Friday, 19 September 2014

Lloyds Bank: Where you're better off dead than alive!

I'm starting a new blog so that people can share their experiences and dealings with Lloyds Bank Bereavement Section. Click on link here

My Mother, Ellen Patricia Sencier, died on my birthday back in December last year. She named my brother Paul and I as joint executors. I have a younger brother Andre, and a sister, Jacqueline Heffernan. On this new blog I will be detailing events from when I first tried to contact my Mother's branch in Clacton just after her death, up until this week, when for the first time in 9 months, I finally got a reply! This was only because I had complained to the Banking Ombudsman. But should I have had to go that far?   

Nearly 50 attempts to get someone/anyone to communicate with me, failed.
E-mails, faxes, phone calls and letters all went unanswered until this week. 

It's a compelling story, unbelievable in places and a series of events that divided a family forever.

If you have had a similar experience, please get in touch and we can pool our stories. I called the consumer magazine 'Which' today, they are very interested and want a script. The hope is that one of the national papers will run it also, but early days! 

Monday, 8 September 2014

Prostate cancer drug candidate shows great promise...

By Arthur Hirsch, The Baltimore Sun
6:16 p.m. EDT, September 6, 2014

A white powdered chemical compound emerged from two University of Maryland School of Medicine laboratories more than 10 years ago with a name destined for oblivion, but a future that now looks promising as a treatment for the most challenging cases of prostate cancer.
Today, VN/124-1 is a drug candidate with a name — galeterone — a pharmaceutical company founded on its potential and a record of strong preliminary results in clinical trials with human patients.
The Food and Drug Administration has put galeterone on a fast track for approval to treat prostate cancer, which kills about 30,000 men a year in the United States. Researchers in hospitals and clinics across the country and in Canada are finishing the trial's second round and preparing for the third, expected to begin early next year.
Dr. Kevin J. Cullen, director of the University of Maryland's Marlene and Stewart Greenebaum Cancer Center, acknowledged that results are preliminary, but he said it's an auspicious beginning.
"I can think of maybe one other drug in the 30 years I've been doing oncology that showed these kind of results," Cullen said. He called it an "incredibly promising start for this medicine."
Dr. Mario Eisenberger, heading the clinical trial at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, said the drug has had impressive results, but "I don't think anyone can say at this point in time whether galeterone is going to be better than the other" drugs already used to treat prostate cancer.
Before galeterone was a medicine, it was a compound born of a collaboration that began in 1996 between two University of Maryland researchers, Angela M. H. Brodie and Vincent C.O. Njar.
The approach was built on work for which Brodie has won some of the most prestigious awards in the field — research not in prostate but breast cancer. In the last 10 years, she won the Charles F. Kettering Prize and the Dorothy P. Landon-AACR Prize for Translational Cancer Research for her work in the 1970s and 1980s helping to develop compounds that block production of estrogen, the female hormone, that fuels the growth of most breast cancers.
More recently, she's turned her attention to prostate cancer, which feeds on the male hormone. She wondered if the approach that worked with estrogen would work with the androgens, or hormones, that fuel prostate cancer: testosterone and the more potent dihydrotestosterone.
Up to now, one main treatment for the most challenging prostate cancers has been shutting down androgen production from the testicles. The procedure, referred to as castration, is most commonly done today by medication not surgery. The testicles produce about 90 percent of the body's androgen. Most of the rest is produced by the adrenal glands, and a small measure from the prostate tumor itself.
Njar and Brodie were looking for a way to fight prostate cancer that continutes after castration.
Their approach is one in a succession of hormone-based treatments that have been used for years, but it's different in combining several effects at once. This one works in three ways to interfere with androgen's effect on prostate cells.
The medication decreases androgen production and interferes with the process by which the substance binds to the prostate cell molecule that responds to the hormone, known as the receptor. These effects have been produced before, but galeterone is the only medication that also appears to damage the receptor itself.
The triple threat showed impressive results in tests with mice about 10 years ago. Brodie and Njar and their research team published results in the Journal of Medicinal Chemistry in 2005, concluding that the compound "is a potent inhibitor of human prostate tumor growth and is remarkably more effective than castration."
After that publication, Tokai Pharmaceuticals, a company in Cambridge, Massachusetts, named and licensed the compound as "galeterone." Clinical trials with human patients started in November 2009.
To fund its anticipated growth, Tokai applied in August to sell $75 million of stock in an initial public offering. While its stock sale is pending, company officials are not available for comment.
According to information posted on Tokai's website, researchers have given the drug to 200 patients in the first two trial phases.
Of the 49 patients in the first trial, 24 showed 30-percent reduction in prostate specific antigen, or PSA, and 11 showed a 50-percent cut. Elevated levels of PSA can be, but are not necessarily, a marker for prostate cancer.
In the second phase, 51 patients — both with and without metastasis, or cancer spread beyond the prostate — followed for 12 weeks also showed significant PSA reductions. Of this group, 82 percent to 85 percent experienced reductions of about a third, three-quarters saw a reduction by at least half.
Cullen said he was struck by the results even in the first phase, conducted less for effects on the cancer than to see how well patients can tolerate the medication at low doses. With such low doses in the first phase of a clinical trial, results like that are "almost unprecedented," he said.
In the third phase of the trial, galeterone will be compared to existing treatments, Brodie and Njar said, and could take up to another year.
The FDA "fast track" can in some cases cut years off the time it takes to bring a drug to market, Eisenberger said.
Galeterone causes none of the adverse effects associated with chemotherapy, including nausea and hair loss. So far, Brodie said, the chief side effect could be deficiency of cortisol, but that has not been a problem so far. The hormone plays a role in regulating blood sugar, suppressing immune response and metabolizing fat, protein and carbohydrates.
Eisenberger said the effects can include fatigue and itching, but nothing requiring cortisol treatment.
Brodie and Njar are making no bold pronouncements at this point, just eagerly awaiting further results.
"We are cautiously optimistic," Njar said.
"It's a wonderful thing if we can save lives," Brodie said.

