Us -Too! Brampton General Meeting 
9 Feb, 2010

"New Developments in Drug Treatments
for Advanced Prostate Cancers"
by
Dr. Sandy Sehdev

Dr. Sehdev presented a highly detailed and informative talk on Hormone Therapy, Chemotherapy,
Bone Health and Future Directions in Cancer Treatment Therapies.
The presentation was followed by a good questions and answer period as well.

Androgen Deprivation Therapy is most commonly administered when earlier
forms of treatment ( Surgery/Radiation/HIFU, Etc ) have failed to control the
cancer or when the disease has already spread beyond the prostate gland on
initial diagnosis. By reducing Testosterone levels this treatment can often control
Prostate Cancer for many years. Various drug combinations and treatment regimens
can often extend the effectiveness of hormone therapy, but at some point some
patients stop responding to the treatment. It is thought that in many cases this is
due to a form of hormone resistant cells becoming more dominant within the
cancerous tissue. This progression can be monitored via PSA levels that are
low while therapy is still effective and begin to rise if and when it begins to fail.

At this point in time Chemotherapy may become a viable treatment option.
Chemotherapy is usually reserved for cases where measureable metastasis is
present or the Gleason Score of the cancer is quite high. Modern Chemotherapy
while still generating some side effects can be effective in two primary ways.
It can extend survival rates by controlling the cancer's growth. It can also improve
quality of life by reducing pain associated with the growth of the cancer.
In the best scenario the treatment can have both of these benefits with reduced side effects.

Docetaxel is one of the more modern forms of drugs used for chemotherapy in
prostate cancer. An anti-fungal agent, Ketoconazole in combination with Hydrocortison
e has also been shown to be beneficial in these same two areas. A person's general
medical condition may also determine whether chemotherapy is safe or not. An inactive
person with other medical complications may be much more acutely affected by
chemotherapy than an active person. The most dangerous potential side effect of
chemotherapy is a reduced white blood cell count which can leave an individual more
susceptible to infections. Hair loss, numbness and tingling in extremities and deformation
of finger and toe nails are other common side effects.

Dr. Sehdev also reviewed Bone Health as it relates to prostate cancer treatment. While
patients are on hormone therapy they often become susceptible to Osteoporosis. Vitamin D,
Calcium and Exercise are highly important in this case to maintain bone health. Complications
from osteoporosis include pain, fractures and spinal cord compression. A relatively new drug
Zometa has been shown to also be effective in helping to maintain bone health and lower most
of the effective risks from osteoporosis.

Dr. Sehdev ended his talk with a review of new research into controlling a major mechanism
of cancer growth, namely angiogenesis. For a cancer tumour to grow, it requires a steady
supply of nutrients. It manages to obtain these nutrients by stimulating the growth of blood
vessels around the tumour. Some new drugs are being targeted at blocking this VegF substance
with an effective trap to contain and neutralize the stimulus.

AUDIO and SLIDES DOWNLOAD

For the fisrt time you can view the complete video of Dr. Sehdev's
presentation. Hopefully we have similar videos of our future meetings.

Us -Too! Brampton General Meeting 
12 Jan, 2010

'HIFU' - High Intensity Focused Ultrasound

By Dr. Edward Woods, FRCPC, Urologist,
Scarborough General Hospital.

'HIFU' ( High Intensity Focused Ultrasound ) is a relatively new treatment for localized
Prostate Cancer in Canada, but has been used successfully in Europe for as long as
ten years. It uses high intensity focused ultrasound to effectively heat and destroy cancerous tissue.

While admitting that Radical Prostatectomy is still acknowledged as the "Gold Standard"
in PCA treatment, Dr Woods indicated that HIFU treatment offers some distinct advantages
in certain cases and studies are ongoing that may result in HIFU being recognized
as a valid treatment alternative in these cases. Studies ongoing in Europe and North
America are yielding treatment success results very close to those seen in more
typical Radiation Therapy and HIFU has a number of distinct advantages over radiation.

HIFU is recommended for the treatment of low to intermediate risk cancers.It requires less
infrastructure than Radiation and the equipment is mobile and can be moved from site
to site to administer treatments without a more localized investment in equipment.

HIFU can be used multiple times if necessary, whereas repeat radiation therapy is not
normally recommended. As such it can even be used as a follow-up or salvage treatment
for surgical or radiation treatment failures. It can be used for patients unsuitable or unwilling
to undergo surgery or radiation therapy.

HIFU demonstrates good results in terms of continence and potency as well. It is delivered
via a Trans-Rectal Probe under a local spinal anesthetic as an outpatient procedure.
Utilizing cold water to protect the rectum, a computer program moves the probe through a
treatment pattern of 500 to 600 small focused burns over the course of 2½ to 3 hours in a
single treatment. The patient is sent home on antibiotics and mild pain killers.

At present HIFU is not covered by the Ontario Government and treatment costs about $20,000.

About Dr. Edward Woods:
Dr. Woods has a specific interest in new technologies within urology, including the
use of lasers and minimally invasive bladder techniques and surgery. He is also
actively involved in clinical research in benign prostatic hypertrophy and prostate
cancer. Dr. Woods works in co-operation with Dr. Orovan with HIFU treatments
being delivered in Hamilton and Scarborough.

AUDIO & SLIDES DOWNLOADS

AUDIO:
Track 01: High Intensity Focused Ultra Sound Treatment (HIFU) Talk
http://www.ustoo-brampton.com/Woods/HIFUTalk.ram
[10.5 Mbytes, Talk time: 00:43:49]

Track 02: High Intensity Focused Ultra Sound Treatment (HIFU) Q& A session
http://www.ustoo-brampton.com/Woods/HIFUQA.ram
[7 Mbytes, Talk time: 00:29:22]

SLIDES:

Part1: HIFU for localized Prostate Cancer - Sildes
http://www.ustoo-brampton.com/Woods/HIFU.pdf
[18 KBytes, Pages 11]

Part 2: Ablatherm HIFU - "The Canadian Experience" Slides
http://www.ustoo-brampton.com/Woods/Ablatherm HIFU.pdf
[1.27 MBytes, Pages 42]

Our thanks to Dr. Woods for an excellent
update and information on HIFU.

In support of our Annual Golf Tournament
Us - Too! Brampton gratefully acknowledges
and thanks all of the contributors :

ACTON GOLF CLUB
BLACK & McDONALD
BULOVA WATCH CO
CLASSIC HONDA
DAIRY QUEEN - BRAMPTON
FORTINOS
GOLF TOWN
HARRY ROSEN
HOME DEPOT - TRINITY COMMON
HYDRO 1 - BRAMPTON
JACK TOTHE
MAYFIELD GOLF CLUB
MIKE BARKIC
OLD PRO DRIVING RANGE
QUADRA CHEMICALS
SARA LEE
SOBEY'S
TD BANK
THYSSEN ELEVATORS
WALMART
ZORRO'S STEAK HOUSE

The Brampton Library (http://www.bramlib.on.ca/)
Review List of all Prostate Cancer related materials held by the Brampton Library . This list includes Books, CDs, Audio CDs and other reference materials.
The Brampton Library also mantains a record in the Peel Community Data Base (http://www.pinet.on.ca/csd.htm) on the Us Too! Brampton Chapter