Friday, 1 June 2018

Ain't the way to die!

Religious fanatics rule every decision relating to this, even in our modern society where dogs are allowed to die with dignity, human suffering is drawn out endlessly. Why? Not because the majority of us want it that way! Parliament, the courts and the churches, the 3 most out of touch institutions in the UK, say it WILL be that way, giving us no choice. 

Sunday, 20 May 2018

The Destructive Power of Secrets

Are you a secretive person or are you the opposite, like me? What makes us that way?

In my case, I think I know! As a child growing up in England just after the war, I was living in what became increasingly a very secretive society, mainly in fear of 'the enemy' and for decades after the war ended. My Mother was from the Irish Republic and at five years old, having been brought up in Ireland, my accent was the same as those who planted bombs in the London Underground where many sheltered from the German bombs. My Father had a war background in the Secret Service and for years had periodic visits from the local police as a 'settling alien.' So EVERYTHING in our family was a secret because everyone lived in fear of information getting to the enemy, even though they didn't exist anymore! But after the war, people would slot you in as the 'new enemy,' whether Irish, black, gay or communist, as an excuse to at best 'keep secrets' or often just to kick the shit out of you.

Later in life, I was bound to become an 'Internet Slut,' throwing my information out there like dirty underwear for all to see, not giving a damn about my secrets, after all, who could be remotely interested? 

I saw this article today which described the destructive power of secrets and well, it made me feel that I'd made the right decision over the years. What do you think?

The Power of Secrets

They divide people. They deter new relationships. They freeze the development of individuals.

There's no question that family secrets are destructive but it matters mightily when and how you reveal them. Resist the temptation to handle them at transition times such as weddings, graduations, and new beginnings.
As a family therapist, I'm a professional secret-keeper. I'm often the very first person with whom someone risks telling a longheld secret. Several decades of guiding people struggling with secrets have taught me that they have an awesome if paradoxical power to unite people--and to divide them.
From government conspiracies to couples having affairs, secrets permeate every level of society. Secrets have existed throughout time, but the nature of secrets has recently changed in our society. Today's families face special dilemmas about secrecy, privacy, silence, and openness.
We live in a culture whose messages about secrecy are truly confounding. If cultural norms once made shameful secrets out of too many events in human life, we are now struggling with the reverse: the assumption that telling secrets, no matter how, when, or to whom, is morally superior to keeping them and that it is automatically healing. My own experience, however, has shown me that telling secrets in the wrong way or at the wrong time can be remarkably painful and destructive.
The questions we need to concern ourselves with are: When should I keep a secret? How do I tell a secret without hurting anyone? How do I know the time is right? I've learned the answers as I've witnessed, sometimes with terror, more often with joy and always with deep respect, families making the courageous journey from secrecy to openness.
Secrets are kept or opened for many complex motives, from self-serving abuses of power to the altruistic protection of others. Understanding the best ways and situations in which to reveal a family secret can help you decide when and how to do so.

Although we encounter secrets in every area of life, they are perhaps most destructive when kept in the home. Families are support systems; our identity and ability to form close relationships with others depend upon the trust and communication we feel with loved ones. If family members keep secrets from each other or from the outside world the emotional fallout can last a lifetime.
There are four main ways that family secrets shape and scar us:
  • They can divide family members, permanently estranging them.
  • They can discourage individuals from sharing information with anyone outside the family, inhibiting the formation of intimate relationships.
  • They can freeze development at crucial points in life, preventing the growth of self and identity.
  • They can lead to painful miscommunication within a family, causing unnecessary guilt and doubt.

A person who seeks to undo the damage caused by family secrets must accept that revealing a secret is not a betrayal but a necessity. Luckily, as you'll see, it's never too late to do so.

