A specialist group of COSA providing information about prostate cancer and urogenital cancer trials and events in Australia.

The purpose of this document is to update the literature on the management of localised prostate cancer. It will serve as a background document for the Australian Cancer Network‘s Working Party on Management of Localised Prostate Cancer, which was formed to agree upon guidelines for management of localised prostate cancer in Australia.

This report has examined the American Urological Association Guidelines on Management of Localised Prostate Cancer (Middleton RG et al, 1995) in some detail, and finds no evidence from recent literature that warrants substantive changes to these guidelines. Available as a single PDF (large file). Hard copies can be ordered.

This case study recounts the experience of Ted, a 60-year-old male diagnosed with prostate cancer. This case study aims to facilitate the development of competencies that reflect the role of the Specialist Cancer Nurse (SCN) in managing disease and treatment related care for a person at risk of or diagnosed with prostate cancer across the cancer journey.

The case study contains four sections:

• Reduce risk
• Find the condition early
• Have the best treatment and support during active treatment
• Have the best treatment and support between and after active treatment.

This primary care urogenital module includes resources and information specific to prostate cancer and other urogential tumours, treatments and side effect management, clincial tools, an opioid conversion calculator and safe handling of cytotoxics.

Free registration is required to access the site.

The ASCO Genitourinary Cancers MOC Module consists of 25 multiple-choice questions which include patient case information, educational links and answer rationales. This activity is a tool for self-assessment of medical knowledge as it relates to genitourinary cancers.

Upon completion of this educational activity, participants will be able to:

• Identify knowledge and practice gaps relating to genitourinary cancers
• Apply knowledge learned toward an enhanced ability to identify genitourinary cancer risks and recommend effective interventions for individual patients
• Demonstrate participation in life-long learning and enhancement of competence.

Medscape from WebMD Prostate Cancer Resource Centre offers specialists, primary care physicians, and other health professionals the Web's most robust and integrated medical information and educational tools about prostate cancer. After a simple, 1-time, free registration, Medscape from WebMD automatically delivers to you a personalized specialty site that best fits your registration profile.

Some of the key features of Medscape from WebMD are:

• Original, professional medical content, including review articles, journal commentary, expert columns, patient education articles, book reviews, and more;
• Prostate Cancer emedicine articles
• Prostate cancer CME
• Conference Coverage: Thought leaders summarize key data and presentations from major medical meetings;
• The Internet's first primary-source medical journal, The Medscape from WebMD Journal of Medicine;
• Selected daily professional medical news in your specialty from Reuters, Medscape Medical News, and medical news journal publishers;
• Physician Optimized MEDLINE;
• Free subscription to Medscape's MedPulse, a weekly email newsletter that highlights what's new in your specialty on Medscape from WebMD;
• More than 125 medical journals and textbooks;
• Business, financial, managed care, and medical practice information

The NGC's mission is to provide physicians and other health professionals and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation, and use.

All of the criteria below must be met for a clinical practice guideline to be included in NGC:

• The clinical practice guideline contains systematically developed statements that include recommendations, strategies, or information that assists physicians and/or other health care practitioners and patients to make decisions about appropriate health care for specific clinical circumstances.
• The clinical practice guideline was produced under the auspices of medical specialty associations; relevant professional societies, public or private organizations, government agencies at the Federal, State, or local level; or health care organizations or plans. A clinical practice guideline developed and issued by an individual not officially sponsored or supported by one of the above types of organizations does not meet the inclusion criteria for NGC.
• Corroborating documentation can be produced and verified that a systematic literature search and review of existing scientific evidence published in peer reviewed journals was performed during the guideline development. A guideline is not excluded from NGC if corroborating documentation can be produced and verified detailing specific gaps in scientific evidence for some of the guideline's recommendations.
• The full text guideline is available upon request in print or electronic format (for free or for a fee), in the English language. The guideline is current and the most recent version produced. Documented evidence can be produced or verified that the guideline was developed, reviewed, or revised within the last five years.

A full range of guidelines and resources relating to prostate cancers. including:

• information about prevention, genetics and causes
• screening and testing unformation about methods of cancer detection including new imaging technologies, tumor markers, and biopsy procedures
• Information about treatment, including surgery, chemotherapy, radiation therapy, immunotherapy, and vaccine therapy
• statistics related to cancer incidence, mortality, and survival
• research
• information and current news about clinical trials and trial-related data

A library of downloadable clinical practice guidelines developed in the UK and internationally relating to the diagnosis, treatment and management of prostate cancer.

A searchable database of internationally developed clinical guidelines relating to the screening, diagnosis, treatment and managment of prostate cancer.

Comprehensive, authoritative, evidence-based information regarding prostate cancer and its associated risk factors, symptoms, diagnosis, prognosis and treatment.