Saturday, 6 September 2014

Exciting new tool to test cancer drugs and personalize cancer treatment...

Stained pathology slides of a patient’s tumor (right) and of an organoid made from that tumor (left).
Credit: Image courtesy of Memorial Sloan Kettering Cancer Center
Research led by investigators at Memorial Sloan Kettering Cancer Center has shown for the first time that organoids derived from human prostate cancer tumors can be grown in the laboratory, giving researchers an exciting new tool to test cancer drugs and personalize cancer treatment.
The researchers, whose results were published today in Cell, successfully grew six prostate cancer organoids from biopsies of patients with metastatic prostate cancer and a seventh organoid from a patient's circulating tumor cells. Organoids are three-dimensional structures composed of cells that are grouped together and spatially organized like an organ. The histology, or tissue structure, of the prostate cancer organoids is highly similar to the metastasis sample from which they came. Sequencing of the metastasis samples and the matched organoids showed that each organoid is genetically identical to the patient's cancer from which it originated.
"Identifying the molecular biomarkers that indicate whether a drug will work or why a drug stops working is paramount for the precision treatment of cancer," said Yu Chen, MD, PhD, Assistant Attending Physician in the Genitourinary Oncology Service and Human Oncology and Pathogenesis Program at MSK. "But we are limited in our capacity to test drugs -- especially in the prostate cancer setting, where only a handful of prostate cancer cell lines are available to researchers."
With the addition of the seven prostate cancer organoids described in the Cell paper, Dr. Chen's team has effectively doubled the number of existing prostate cancer cell lines.
"We now have a new resource at our disposal that captures the molecular diversity of prostate cancer. This will be an invaluable tool we can use to test drug sensitivity," he added.
The use of organoids in studying cancer is relatively new, but the field is exploding quickly according to Dr. Chen. In 2009, Hans Clevers, MD, PhD, of the Hubrecht Institute in the Netherlands demonstrated that intestinal stem cells could form organoids. Dr. Clevers is the lead author on a companion piece also published in Cell today that describes how to create healthy prostate organoids. Dr. Chen's paper is the first to demonstrate that organoids can be grown from prostate cancer samples.
The prostate cancer organoids can be used to test multiple drugs simultaneously, and Dr. Chen's team is already retrospectively comparing the drugs given to each patient against the organoids for clues about why the patient did or didn't respond to therapy. In the future, it's possible that drugs could be tested on a patient's organoid before being given to the patient to truly personalize treatment.
After skin cancer, prostate cancer is the most common cancer in American men -- about 233,000 new cases will be diagnosed in 2014. It is also the second leading cause of cancer death in men; 1 in 36 men will die of the disease.
Despite its prevalence, prostate cancer has been difficult to replicate in the lab. Many mutations that play a role in its growth are not represented in the cell lines currently available. Cell lines can also differ from their original source, and because they are composed of single cells, they do not offer the robust information that an organoid -- which more closely resembles a living organ -- can provide.