Not all secrets are destructive. Many are essential to establishing bonds between two people. When siblings keep secrets from their parents, for example, they attain a sense of independence and a feeling of closeness, but the creation of any secret between two people in a family actually forms a triangle: it always excludes, and therefore, involves another.
When family members suspect that important information is being withheld from them, they may pursue the content of the secret in ways that violate privacy. A mother reads her daughter's diary. A husband rifles through his wife's purse. Relationships corrode with suspicion. Conversely, family members may respond to a secret with silence and distance, which affect areas of life that have nothing to do with the secret.
Either way, the secret wedges a boulder between those who know it and those who don't. To remove this obstacle, families must break the triangle formation.
Molly Bradley first called me during what should have been a joyous time. She had recently given birth. Her happiness, however, was bittersweet. Molly felt a deep need to surround herself with family but hadn't spoken to her brother, Calvin, in six years. The reason, I discovered, reached back 30 years to a secret made by Molly's mother.
When Molly, Calvin, and their youngest sister, Annie, were teenagers, their grandmother committed suicide. Molly and Annie were told she died from a heart attack. Only Calvin, the eldest, knew the truth. His mother made him promise not to tell. His sisters sensed a mystery, but if they asked about their grandmother, their mother switched topics.
Making secrets soon became the family's modus vivendi. Their aunt committed suicide two years after their grandmother's death. Calvin fathered a child out of wedlock. Each secret was kept from Molly and Annie, amplifying the family pattern of secrecy Calvin grew distant from his sisters, their relationship weakened by mistrust. Eventually, Molly guessed the truth of her grandmother's death but, in her family's style, told only Annie. Secrets between Calvin and his mother were matched by those between Molly and Annie, tightening family alliances.
From the outside, the family looked like two close pairs--Calvin and his mother, Molly and Annie. But the pairs were actually triangles; Calvin and his mother distanced themselves from the girls with their secret, forming one triangle, while Molly and Annie, keeping their own secrets from the rest of the family, formed another.

Molly convinced her two siblings to enter therapy, but each felt that overcoming feelings of alienation was impossible. When I asked Annie if she'd ever considered confiding in Calvin as a child, she told me the thought had never occurred to her. If family members cannot even imagine a different way of interacting, then secrets have truly taken hold of their lives.
In order to bridge the distance between the Bradley children, I asked them to relive their memories of how it felt to keep, and be kept out of, secrets. Molly, Annie, and Calvin each acknowledged that their needs to connect with each other had gone painfully unmet. Calvin explained tearfully that being forced to keep information from his sisters left him unable to relate to them, causing him to withdraw into himself. Molly revealed that watching her infant son each day made her miss Calvin and the relationship they'd never had more and more.
The siblings finally began to share long-held secrets, realizing that they were bound and supported by their desire for closeness. After the fourth session of therapy, they went to dinner together for the first time in years. "This was so different from any other family event," Annie reported. "Things felt genuine for the first time."
As a lifetime of confessions and hopes emerged into the open, the mangle of secrecy was replaced by one-to-one relationships. When everyone in a family knows a secret, triangles cannot create barriers between members.
All families have some secrets from the outside world. Yours, no doubt, has shared jokes and stories told only within the family circle. You also have a zone of privacy that demarcates inside from outside, building your family's sense of identity. But if a dangerous secret, one concerning an individual in immediate physical or emotional jeopardy, is held within your house, the boundaries between family and the rest of the world become rigid and impenetrable. Friends and relatives are not invited in, and family members' forays out are limited. "Don't tell anyone our business" becomes the family motto.

Some families create inviolable rules to keep information hidden, making it impossible for members to ask for assistance or to use needed resources in the outside world. Even problems that do not touch on the secret may go unresolved if the resolution requires outside help.
When Sara Tompkins, 37, first came to see me, she spoke with great hesitation. "If my family knew I was speaking to you, they'd be very angry," she confided. She told me about growing up in a family that completely revolved around her mother's addiction to tranquilizers. "My father is a physician. To this day, he writes her prescriptions. No one was supposed to know. The worst part was, we were supposed to act like we didn't know. Our family invented 'don't ask, don't tell' long before the government ever thought of it."
Even though Sara hadn't lived with her family for 15 years, this was the first time she had ever broken the family rule against speaking about the secret. When Sara left home for college, she was surrounded with new and exciting faces, each seeking lifelong friends and stimulating late-night discussions. But Sara found herself unable to open up, ultimately finding few friends and fewer lovers. She found it difficult to reveal anything personal about herself to anyone, and even suspected others of withholding from her.
Secrets were how she had learned to process and handle incoming information. Sara finally sought therapy when she realized that she had never been able to sustain a romantic relationship past the second date.
When a family's secret is an ongoing condition, such as drug addiction, physical abuse, an illness, then both family relationships and interactions with the outside world are profoundly affected. In families like Sara's, members must organize their everyday lives around the needs of the secret while performing the breathtaking feat of pretending not to notice anything is out of the ordinary. Conversation is superficial since what is truly important cannot be discussed. Members become paralyzed, unable to develop relationships with others or to deepen the relationships within the family.
Since individual well-being takes a backseat to group fidelity, being the family member who challenges internal secrets is difficult. Taking the risk of opening a long-held secret to friends and loved ones may seem like an act of betrayal. The anticipated catastrophe of exclusion from the family stops many people, often long after leaving home.
But breaking the rules of family secrecy is necessary to ensure the achievement of freedom and honesty crucial to making and sustaining authentic relationships. One of the best ways to ease into revealing long-hidden information is to tell an objective listener, like a therapist.