Multimedia resources including anatomical drawings are available on the site. 

The EAU represents the leading authority within Europe on urological practice, research and education. The EAU delivers training, stimulates research and broadcasts information. The EAU’s scientific publications encourage discussion and its expert recommendations guide urologists in their every-day practice.

The website contains information including upcoming events and educational opportunities, guidelines, latest research and publications, urological nursing, CME activities and members only sections.

The Prostate Cancer Foundation of Australia (PCFA) is the national body for prostate cancer in Australia. It funds research and other efforts to reduce the impact of prostate cancer on the community.

The website includes information for health professionals including downloadable booklets and information:

• Prostate Cancer for General Practitioners: PSA Booklet II is a guide for general practitioners faced with the question of how best to manage consultations with men who present for a general check-up or who have particular concerns about prostate cancer.
• How to talk to patients about PSA is a downloadable poster that assists GPs to discuss risk with their patients to assist in the early detection of cancer.

ASCO's Prostate Cancer Portal offers prostate cancer specific resources including the latest information from:

• ASCO's Virtual Meeting
• The Journal of Clinical Oncology
• Prostate Cancer Clinical Practice Guidelines
• Meeting abstracts
• Educational Book manuscripts
• ASCO Daily News.

The Imedex E-Learning Center is designed to meet the needs of the busy healthcare professional with a complete suite of innovative E-learning products. Dozens of clinically-relevant, accredited activities are available to practitioners every day at no charge, focusing on impacting the clinical management of patients around the world.

Prostate cancer activities include webcasts, interactive case studies and podcasts.

Providing relevant, high quality and up-to-date information, MedConnect is a gateway to leading local and international medical news, research, events and resources to allow health care professionals to stay connected to the most important developments in medicine.

The prostate cancer page features the latest news, research, drugs, podcasts, videos, articles, conferences and events.  

Users can sign up for free to receive daily news feeds and journal summaries about their specialist topic.

Prostate cancer is the commonest cancer to affect men, and the second most common cause of men’s deaths from cancer. Testing for prostate specific antigen (PSA) can lead to the diagnosis of localised prostate cancer, when patients can be offered treatment that is potentially curative. However, there are a number of uncertainties surrounding the PSA test and the diagnosis and treatment of prostate cancer. There is no good evidence that the benefits of a screening programme outweigh the harms.

The prostate cancer risk management programme aims to help you give clear information to men who ask about testing for prostate cancer. This module is based on the programme. It offers practical advice, but is not meant to replace clinical judgment. The module encourages healthcare professionals to take into account patients' values and preferences when caring for them.

After completing this module, you should know:

• How to advise men who are worried about prostate cancer
• What information you should give them
• The treatment options available to men diagnosed with clinically localised cancer.

Information about the genetic risk of prostate cancer and methods of preventing the development of the disease.

The deCODEme Genetic Scan identifies all the twenty-five variants listed above and uses them to provide customers of European descent with a personalized interpretation of their genetic risk for developing prostate cancer. For African-Americans, the deCODEme Genetic Scan currently provides a personalized genetic risk interpretation using two variants on chromosome 8 for which scientific risk data are available.

At present, the necessary scientific information to interpret the genetic risk for women of other ethnicities is not available. This information will be added as soon as it becomes available and we are assured of its quality.

Information from the National Cancer Institute regarding prostate cancer prevention, screening and detection, including:

• Prevention, Genetics, and Causes of Prostate Cancer
• Screening and Testing for Prostate Cancer
• Selenium and Vitamin E Cancer Prevention Trial (SELECT)
• The Prostate Cancer Prevention Trial (PCPT)
• Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial
• Prostate and Urologic Cancers Research Group in the Division of Cancer Prevention

This practice resource was developed as part of a training workshop on discussing pros and cons of PSA testing in general practice (workshop approved as Group 1 continuing Education Activity by the RACGP. It incorporates current Australian recommendations about screening for prostate cancer.

Also includes a drug calculator for health professionals, which requires a password. An online application form needs to be completed for access to the drug calculator function.

Downloadable clinical practice guidelines developed and endorsed by NCCN for the early detection of prostate cancer.

This site links to a range of algorithm and nomogram tools and software developed to assist in predicting the extent of prostate cancer, including those developed by John Hopkins University and Memorial Sloan Kettering Cancer Centre.

Predictive algorithms and nomograms combine multiple variables to provide information that is statistically more significant than any individual variable. A nomogram is "an objective tool that uses an algorithm or mathematical formula to predict the probability of an outcome". These tools can give probabilities of cancer location or of treatment success, based on scientific studies done with hundreds or thousands of patients. 

Algorithms/nomograms may be valuable for evaluating the potential extent of disease and risk of recurrence but they do not determine outcomes.