Story Source:
The above story is based on materials provided by Memorial Sloan Kettering Cancer Center. The original article was written by Julie Grisham.  

Wednesday, 3 September 2014

Scottish Independence? If in doubt read on...

Would you vote for the package below? Because essentially, that's what you will be doing if you vote 'No'!

"Imagine Scotland was already independent and we were about to have a referendum on whether to join a union with the rest of the UK.
Could the Pro-union side convince us that getting together would be better when we were told what would happen to Scotland after such a union? 

Some bullet points from the campaign…

-Your main Parliament will move 600 miles away, and your MPs will be in a tiny minority & will therefore have limited ability to effect policy on your behalf

-Scotland will get a government it didn’t vote for.

-All of your oil and gas revenues will be handed over to the treasury in London.
-Even though not 1 inch of track will touch Scottish soil your taxpayers will contribute £4.2bn to the HS2 project.
-Your taxpayers will also subsidise the crossrail project to the tune of £4.2bn
-The biggest nuclear weapons facility in Western Europe will be built on the river Clyde, just 30 miles from your largest city.
-Even though you only have 8.2% of the UK’s population you will contribute 9.9% of the UK’s total tax take yet will only receive 9.3% of that tax take back to spend in Scotland (you will lose £4.4bn per year to the UK treasury)
-You will devolve all of the economic levers you have used to shape your economy directly to London and will now only have control of 7% of your economy
-Even though 79% of your MP's voted against it we will privitise your publicly owned mail service
-Even though 91% of your MPs voted against the bedroom tax in your parliament, we will impose it.
-Even though 82% of your MP's believed that a VAT increase would be detrimental to your economy, we will impose a VAT increase.
-You will join a country whose health and education services are rapidly being privatised.
-Now and again you’ll get dragged into an illegal foreign war.
-An austerity budget will be imposed from London cutting jobs and threatening vital public services even though 81% of your MP's voted against the cuts.
-The financial regulation system will be so weak and so lax that your whole economy will be brought to the brink of collapse.
-The most weak and vulnerable in society, instead of getting the protection and support they deserve will be interrogated and humiliated in an effort to get them off the meagre levels of support to which they are entitled.

Who in Scotland would vote for such a package?

Who would vote for that union?

So why would anyone vote to remain in such a union now?

This is about democratic ownership, social responsibility and the fact that Scotland on its own will be economically stronger from day one of independence....."

(I discovered this article when Forbes Manson shared it on Facebook)

Sunday, 31 August 2014

10 keys to happiness...

10 keys to happiness by Deepak Chopra:

1. Listen to your body’s wisdom, which expresses itself through signals of comfort and discomfort. When choosing a certain behavior, ask your body, “How do you feel about this?” If your body sends a signal of physical or emotional distress, watch out. If your body sends a signal of comfort and eagerness, proceed.
2. Live in the present, for it is the only moment you have. Keep your attention on what is here and now; look for the fullness in every moment.Accept what comes to you totally and completely so that you can appreciate it, learn from it, and then let it go. The present is as it should be. It reflects infinite laws of Nature that have brought you this exact thought, this exact physical response. This moment is as it is because the universe is as it is. Don’t struggle against the infinite scheme of things; instead, be at one with it.
3. Take time to be silent, to meditate, to quiet the internal dialogue. In moments of silence, realize that you are recontacting your source of pure awareness. Pay attention to your inner life so that you can be guided by intuition rather than externally imposed interpretations of what is or isn't good for you.
4. Relinquish your need for external approval. You alone are the judge of your worth, and your goal is to discover infinite worth in yourself, no matter what anyone else thinks. There is great freedom in this realization. When you find yourself reacting with anger or opposition to any person or circumstance, realize that you are only struggling with yourself. Putting up resistance is the response of defenses created by old hurts.
5. When you find yourself reacting with anger or opposition to any person or circumstance, realize that you are only struggling with yourself. Putting up resistance is the response of defenses created by old hurts. When you relinquish this anger, you will be healing yourself and cooperating with the flow of the universe.
6. Know that the world “out there” reflects your reality “in here.” The people you react to most strongly, whether with love or hate, are projections of your inner world. What you most hate is what you most deny in yourself. What you most love is what you most wish for in yourself. Use the mirror of relationships to guide your evolution. The goal is total self-knowledge. When you achieve that, what you most want will automatically be there, and what you most dislike will disappear.
7. Shed the burden of judgment – you will feel much lighter. Judgment imposes right and wrong on situations that just are. Everything can be understood and forgiven, but when you judge, you cut off understanding and shut down the process of learning to love. In judging others, you reflect your lack of self-acceptance. Remember that every person you forgive adds to your self-love.
8. Don’t contaminate your body with toxins, either through food, drink, or toxic emotions. Your body is more than a life-support system. It is the vehicle that will carry you on the journey of your evolution. The health of every cell directly contributes to your state of well being, because every cell is a point of awareness within the field of awareness that is you.
9. Replace fear-motivated behavior with love-motivated behavior. Fear is the product of memory, which dwells in the past. Remembering what hurt us before, we direct our energies toward making certain that an old hurt will not repeat itself. But trying to impose the past on the present will never wipe out the threat of being hurt. That happens only when you find the security of your own being, which is love. Motivated by the truth inside you, you can face any threat because your inner strength is invulnerable to fear.
10. Understand that the physical world is just a mirror of a deeper intelligence. Intelligence is the invisible organizer of all matter and energy, and since a portion of this intelligence resides in you, you share in the organizing power of the cosmos. Because you are inseparably linked to everything, you cannot afford to foul the planet’s air and water. But at a deeper level, you cannot afford to live with a toxic mind, because every thought makes an impression on the whole field of intelligence. Living in balance and purity is the highest good for you and the Earth.

Sunday, 24 August 2014

Zimbabwe - loved it!

How many times in our lives do we go from Wednesday to Saturday and ever remember much of what happened a few weeks later?

When I packed I took a note book to record a diary, but it wasn't needed. Every moment was precious, be it sight, sound, smell, taste or feeling, it was all new to me; I was on overload!

The flight from Johannesburg to Harare was an hour and 40 minutes marked half way by the Limpopo River, also the border between the countries. I've never seen it at ground level but from 36,000 feet it looked huge! Harare airport is small with only 3 gates, but very personal. When I didn't know the address of the  person I was staying with, security escorted me out front to ask the guy who was collecting me, then back to passports control.

I was in Harare to represent and introduce our company, e-perceptum, at a head-teachers conference. Along with our partner technology company we were invited to the University as part of an ongoing government initiative, to expand e-learning throughout the country. Before the start of the presentation I suddenly developed a gusher of a nose bleed, going through a whole toilet roll in 15 minutes. Security fetched a nurse, a doctor followed from a nearby practice, a bit of an overkill for a nose bleed I thought. I joked that I always get nose bleeds when I listen to teachers talking for over 5 hours, but it fell on deaf ears. The first question was, "Have you come from Nigeria?" Ah! Ebola! One of the symptoms is nose bleed, suddenly it all fell into place. A quick temperature check and I was cleared and people started walking close to me again!
Quick sandwich before we went on stage

Our presentation film on DVD along with flyers and information at our stand went out to all delegates, and the following day was peppered with meetings and phone calls. I can't give any detail really because that's the way it works there. If you behave and show respect, they reciprocate, then you can make great progress.