Only rarely do my clients want their first and final telling to be with me. Making secrets with a professional helper is a double-edged sword. A client's relationship with a therapist, minister, priest, or rabbi can be an excellent arena to dissolve shame, find acceptance and empathy, and seek new resources for support and strength.
At the same time, sharing secrets only with professionals may negatively affect marriage and other relationships. Important issues may be discussed more in therapy, for example, than at home. Instead of being a dress rehearsal for life, therapy becomes the show. Most often, I find that people want a receptive and apathetic context in which to unpack a secret initially, room to explore the consequences of telling others, then the help to do it well.
Imagine if your sister made a secret with you on the eve of your wedding and told you that you must not tell your husband. Or you are dragged into a secret about your parents just when you are taking tentative steps into the outside world. If a secret is made at a key point in development, the natural unfolding of self and relationships may be frozen. The shifting of boundaries that ordinarily would occur is suspended, creating a developmental deep freeze.

Every family experiences developmental stages. These are most evident when someone enters the family by marriage or other committed relationship, birth, or adoption, and when someone exits the family by leaving home or through separation, divorce, or death. Such entrances and exits require that a family reinvent itself in order to accommodate new roles. The stages of development are not discrete events but rather processes that take place over time. When that process goes well, complex adjustments occur in every corner of the family. When a secret is made in the midst of this process, adjustment screeches to a halt.
Samuel Wheeler tried to leave home when he was 19, but his discovery of a central family secret pulled him back and short-circuited his young adulthood. When Sam came to see me, he was 34 and still struggling with the aftermath. Aimless, jobless, and depressed, Sam wondered why he had never really found his focus. As we explored his past, I realized that Sam's life had frozen when his attempts to assert independence were squelched during his first year of college.
Early in his first semester, Sam invited his mother to visit. "I was more than surprised when she arrived with a close friend of the family, Duncan," said Sam. Each morning for three days, Mrs. Wheeler left Sam's apartment at five A.M. and returned to have breakfast at eight o'clock. When Sam finally asked what was going on, his mother admitted that she and Duncan were having an affair. She also revealed that his younger sister had actually been fathered by Duncan.
"My mother had kept this secret for years," Sam mused. "Why did she have to put it in my face at that moment?" The ill-timed revelation kept Sam from proceeding with his new life and developing his own identity. While very bright, Sam did poorly his first year in college, dropped out, and went back home. He had subconsciously returned to play watchdog for the family's relationships. His sister was only 15, and he was worried that she would discover the secret. He remained home until she left for college.

Giving voice to the developmental deep freeze, Sam said, "Knowing these things about my mother's life has kept me from changing my relationship with her and my dad in ways I would like. I wanted to get closer to my dad, but this secret is like a rock between us."
Pulling Sam into a secret just as he and his family were moving apart also kept him from asserting independence. While there is no such thing as the perfect moment to open a secret, there are better occasions than a life-cycle ritual, such as a wedding or graduation. Because family relationships are already shifting, rituals may seem a perfect time to open a secret. The excitement of a major life change, however, will prevent resolution of the secret. Either the importance of the secret will be lost in the event, or the secret will diminish the importance of the ritual.
For family members to have the strength to handle a life-altering secret, it should be told at a normal time in everyday life, otherwise, the development linked to a life passage will stop in its tracks.
When secrets are as much a part of families as birthdays, it may seem impossible to extricate them from the daily routine. But I know it can be done. Each time I meet with a new client, I'm moved by the courage people bring to this endeavor, by the human desire to heal and to connect.