Researchers at Memorial Sloan-Kettering Cancer Center have pioneered the use of computerized devices to help patients and their physicians decide among the major treatment choices for several cancers.

Available tools include:

This 2009 policy reaffirms the position of the RACGP on prostate cancer testing, recommending that patients should be fully informed of the potential benefits, risks and uncertainties of prostate cancer testing and then make their own decision about being tested after discussion and assessment by a GP.

Where a patient chooses to be tested, the RACGP recommends that both PSA and DRE should be performed.

This webpage summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for prostate cancer. Supporting documents to the recommendations can also be downloaded.

This booklet provides information on common reactions to prostate cancer, helpful strategies, and information on depression and anxiety.

A fact sheet, "Prostate cancer: the risk of depression/anxiety fact sheet" is also available.

New Approaches to Advanced Prostate Cancer

CME Webcast - October 2010

Overview
This CME webcast (slides + audio) presents a review of current issues in treating advanced prostate cancer, discussion of several new therapeutic approaches (androgen blockade, immunotherapy, treatments to preserve bone health and chemotherapy), and a discussion of two case studies by two national experts in the field.

Learning Objectives

• Assess and discuss data on approved and leading late-stage therapies for advanced prostate cancer (hormonal, immunotherapy, bone health, chemotherapy).
• Assess strategies to integrate these new therapies into your own practice for the treatment of advanced prostate cancer.
• Improve patient counseling on new therapeutic options for advanced prostate cancer.

This patient management framework is a guide to the optimal care management of patients with Prostate Cancer. It is intended to improve patient outcomes by facilitating consistent care based on evidence and best practice and sets out the key requirements for the provision of optimal care which need to be considered at each step of the care pathway.

In contrast to clinical practice guidelines that guide appropriate practice and decision making, the patient management frameworks provide a guide to the patient journey to ensure patients with cancer and their families receive optimal care and support.

Free prostate cancer CME courses consisting of a web cast and post test for health professionals interested in new developments for treatment of prostate cancers.

Information on adenocarcinoma of the prostate, which comprises over 95% of all prostate cancer, is included in this Profiler tool. Other rare types of prostate cancer and precancerous conditions of the prostate are not included.

The Prostate Cancer Profiler treatment decision support tool helps you understand how your diagnosis, test results, and medical history affect your treatment options. Your free Treatment Options Report will include descriptions of treatments, side effects, and questions to ask your doctor…customized for your unique diagnosis.

The primary aim of this 13-week subject is to provide Division 1 Registered Nurses with knowledge and skills required for this specialist area of nursing practice.

Key topics covered:

• review of anatomy, physiology and age changes
• diseases of the prostate
• current trends in the treatment and management of prostate disease
• targeted assessment and management of symptoms related to prostate disease
• provision of skilled nursing care and support for the person and their family living with prostate cancer
• and the nurse‘s role in health education and health promotion.

Information about radiation therapy treatment options for patients prostate cancers, including downloadable PDF fact sheets including information about possible side effects of treatment.

This series of 10 questions is designed to educate oncology specialists and other healthcare professionals on the recent developments in the care of patients with advanced prostate cancer. Upon completion of this activity, participants should be more readily able to incorporate emerging and standard therapeutic strategies into their daily clinical practices.

Spaced Education was originally developed at Harvard Medical School and takes advantage of the psychological finding that educational encounters which are spaced and repeated over time result in more efficient learning and improved learning retention.  Programs that used Spaced Education are built around participants answering small numbers of case-based multiple choice questions that are emailed to participants over a number of weeks. Upon answering a question, participants are given succinct feedback and links to further resources. Questions are repeated using an evidence-based adaptive algorithm which personalizes the spacing of a course to the demonstrated knowledge level of each participant. The program is completed once the participant has retired all the questions by answering them correctly twice.

Provides links to a wide range of evaluated resources and learning activities in the areas of supportive and psychosocial care, including survivorship.

CareSearch is an online collection of evidence based resources relating to palliative care. This Australian web site provides access to scientific abstracts, government reports, refereed journal articles and sources of data. It also contains information on national research and other projects, resources for patients and carers, models of service provision and educational opportunities including online learning packages

Provides links to a wide range of evaluated resources and learning activities in the areas of palliative care, pain management and end of life planning.

Comprehensive information regarding the prostate cancer.

Consumer targeted overview of prostate cancers including information regarding risk factors, signs and symptoms, diagnosis, treatment and links to a patient resource centre.

Information about prostate cancer, prevention, symptoms and diagnosis written for patients and consumers.

Information is also included about the treatment of prostate cancer, side effects, clinical trials and living with the disease.

This interactive tutorial assists patients to find out what prostate cancer is and how it can be diagnosed and treated.