I stayed with a wonderful family who were building, while living in their house, way out in the countryside on a gently sloping hillside. No toilet yet, just a hole in the ground which could have been bigger, but then you wouldn't have wanted to fall through that space!

The children thought it hilarious every time I paid a visit, and I made loud noises as I pushed so not to disappoint. On the last day I took imodium as a treat; one days rest from that bloody hole was worth the constipation. 

We also had a braai (bbq) the night before I left, and the african sunset was one hell of a backdrop as the men and women talked and laughed and the children played. Nobody drank alcohol, it was a 4 day dry out to me but it felt great. I was an 'elder'! Yes, in Africa it's different when you're old. I explained to the bemused throng that in the UK, families put their old people in special homes to die with other old people. Often smelly places where they get very depressed and lonely. In Africa, the elders are respected by all for their experience and knowledge and are always the first to be considered and consulted in everything that goes on. You might think Africa is still a bit primitive but believe me, I was shown great respect in Zimbabwe by everyone, regardless of their age or economic circumstances.

But back to earlier…I got the chance to walk around Harare for a few hours by myself. I was the only white person, I didn't see anyone else that even came close! I knew I was in 'real Africa' for sure. Everyone spoke English along with their own tongue, something you couldn't claim in London. I bought a handmade shoe brush from a street seller, I wanted a souvenir that would remind me of Harare every-time I used it. I wasn't to notice the 'made in China' label until later that day! A man rooting in a bin pulled out a half eaten sandwich and started to tuck in. I pulled out the 2 dollars I'd just been given in change for the brush and held it out to him. He looked at me and said, "I have everything I need, give it to that man over there", pointing at an old chap in a wheel chair who had no legs. I went over and offered him the money. He said, "I'm not a beggar, why are you giving this to me?" I explained that I hadn't assumed he was a beggar, but that the young man eating the sandwich had asked me to give him the money. He took it, thanked me and acknowledged the other man with a slight wave. I'll never forget that or the lesson behind it.

Was I familiar with the '3 bucket system'? I said yes because, what could be complicated about 3 buckets at wash time? I entered the room and hey, just to add to it, there were 4, not 3 buckets!
I brushed my teeth and scooped a big handful of water from the green bucket to rinse my mouth. Tasted funny, mouth went a bit tingly and numb, thought maybe that's the way water tastes here. The other buckets were simply hot and cold, but this was to be nowhere as easy as having a shower. It took ages sloshing water on, especially around those difficult areas! I later found that the mouth wash was a chlorine based sanitizer!

Never carry a fully fired up braai into the house! Why? Mmm let me think! Firstly there are kids running everywhere, secondly it's very hot, and thirdly? Yes, it might just fill the house with fumes so that nobody can breathe!
5 minutes later, sure enough, we were all back outside coughing and laughing!

Thank you Batsie and Prisca for making me part of your family and friends for 4 amazing days, I look forward to our next trip over in the very near future. There are good times ahead for the people of Zimbabwe and a bright future for your children, I'm certain of that. I'm sorry I didn't eat the liver at breakfast time but I tried to make up for it with the beef and papa later that day.

Here are a few more photos…

Sugar cane

Tuesday, 12 August 2014

Tribute to Robin Williams...

So sad to hear that Robin Williams has passed away today. I remember watching Mork & Mindy and thinking, hey, there is a better place out there. An amazingly funny guy who made me laugh out loud, and not many can do that. We are watching 'Good morning Vietnam' tonight in remembrance of this great and oh so funny man.

Things that Robin said that made me laugh….

“No matter what people tell you, words and ideas can change the world.”