Monday, 14 May 2018

The Distorted Picture

As you move through the generations, one day you come to realise that as people die, those left alive change that person's story, bit by bit, leaving just a distorted picture. 

That's sad, don't you think?

Wednesday, 9 May 2018

Is he a controlling man? The shift from attentive to stifling can be subtle. What are the warning signs?

1. He sweeps you off your feet

"When I ask women what their abusers were like when they first met, they often say “charming,”’ says Sandra Horley, CEO of Refuge and author of Power and Control. ‘Whether builders or barristers, these men are caring and attentive at the start. They know how to make women feel special.’ Flowers, surprise trips, grand gestures or just 24/7 attention – he’ll put you at the centre of his universe to bowl you over. ‘It’s a weapon and a disguise,’ says Horley. It convinces you that he is your ‘ideal man’, your ‘happy ending’. And when abusive behaviour creeps in, he can turn the charm to manoeuvre, confuse and pull you back.

2. He hurries the relationship on
He declares his love, pushes you to go on a holiday, move in together, get engaged, try for a baby… Racing through key stages is a definite red flag, says Dr Jane Monckton-Smith, former police officer, criminologist and domestic violence expert. ‘A man who acts like this wants to take full control very quickly. He will often push things at a rate that makes everyone else think, “Whooah!” It may be flattering and exciting but if you feel you need to slow it down, do so. A good man will be fine with that.’
3. He’s sensitive to criticism
‘A controlling man can’t deal with any kind of challenge,’ says Monckton-Smith. ‘So a key personality trait is often that he’s hypersensitive to any kind of criticism, however low-level.’ Perhaps he gets angry simply because you take a breath when he accelerates on a corner (‘You have a problem with my driving?’) or he sulks at an innocent comment such as, ‘Have you had your hair cut?’ (‘Why? What’s wrong with it?’) If you’ve learnt to bite your tongue rather than risk anything being ‘misconstrued’, be wary.
4. He has a problem with your friends
A controlling man needs to isolate you to make you dependent on him. ‘The first stage will often be getting rid of the people who are closest to you, those who care the most and can question what he’s doing,’ says Monckton-Smith. ‘Often that’s your best friend.’ He may instigate problems: ‘They don’t like me,’ he'll say! He often does it so well that he seems reasonable – but the end result is the same: a growing distance between you and the people you love.


By Refuge CEO Sandra Horley
Recognise you’re being abused. This is an important first step. Ask yourself whether you’re in control of your own life or if someone else is pulling the strings.
Talk to someone you trust. Abusers isolate their partners and make them believe it’s their fault or that they’re imagining things. Speaking to someone who can assure you that what’s happening is real can be very powerful.
Ask for help. Call a helpline and access confidential support (see below).
Don’t blame yourself and remember you’re not alone. Thousands of women find themselves in abusive relationships. Your partner is responsible, not you. 
5. He’s jealous
It starts small. A hurt look when you plan a night out with friends or a sad sulk when you go for spontaneous after-work drinks with colleagues. He may say, ‘I just want you all to myself,’ or ‘I can’t help it, I love you so much, I hate sharing you.’ ‘This may seem flattering, but it’s not a sign of love,’ warns Horley. ‘Drip by drip, it isolates you from contact and support, and makes you dependent on him.’
6. He has his own idiosyncratic ways
There are things he likes ‘just so’, and they may seem so minor that it’s easy to go along with them. It could be rules about the house – perhaps he doesn’t like anyone going in his office or hates people rearranging the bookshelves. There may be certain programmes he has to watch or certain times he likes to eat. On their own, they’re trivial. Collectively, they become oppressive. ‘He’s making the rules,’ says Horley. ‘He’s saying, “I’m in charge, I get my way, you can’t challenge me.”’
7. He’s changing the way you look
‘It starts with comments about your appearance that aren’t complimentary,’ says Monckton-Smith. ‘“Are you going to have another biscuit?” “How much make-up are you wearing?” “You’re not putting on that dress, are you?” These remarks don’t go away – they always escalate.’ So you go lighter on the lipstick and ditch your favourite dress. ‘You try to reflect back to him the image he wants to see,’ says Clare Phillipson, director of Wearside Women in Need. ‘And little by little, your sense of self fades away completely.’
8. He takes charge of your finances
‘He often sets the stage by introducing the idea that he’s better at managing money,’ says Dr Nicola Sharp-Jeffs, director of charity Surviving Economic Abuse ( Maybe he says you’re a bit of a spendthrift, that you could live a lot better with a bit more care. ‘That’s often followed with the romantic, “I’ll look after you” promise.’ He may rush you into having joint bank accounts and shared financial arrangements because you’re ‘partners’. Gradually, you find you’re ‘frozen out’ of financial decisions, you don’t know what he earns or how much is in the account, passwords are changed – and you can’t spend money without feeling anxious, guilty or fearful.
9. He worries about you
He likes to know where you are and how long you’ll be out, and usually checks up, calling or texting to make sure you’ve ‘arrived safely’ or you’re ‘home on time’. He’ll claim it’s only because he worries about you. Technology is another means of monitoring you, says Horley. Perhaps he knows your phone access code or your internet password, or he mentions things that reveal he scrutinises your social media. Before long, it becomes spying. ‘The possibilities are endless,’ says Horley: phone numbers are stored on a shared cloud so he knows who you speak to; there’s spyware on your laptop and a tracker on your car so he knows your every move.

