter 2016 Insights | Winter 2016 17 In DIY GOLF CHALLENGE: the SPOTLIGHT THANK Patrick McIntosh from before being given the all diagnosis, it is possible to Smallfield, Surrey clear in June 2014. Then return to an invigorated life Swinging into action for men began months of intense after cancer. As well as YOU Last year Patrick, 58, set training to build himself raising £32,160 for with prostate cancer a world record when he back up for the 222km Prostate Cancer UK, became the first triple trek, reaching the Pole on Patrick estimates he’s £485k cancer survivor to reach the 17 January last year. reached more than a To the Distinguished To help make sure they raised as much as possible, South Pole unsupported. billion people through Gentlemen’s Ride, whose “It felt like running a the family also organised a raffle, a silent auction and media coverage and talks. 2015 event raised nearly Diagnosed with unrelated marathon every day for 11 even managed to get hole sponsorship from local half a million for us and bowel, skin and prostate days straight, while also companies. They sent lots of letters and emails to almost 2.5million dollars cancer within just 13 dragging a 55kg sledge in various companies to ask for donations. worldwide. months of each other in -30°C at 13,000ft above Their hard work paid off and they managed to collect 2012, Patrick had some sea level with a constant a fantastic range of prizes. There was a signed cap of his lower intestines headwind,” says Patrick. from American pro Rickie Fowler, a signed shirt from removed, skin grafts and He wanted his trip to raise 174 Englishman Ian Poulter and a hot air balloon ride for a radical prostatectomy To Tom Davies who, at two, as well as some fantastic rounds of golf at Woburn awareness of symptoms 19, became the youngest Golf Club and Hanbury Manor – to name but a few! and prove that, with early person ever to cycle round the world. He spent 174 Jack and his mum then approached local supermarkets in control of everything; cancer patients. Dad was days cycling over 18,000 who donated items for their golf day goody bags, which it was scary that cancer a very no-nonsense kind miles and raised over also had the Prostate Cancer UK golf balls, tees and TOP seemed to be in control of of guy, but he agreed to £60,000 for us and two pencils in. The whole family chipped in: Jack’s dad him. I felt powerless and meet him and was soon other charities. For the golf-loving Wilson family, organising a stamped the logo he created on all of the promotional wanted to help. benefitting from a range of sponsored nine-hole competition to raise money material for the event and made up all the hole sponsor DAD complementary regimes for Prostate Cancer UK seemed like the obvious plaques; Jack’s mum baked enough cupcakes to feed “I was indignant when I he was unlikely to have thing to do after grandad Graham was diagnosed. a small army; and his brother, James, spent an evening £15,009 discovered that prostate explored otherwise. From getting their local course on board to To Paul Mackie, who raised packing all the bags up. Thanks to all their efforts, they cancer kills around as securing donations for prizes, they are an more than £15k from managed to surpass their £500 target before the event many men each year “For dad to be alive and inspiration for anyone holding a golf day for an August bank holiday had even begun so Jack upped his target to £1,000. as breast cancer kills well 15 years after we Men United this spring. BBQ with a silent auction, women, yet funding and thought we’d lose him is On the day, Jack and his family were overwhelmed by tombola, raffle and a 10km awareness was much truly amazing for us all. When 12-year-old Jack Wilson’s grandad, Graham the generosity of those who took part. Through entries, cycle challenge. Superb! smaller. Like dad, I work I have no doubt that the Cowan, was diagnosed with prostate cancer in 2009, the raffle, silent auction and donations they managed Our former chairman, in advertising so my first important work he’s done it was a shock to all the family. They spend a lot of time to smash their original target eight times over, raising a Paul Forster, was step was to persuade my with Prostate Cancer UK playing their favourite sport of golf together at their local whopping £4,000. diagnosed with prostate clients, then sponsors of means more dads will course, Chesfield Downs. So when Jack’s school set cancer in 1999. But after the 6 Nations rugby, to run be around him the ‘Year 8 Challenge’ to make a difference to the Jack said: “Prostate Cancer UK is such a fantastic extensive treatment, £53k awareness-raising ads for their lives of others, he decided to use his love of golf to help charity because this disease affects so many families. he’s cancer-free today To everyone who took part for Prostate families men like his grandad by holding his own golf day. Raising awareness and money through fun events and recently received in Movember this year. Cancer UK in too.” like my golf day can only go some way to hopefully an MBE for services Our network of MoBros and around With the help of his mum and dad, Jack started to eradicating this disease in the future.” to prostate cancer and MoSistas raised an organise his event. He had no idea how much it might patients. His daughter, matches. astonishing £53k with raise so he set a modest target of £500 on JustGiving. Jack’s grandad, who had undergone successful Simone, tells us why I’d also met their furry lips and They contacted their local golf course