“I was an only child. I did have kind of like a lonely existence. The idea of being a character who is kind of isolated, I can relate to that.”
“But only in their dreams can men be truly free It was always thus and always thus will be.”
“You’re only given a little spark of madness. You mustn’t lose it.”
“What’s right is what’s left if you do everything else wrong.”
“Never pick a fight with an ugly person, they’ve got nothing to lose.”
“After I quit drinking, I realized I am the same asshole I always was; I just have fewer dents in my car.”
“Ah, yes, divorce … from the Latin word meaning to rip out a man’s genitals through his wallet.”
“If women ran the world we wouldn’t have wars, just intense negotiations every 28 days.”
“Reality is just a crutch for people who can’t cope with drugs.”

Saturday, 9 August 2014

Is there rabbit in 'Bunny Chow'?...

Had my first 'Bunny Chow' yesterday, loved it but couldn't finish. This dish can be just about anything, served in a hollowed out loaf, or half loaf of bread. You're supposed to eat it all, but after I'd finished the beef curry, there was no chance of eating the bread. Top quality food though and at less than £5 you can't go wrong!

Been in South Africa 9 months now and in theory, 3 months left to go because that's when our rental contract expires. But then what? Well either the work that we have will keep flowing and keep us here for a while, or we will head off to Jaipur in India come the end of November. Christmas in India? Never had such uncertainty in my life! My Dad used to say, "When your life becomes certain, end it". I prefer, 'change it'. 

Wish I could write stuff about what my kids are up to, but they have completely banned me from that. They don't want their private lives splattered all over the internet, which I understand. With my parents, everything was a secret, everything was private. "Don't tell the neighbours", my Mum would say, "What would they think?" As I grew older I realised that people have enough on their own plates without the triviality of thinking what I'm doing. But wouldn't it be nice to imagine that one day, if I had grandchildren, I could announce it on here and show a wee photo or two! 

I heard on the news that the UK will soon have everyone on 'super-fast broadband', with speeds of up to 80 Mb/s. Currently they are struggling with speeds as low as 12 Mb/s in some areas! Wow! I had to laugh because on average our download speed here rarely hits 2, is mainly below 1.5 Mb/s and often, it's just gone! We've got used to downloading films overnight so that we don't have to watch them live, and pausing to catch up for 3 minutes every 2 minutes. I think of it as 'African speed' because nothing happens fast here, and in general, I like that.

Wednesday, 6 August 2014

We have lost a great man today in Terry Herbert...

It was very, very sad to hear the news today that Terry Herbert had passed away in Australia. He founded YANA after being diagnosed with prostate cancer about 12 years ago. It stood for 'You Are Not Alone', and became a support and awareness group for thousands of men worldwide. When you joined you certainly realised that you were not alone. Although I never met Terry in person, we knew each other very well through our numerous communications. In the early days of my diagnosis he gave me sound advice on winning the mental battle and started me off on the road to helping others. It's hard to believe he's gone, but I'm sure YANA and the memory of Terry Herbert will live on with us all. He was from South Africa originally, and it is from here that I send condolences to his family and friends for their sad loss.

Friday, 1 August 2014

Yorkshire Day…let's celebrate

Happy 'Yorkshire Day' to Yorkshire folk around the world.
I moved from Essex to Harrogate, Yorkshire in 1967 and what a great escape that was!
My partner Beverley was born in Leeds and grew up in Barnsley. Now if you want to see a town that's still very Yorkshire, go to Barnsley.
What I'd give to be in Yorkshire today!

Monday, 28 July 2014

Prostate Cancer UK…

Visit the 'Prostate Cancer- UK' website. You'll find just about everything you need to know, and you can even do 'live- chat' with specialist nurses.

Saturday, 26 July 2014

Androgen Deprivation Therapy, all you need to know...