10. He puts his hands on your throat
Perhaps it was one heated row, and he was so sorry afterwards but you drove him crazy and no one else has that effect on him… Women can be hesitant to label ‘hands on throat’ as serious – after all, it may be over quickly and without leaving a mark, ‘but I can’t stress enough how serious it is’, says Monckton-Smith. ‘Even if he doesn’t hurt you, placing his hands on your throat or over your mouth indicates that his default position is to threaten your life.’ In fact, one study found that it is associated with six-fold higher risk of attempted murder further down the line and seven-fold of murder. ‘If it happens just once, irrespective of anything else, get out of that relationship,’ warns Monckton-Smith.
The National Domestic Violence Helpline is a partnership between Refuge and Women’s Aid, 0808 200 0247. For more information, visit Refuge also runs a website with information on supporting someone who may be in a controlling relationship,

Thailand help....

Sunday, 29 April 2018

You Lucky Guy!

Nearly 8 years after surgery, today was the 16th time I sat nervously waiting for my PSA result, which ultimately tells if cancer has returned. It wasn't easier than any other time, it never gets easier! Then again, I'm never any less grateful than I was today when, once again, I was given the, 'all clear.' 

It's a well-trodden path and one I've begun to study, seeing the familiar patterns recurring and trying to make some sense of the emotional ride.

There are 4 stages of PSA anxiety:

1. The weeks leading up to the test...
In Bangkok I can go at any time without an appointment, I just decide to go on the day, so this minimises any anxiety. In the UK I would have to make the appointment more than a week before so always had it on my mind after that.

2. Waiting for the result once the blood has been taken...
The wait here is an hour so not a big deal, unlike the UK where the result came back 3/4 days later. That was/is not good!

3. When handed the result... 
I open the envelope and scan quickly for the magic figure (<0.003), thinking it almost unimaginable that it could be bad, but hoping I could hold it together if it was (Even <0.004 would be a disaster). Today it was again good, but 'good' is too small to cover it, so 'bloody insanely marvelous!' Joy, relief, then sorrow, sadness, then back to happy, all a bit of a mix until it quickly settles at very happy and relieved.

4. Tomorrow...
I'm ready for it! I'll have a day where I feel very down and a little depressed. No idea why, but it's become the pattern, every time the same! Can't work it out but hey, I don't care, I'll smile and I'll think to my self, "You lucky guy!"


Monday, 23 April 2018

In memory of my friend Martin

Martin died at Eastbourne General Hospital in England at 5 pm on 16th February 2018, his partner Naty and his daughter Laura at his side.

Martin and I had often joked about death, I guess when you get to a certain age that’s all you can do. We agreed that whoever died first would wait to meet the other, wherever that was, we didn’t profess to know. We did agree that all organised religion was a crazy man-made invention, designed to control populations and that we were going to rise above that. He was a genuinely nice guy of the traditional school, loved crap jokes, loved his partner Naty, his daughter Laura, and loved life with all his heart.