and decided surgery, was also able to be there on the day and take he’s also a Top Dad. a guy who sponsored moves. on a nine-hole competition, which enabled all levels of part in the event. He said: “I’m so proud of Jack for practised Reiki “I’d just turned 30 when golfers to enter. They publicised the event at the club the original idea and for his involvement. Also, the rest with we discovered dad had and among friends and family and soon had almost of the family for the planning and management of the £42,000 prostate cancer – hardly 70 players, aged 8 to 80, signed up to take part. whole day, which was such a success.” To the thousands of you a child, but to me he was who held a Lads Night still my problem-solving, In last September. Your DIY-fixing, money-lending poker-playing skills and daddy. My sister and I were Do what you love for Men United this spring and organise your own golf day. For advice and merchandise, generosity have so far shocked and upset to the visit prostatecanceruk.org/golf, email [email protected] or call 0800 082 1616 handed us £42k. core. Dad was always
18 Insights | Winter 2016 19 18 Edinburgh May-October Night Ride Yorkshire Three PeaksSee theChallenge city’s famous GET INVOLVED EVENTS landmarks, like Arthur’s Boot up and conquerSeat the and three Holyrood Five ways to get your mates together and raise money for us as Men United highest peaks in YorkshirePalace, by in moonlight in one day, led by a professionalthis fantastic nocturnal CALENDAR 50km cycle. February - July 2016 guide and including two nights’ accommodation. Pick any weekend Join the Men United Chip in with FEBRUARY APRIL and sign up as a group or individual. March with Jeff Stelling some golf fines 27 Sahara Desert Trek 17 Brighton Marathon Journey past sand Help us top last year’s 21-30 March All year round dunes and oases on total of more than £70k this 100km nine-day by running for us with a Walk with Sky Sports’ helping spread the word Hit the greens with your Get your Chipping-in pack challenge through the minimum sponsorship legendary Jeff Stelling as about our new 10-year friends and do something at prostatecanceruk.org/ epic African desert. of £400. he takes on 10 marathons strategy to beat prostate great together by taking chippingin in 10 days to help beat cancer to men part in our Chipping-in 28 Vitality Brighton 24 Virgin Money prostate cancer. Join him across the challenge. Make every air Half Marathon London Marathon either for a day or a whole country. shot, ball in a bunker or Sign up to one of Run the ultimate road leg, with a chance to meet out of bounds a fineable Britain’s most popular race for us and we can the man and enjoy food MenUnited offence and then donate road races and we’ll offer you a personalised JUNE JULY and accommodation en March.org the money at the end to support you with training training day, post-race 3-5 Football to 20 London to Paris route. As well as raising help us save lives. tips and an exclusive physio and a fantastic Amsterdam Bike Ride money for us, you’ll be running top. after-party. Leaving from London Do the classic 300-mile or Yorkshire, our ride with Men United MARCH MAY classic cycling event and feel the satisfaction Football League stopsat various football of raising vital funds as 13 Vitality Bath 28-29 Edinburgh clubsen route to Ajax’s the Eiffel Tower looms collections Half Marathon Marathon Festival Amsterdam ArenA. All into view. Two traffic-free laps With no minimum the logistics are taken March-April of the stunning World fundraising target and care of so you’re free 31 Prudential Ride Heritage City that’s one the iconic streets of to just enjoy the ride. London-Surrey 100 Through March and April, amazed how much of the highlights of the Auld Reekie, Scotland’s Recreate the thrill of we need volunteers to money these collections running calendar. premier marathon is 23-25 Grand London 2012 with shake collection buckets raise and how much fun great for experienced Depart Classic 25,000 others on the at football grounds across you’ll have doing it. 13 Adidas Silverstone runners and first timers. A unique opportunity to 100-mile, closed road the country and help Half Marathon ride the 117-mile Grand circuit from the capital to us raise thousands for Email volunteer@ Run the British Grand 30 Bupa London 10,000 Depart stage of the 2016 Box Hill. A must-do for our vital prostate cancer prostatecanceruk.org Prix race track and Starting and finishing Tour de France with any cycling fan. research. You’d be to find out more. secure a PB on this in front of Buckingham Men United, eight days fast, flat course. Palace, the capital’s before the pro peloton. most popular 10k event Donate your Tee up for attracts over 12,000 amateur and pro runners, and even larger crowds special day our Golf Day to cheer you on at All year round 28 April every turn. Whatever you’re occasion. We know your Swing into action with prestigious Edinburgh celebrating – be it day is special to you, but Men United and secure course at Wentworth, birthday, anniversary, by donating it you can your place at our annual just weeks before the retirement or bar mitzvah make it special to men Prostate Cancer UK golf PGA Championship. – donating your day to everywhere, too. day. Play a fun-filled, Check out full details and sign up to all these events – plus many more – at Prostate Cancer UK is a challenging and iconic Email specialevents@ prostatecanceruk.org/get-involved fantastic way to mark the prostatecanceruk.org/dyd 18 holes on the prostatecanceruk.org
