Re: Excellent meeting in Manchester UK today

[Guest guest]

,

Mr Parr sounds like the kind of man we need here. As you know informed choice is my bag, especially in these days of more insignificant disease being diagnosed due to the widespread use of PSA testing. Even Kirby in his address to the Prostate Cancer Charity Annual Conference had to admit that brachytherapy needs to be looked at more here in the UK.

<SNIP>Just looking at other technologies, ever so briefly, because I know that we must move on - brachytherapy was mentioned. Only 2% of patients in the UK with localised prostate cancer are treated with brachytherapy as opposed to 30% in the USA . So this is definitely a treatment that needs to be introduced more widely into the UK. We could discuss it if we had some time and the ways and means that it is being undertaken right now. I went to New York just a few months ago to watch the best known American brachytherapist in action and I was really impressed by this new form of treatment and also impressed by the ten-year results that had been reported from Seattle and elsewhere. Just a few pictures of how brachytherapy is undertaken, ever so quickly <SNIP>

Mind you he still refers to brachytherapy as a 'new treatment' even though he goes on to say that he was impressed by the 'ten-year results' I guess that was the surgeon really coming out in him. But alas I think we are gradually winning the war as far as informed choice is concerned. More and more enlightened docs like Mr Parr are coming through.

Hope you are well

Subj: Excellent meeting in Manchester UK today

Date: 11/12/2004 21:23:59 GMT Standard Time

From: bryan.metcalf@...

Reply-to: ProstateCancerSupport

To: ProstateCancerSupport

Sent from the Internet

Mr N Parr, a urologist on the Wirral spoke on the choices given to his patients.

, you will be putting in a transfer request for this man.

He has provided an advised choice procedure such that only 25% of his patients with "localised" PCa have gone for surgery. Some have gone to Cookridge for brachytherapy, quite a few EBRT and some active monitoring. By advised choice they have been given all options but patients by patient they have considered the postives and negatives about each treatment.

He took heed of listening and research projects and will shortly be able to provide cryotherapy and brachytherapy on the west side of the Pennines.

His caring is not confined to the early cancers, he has now started a trial which looks at bone density before Zoledex (or alternative LHRH) OR Casodex. Just as a byline he gives a choice of no aneasthetic or local or no needle anaesthetic for biopsies, an option of local anaesthetic for Zoledex or alternative LHRH with fine needle.

He has seen about 42% of the initial men have osteoporosis before treatment - these get Casodex, some men have osteoponesis ( I think this is right - this is a lower than normal bone density). He has found that these men need Zometa after a year or so, men who have normal bone density after a year or two exhibit lower bone density and are into osteoponesis in an average of 3 years. He said that just stopping Zoledex does not recover lost bone density and in intermittent treatment the testosterone recovery is less during each gap in treatment.

The final thing I remember was he advocated the use of Strontium early when pain first develops and this seems to have treatment value as well as pain relief.

There was much more in a very informative talk. I hope people can add what I have missed!!

Best wishes

[Guest guest]

,

You certainly lead a full life. Hope your wife and mother-in-law get well quickly. I had a similar event a couple of weeks ago. A deer leapt out in front of me and caused a lot of damage to my car. Poor thing was dead. I'll never go to heaven now I've killed Bambi.

Talking of football. My team allowed me to place posters in their toilets a couple of years ago promoting PCa awareness. That was in the days I believed in a National Screening policy. I may come around to that view again if we get doctors like Mr Parr coming through.

Subj: Re: Excellent meeting in Manchester UK today

Date: 11/12/2004 23:30:18 GMT Standard Time

From: bryan.metcalf@...

Reply-to: ProstateCancerSupport

To: ProstateCancerSupport

Sent from the Internet

I knew that you would wish that it was a game of soccer and you would want to transfer the Wirral's star centre forward to Middlesborough. I doubt Merseyside would want to lose him, not after losing Wayne Rooney from Everton, (although he seems to have left a legacy of skill as the blues beat the reds of Liverpool today).

You asked how I was, I feel fine. I see Dr Bottomley who is visiting York from Cookridge on Monday. Will keep you informed.