He was intrigued by the idea of writing and always interested in what I was working on next, often contributing ideas when I was stuck with an imagination that knew no bounds. I often told him that if he went first, I’d write about him, he’d laugh, I can still see the smile, hear the chuckle. “What’s to write about?” he’d say, little knowing that his last 6 months would provide a story that could save the lives of others, if only I could get the message across.

So, the $10,000 question now is, if Martin had had medical insurance, would he still be with us today? Maybe, maybe not, you decide… (he’d have liked that)

Naty and Martin
Martin had been with Naty for nearly 3 years, meeting on the Internet, as my wife and I had 10 years before. She was from the Philippines, mine from Yorkshire, very similar cultures and food, so I’m told! Like any couple they went out, often with us, had fun, smiled a lot, enjoyed holidays and looked forward, as many do, to a future full of things that make life worth living. After a visit to England, Martin was delighted that his family seemed to have accepted Naty and he’d also decided that Bangkok would be his future home as he loved it here. He had dozens of friends made mainly through the Bangkok English Speakers Lunch Group, where he was an ever-popular Event Host.

Decisions we make every day can affect the rest of our lives, we all know that. Some of those decisions seem so minor at the time, not even fully thought out, even though they can go on to have long-term catastrophic consequences. So, when Martin had a bad cough, after delaying perhaps a little longer than he should have, he decided to get checked out at his nearest hospital, also knowing that it was far less expensive than many others nearby.

His cough, became a chest infection, then pneumonia and in a surprisingly short time, he was hooked up on life support, knowing he had no medical insurance, but hoping he would get better, soon. Naty and I were with him when his heart stopped, the monitor flat lined and the alarm came on. He was essentially dead for a few minutes before the doctors brought him back, we were in a state of shock, unable to take in what had just happened, I’ll never forget that! The worse part about that hospital were the accountants, the most important department in any hospital here because you have to pay if you want treatment to continue. They would come to his bed every Friday to take his credit card, like uncaring robots, maybe they were! 
Martin with his daughter, Laura

Martin’s daughter Laura flew over to support Natty and began the long process of trying to get her father better while trying to fund the process; something that proved extremely arduous.

A family decision was made to move Martin to a better hospital, even though far more expensive, a place with a specialist chest unit. Nobody was aware until that point that the hospital he was in was not equipped to look after someone in his condition! It’s alright to say in hindsight that Martin should have gone to this better hospital first, but he didn’t and I would have probably done the same given the circumstances, but at least now his chances of recovery would surely improve? He did recover and was eventually discharged, though extremely weak and still looking very unwell. He wanted to be fit enough to fly back to England where he could not only have free treatment under the National Health Service but could also be closer to friends and family. This came about eventually and he and Naty flew back to a bitter winter in England but a very warm welcome from his daughter Laura, who had single-handedly refurbished his flat as a welcome home surprise. Martin was over the moon! He started the process to ensure Naty’s visa and was soon making plans for a return to Bangkok, convinced he could now get the best treatment and make a full recovery.

The cost to Martin of his experience in Bangkok was over 2 million Baht, and would later also cost him his life, because on his return to his home country he was constantly in and out of hospital, struggling to regain health, tragically, eventually losing that battle.

Naty stayed for the funeral, over a month after Martin’s death, such are the winter queues at the crematoriums. Her visa would have run out soon after so she was lucky in many ways not to have that as an added problem. However, back in the Philippines now, trying to pick up the pieces of her life, she has discovered that she wasn’t even named in Martin’s will. She’s shocked, bewildered and mainly lost for words as she comes to terms with her situation, best described as dire, the past 3 years just fond memories.

Martin often told me that if anything happened to him, Naty would be well taken care of, and I know he loved her and meant that, so what went wrong? I guess it was just one of those things that we all intend to do, but don’t ever get around to, because it never becomes top of our list, and hey, we’re never going to die, are we? Solicitors in England are now trying to sort out some support for Naty from Martin’s estate, and are hopeful of a good outcome, but until then, she has to rely on friends and relatives for essential support.