20 Insights | Winter 2016 Insights | Winter 2016 21 Other useful organisations Translating the risks Bladder and Bowel Macmillan Foundation Cancer Support of prostate cancer Our www.bladderandbowel www.macmillan.org.uk foundation.org 0808 808 0000 0845 345 0165 (Mon-Fri, 9am-8pm) in all communities Information and support Provides practical, financial for all types of bladder and and emotional support for services bowel problems. people with cancer, their family and friends. British Association Specialist Nurses Information on Regional services The blue men on this map for Counselling & Maggie’s Centres 0800 074 8383 prostate cancer To find out what local represent the locations of Psychotherapy www.maggiescentres.org support and services are support groups who have www.itsgoodtotalk. 0300 123 1801 (Mon to Fri 9am-6pm, 0800 074 8383 available in your area visit asked to be listed on our org.uk Provide information and Wed 10am-8pm) We provide free information prostatecanceruk.org/ website. Find a group near 01455 883 300 support to anyone affected Our Specialist Nurses on prostate cancer and find-local-support you at prostatecanceruk. Provides information about by cancer. Their website have the time to listen and prostate disease. Order org/supportgroups counselling and details of holds a list of centres answer your questions or download copies from therapists in your area. across the UK and has on anything to do with the publications section Live chat Please note that some an online support group. prostate cancer and of our website or call our groups run meetings in Cancer Black Care Our Specialist Nurses are Swarn Singh Kang is a Labour councillor in Southall prostate disease. Specialist Nurses for help more locations than the cancerblackcare.org.uk NHS Choices available online to answer Green, West London, and was diagnosed with choosing the publications one listed. 020 8961 4151 www.nhs.uk your questions and help prostate cancer in 2005. Earlier this year, the 77-year- One-to-one you need. Provides information and Provides information to you find the information old was invited by his GP to a focus group where we support to people from support you in making telephone support you need. were testing our new translated awareness leaflets. 0800 074 8383 Black and minority ethnic health decisions, including communities who are an A-Z of treatments “It was the first time I’d properly shared my story. And Talk things over with affected by cancer. and conditions, and it was then that I realised the difference talking about it someone who’s been there. information on NHS health could make. Men started asking questions and talking We match callers with Cancer Research UK services in your local area. about going to see their GP. trained volunteers who’ve Having cancer researchuk.org had a similar experience. comprehensive 0808 800 4040 Penny Brohn “In my community, cancer is a taboo subject and Provides information Cancer Care prostate cancer by its nature even more so. Men simply Online community yet easy-to-read about living with cancer. www.pennybrohn don’t know anything about it. With prostate cancer cancercare.org Join the community online affecting one in eight men, sharing my story might and digestible Complementary and 0845 123 2310 and talk to others who know encourage Asian men to talk about it.” Natural Healthcare Offers support using what you’re going through. information and Council complementary therapies You can ask questions, Read Swarn’s full story at prostatecanceruk.org/swarn explanations www.cnhc.org.uk and self-help techniques. post information and share 020 7653 1971 Working hand-in-hand your ups and downs. made a world of Details of complementary with medical treatment. community. Our new awareness leaflets in therapy practitioners who prostatecanceruk.org difference to me Punjabi, Gujarati, Urdu, Bengali, meet national standards of Relate Tamil and Polish have been competence and practice. www.relate.org.uk developed in consultation with 0300 100 1234 Fatigue support Prostate cancer community groups, cultural Health with Pride Relationship counselling 0800 074 8383 support groups experts and the charity Cancer www.healthwithpride. and sex therapy for Meet and talk to other Equality. They give information If you have prostate cancer nhs.uk individuals and couples. people affected by about prostate cancer and other and you’re struggling with Information on cancer prostate cancer who prostate problems, including fatigue, our Fatigue Support issues and erectile Sexual Advice understand what you’re who is at risk and what changes service is designed to dysfunction for gay and Association going through. There are to look out for. We also explain what to do if you help you manage your bisexual patients. www.sda.uk.net more than 70 independent think you have a prostate problem, and what might tiredness so you can do 020 7486 7262 groups across the UK. happen at the GP surgery. the things you want to do. Provides a helpline service for advice and information Download them for free from our website at Find out more about our services at about erectile dysfunction. prostatecanceruk.org/publications prostatecanceruk.org/get-support
22 Insights | Winter 2016 Insights | Winter 2016 23 WHAT MAKES THE MAN CAN BREAK THE MAN Join the fight against prostate cancer. Your manhood’s at risk. prostatecanceruk.org/menunited
24Prostate Cancer UK is a registered charity in EnglandInsights and Wales (1005541) | Winter and in Scotland 2016 (SC039332). Registered company number 02653887. 3762