The trauma of the week wasn't mine but Maureen's. She was driving on the main A63 towards our village after picking her 91 year old mum up and a born again motorcyclist lost control overtaking cars coming towards her. She braked. The motorcyclist managed to part company with his bike somehow, the bike slid into Maureen's car. The impact went up the brake pedal and she suffered stress fractures in one foot and one leg. She now has a pot on each leg and a zimmer frame to hoblle round with. Her mum is in hospital with a broken sternum from the seat belt, which saved further damage. The specialist said the older we are the more brittle our bones become. I don't think we will be climbing mountains this Christmas holiday! The car had a 3 foot hole where the bumper was.

Hope you are faring well

[Guest guest]

I knew that you would wish that it was a game of soccer and you would want to transfer the Wirral's star centre forward to Middlesborough. I doubt Merseyside would want to lose him, not after losing Wayne Rooney from Everton, (although he seems to have left a legacy of skill as the blues beat the reds of Liverpool today).

You asked how I was, I feel fine. I see Dr Bottomley who is visiting York from Cookridge on Monday. Will keep you informed.

The trauma of the week wasn't mine but Maureen's. She was driving on the main A63 towards our village after picking her 91 year old mum up and a born again motorcyclist lost control overtaking cars coming towards her. She braked. The motorcyclist managed to part company with his bike somehow, the bike slid into Maureen's car. The impact went up the brake pedal and she suffered stress fractures in one foot and one leg. She now has a pot on each leg and a zimmer frame to hoblle round with. Her mum is in hospital with a broken sternum from the seat belt, which saved further damage. The specialist said the older we are the more brittle our bones become. I don't think we will be climbing mountains this Christmas holiday! The car had a 3 foot hole where the bumper was.

Hope you are faring well

[Guest guest]

,Sorry I missed it,being on holiday in Florida.I attend the local support

group here and

picked up a copy of the latest brochure from RCOG in Aylanta..They claim a very

high percentage

cure rate of 85%.Their technique is unique.They implant the seeds with iodine on

silver and also

implant gold.The metals enable x-rays to locate the seeds and prostate.They then

irradiate the

prostate over several weeks,making adjustments if necessary,the technique

enables little or no

damage to the rectum,uretha or nervesz so sexual function is retained,with no

incontinence.They

never use hormones !! Their technique does not appear to be used anywhere else

in the US or

anywhere else in the world.

--- Metcalf wrote:

> Mr N Parr, a urologist on the Wirral spoke on the choices given to his

patients.

>

> , you will be putting in a transfer request for this man.

>

> He has provided an advised choice procedure such that only 25% of his patients

with " localised "

> PCa have gone for surgery. Some have gone to Cookridge for brachytherapy,

quite a few EBRT and

> some active monitoring. By advised choice they have been given all options but

patients by

> patient they have considered the postives and negatives about each treatment.

>

> He took heed of listening and research projects and will shortly be able to

provide cryotherapy

> and brachytherapy on the west side of the Pennines.

>

> His caring is not confined to the early cancers, he has now started a trial

which looks at bone

> density before Zoledex (or alternative LHRH) OR Casodex. Just as a byline he

gives a choice of

> no aneasthetic or local or no needle anaesthetic for biopsies, an option of

local anaesthetic

> for Zoledex or alternative LHRH with fine needle.

>

> He has seen about 42% of the initial men have osteoporosis before treatment -

these get Casodex,

> some men have osteoponesis ( I think this is right - this is a lower than

normal bone density).

> He has found that these men need Zometa after a year or so, men who have

normal bone density

> after a year or two exhibit lower bone density and are into osteoponesis in an

average of 3

> years. He said that just stopping Zoledex does not recover lost bone density

and in intermittent

> treatment the testosterone recovery is less during each gap in treatment.

>

> The final thing I remember was he advocated the use of Strontium early when

pain first develops

> and this seems to have treatment value as well as pain relief.

>

> There was much more in a very informative talk. I hope people can add what I

have missed!!

>

> Best wishes

>

>

>

>

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