Martin, now’s your chance, come on, what advice would you give anyone who finds themselves in a similar situation to what you’ve just experienced?

“Daniel me old mate, firstly they should at least have some basic medical cover, but if they haven’t, as many expats don’t, still avoid going for the cheapest hospital, it could work out far more expensive in the long term. Secondly, if they have a partner who they love and care about deeply, make sure they provide for them in their will; especially if they have nothing! Thirdly, thanks for the promised write-up, I’ll do the same for you one day if I ever get out of this place!”

Don’t worry Martin, we’ll look after Naty, take a rest and hang around for me, though I might be some time yet; I hope!

Sunday, 22 April 2018

Scottish Prostate cancer testing breakthrough...

Ultrasound technique overcomes problems with current methods to diagnose the most common cancer in men.
 Electron microscope image of prostate cancer cells. Photograph: Electron Microscopy Unit, Cancer/Getty Images/Visuals Unlimited
Scientists have announced the development of a highly accurate and reliable technique for diagnosing prostate cancer. The Dundee University-based team say they have used an ultrasound process called shear wave elastography (SWE) to detect prostate tumours. The method is non-invasive and cheaper than current detection techniques.
Prostate cancer has become the most common cancer in men in the UK. One in eight men will develop the condition at some point in their lives with more than 47,000 new cases being diagnosed every year. Men aged 50 or over, men with a family history of prostate cancer, and black men are at greatest risk of developing the condition.
“Current diagnosis of prostate cancer is extremely inefficient, leading to unnecessary treatments for many patients,” said the Dundee University team’s leader, Professor Ghulam Nabi. “Our new method is far more accurate and also allows us to identify the difference between cancerous and benign tissue in the prostate without the need for invasive surgery.”
The prostate is a small gland in the male reproductive system and is normally about the shape and size of a walnut. Current methods for determining if a prostate has become cancerous include a physical examination of the prostate (known as a digital rectal examination or DRE), MRI scans, a biopsy or tests to determine levels of the chemical prostate-specific antigen (PSA) in the blood.
Stephen Fry, who has had surgery to deal with a prostate tumour, says he is excited by the new diagnostic test.
 Stephen Fry, who has had surgery to deal with a prostate tumour, says he is excited by the new diagnostic test. Photograph: HGL/GC Images
Each carries problems. PSA results can be unreliable; a DRE is not good at identifying which cancers are benign and which need treatment; MRI scans cannot always give a definitive answer; while a biopsy carries a risk of infection and is expensive.
The new method aims to get round the problems by targeting the prostate with ultrasound. Cancerous tissue is stiffer than normal tissue so shear waves are slowed as they pass through a tumour.
“We have been able to show a stark difference in results between our technology and existing techniques such as MRI,” added Nabi. “The technique has picked up cancers which MRI did not reveal. We can now see with much greater accuracy what tissue is cancerous, where it is and what level of treatment it needs. This is a significant step forward.”
The trial tests involved around 200 patients. “Now we need to use this on a wider scale to build more data but there is clearly the potential to really change the way we manage prostate cancer,” Nabi said.
SWE technology is already used in diagnosing breast cancer and liver diseases. However, to make it applicable to prostate cancer a special probe had to be developed by the team.
“The technique now needs to be tested in a much larger number of men to confirm just how well it can detect the aggressive cancers, while also ruling out those who do not have prostate cancer,” said Simon Grieveson, head of research funding at Prostate Cancer UK, which funded the Dundee project (with support from the Movember Foundation).
“With an average of one man dying every 45 minutes from prostate cancer in the UK, the need for a more reliable test that can identify dangerous forms of the disease earlier is greater than ever.”
In the past few years, a number of celebrities have revealed that they had been diagnosed with prostate cancer and have joined campaigns to raise awareness of the disease, including Michael Parkinson, Ian McKellen and most recently Stephen Fry, the comedian and former rector of Dundee University, who this year described how he had surgery to deal with a prostate tumour.
“This breakthrough comes at a time when prostate cancer is being pushed to the forefront of our consciousness in the UK, not least because of the disturbing upward trend in its prevalence,” said Fry. “It is therefore doubly exciting to hear of the new techniques in diagnostic imaging.