Lucy Frisch
Associate Publicist, Demos Health

11 West 42nd Street, 15th Floor

New York, NY 10036

(T) 212-804-6337

Having reviewed this book I found it amazingly helpful and full of sound, practical advise. 
If you want a copy please contact Lucy (details above)

In the days before prostate-specific antigen (PSA) could be measured by a blood test, it was common for men to appear in the doctor’s office complaining about pain, which would turn out to be due to the spread of prostate cancer to their bones. The standard therapy at that time was orchiectomy, or surgical removal of the testicles. The testicles produce testosterone, a male hormone, or androgen, known to stimulate the growth of prostate cancer. In the early 1940s, this procedure had been shown to relieve pain due to metastatic prostate cancer, and thus became the “gold standard” for treating the disease. The early 1980s saw the approval of injectable drugs called gonadotropin- releasing hormone (GnRH, also called luteinizing hormone-releasing hormone, LHRH) analogs, which offered a much-needed alternative to the permanent orchiectomy. Since these drugs could turn off the testicular production of the androgen testosterone, the treatment was called androgen deprivation therapy (ADT). Many men opted for the drugs rather than orchiectomy. Soon after the GnRH analogs became available, the U.S. Food and Drug Administration (FDA) approved the PSA test. Over time, this test allowed us to find a whole new population of prostate cancer patients, namely, those men who had had surgery or radiation for localized prostate cancer and who now had a rising PSA measurement without any evidence of disease having spread to their bones or elsewhere. This condition is commonly called “biochemical relapse” because only the blood test indicates return of the cancer. Out of concern for the continuously rising PSA, we often started ADT, even though the men did not have any evidence of metastases. In most cases, ADT was very successful in bringing the PSA down to undetectable levels for long periods of time.
However, I began to hear from patients treated with ADT shots for biochemical relapse that they were feeling fatigued and experiencing a whole host of other symptoms. In the past, I had often encountered men with metastatic disease, who had either started the ADT injections or had had an orchiectomy, complain of fatigue. My na├»ve response was, “Of course you have some fatigue. You have metastatic prostate cancer.” But now a light bulb went off: the fatigue and other symptoms experienced by the biochemical relapse patients were from the ADT! Unlike the men I had encountered earlier in my practice, these men did not have metastases and had been feeling fine before the shots were started. Thus began an era of intense clinical research on the effects of ADT on the physiology, psychology, and cognitive functioning of men so treated.
The list of potential side effects of ADT is lengthy, and the list of different ways to address these side effects is even longer. Busy physicians may have only enough time to skim over these details, leaving the patient and his family unprepared for what to expect. In spite of our best efforts to educate patients and their partners about ADT, we often still feel we are not doing enough.
I met Richard Wassersug in 2006, when he came to Seattle for a visit. He was interested in intermittent ADT, and we met in a conference room with Monique Cherrier, PhD, my colleague who has collaborated with me in studying the effects of ADT on cognitive function. Dr. Wassersug explained that he was a scientist who primarily studied amphibian developmental biology, but, more importantly for our conversation, he was a man who had prostate cancer. As a scientist, he was a keen observer of the side effects of ADT and was also doing some laboratory and clinical research with colleagues in Halifax on the effects of ADT. Through research, personal observation, and staying in tune with men treated with ADT all over the world via Internet blogs and websites, Dr. Wassersug has accumulated a vast understanding of the side effects, how to explain them, and how to talk with men about dealing with them.
Around the same time as my meeting him, Dr. Wassersug sought out  Dr. Robinson of the Tom Baker Cancer Centre. Soon they began collaborating. Dr. Robinson, a renowned psychosocial oncologist working with couples affected by cancer, clearly valued the dual perspective of Dr. Wassersug, the prostate cancer patient, and Dr. Wassersug, the research scientist.
Dr. Robinson and his then student, Lauren Walker, have since then been collaborating with Dr. Wassersug on various projects related to ADT. Dr. Wassersug found in Drs. Robinson and Walker specialized clinical skills, patient education expertise, and invaluable knowledge of a broad range of patient experiences. Equally passionate about improving the lives of men on ADT, these three individuals, plus other collaborators along the way, have significantly changed the ways in which patients are cared for while on ADT.
As a research team, Drs. Wassersug, Robinson, and Walker have found that patients and their partners remain poorly informed about the side effects of ADT. They established an ADT Working Group of about 20 professionals (i.e., researchers and clinicians) that make recommendations about the psychosocial care of men on ADT. Their research has demonstrated considerable variability in the information that health care professionals believe to be essential to provide to patients. As a team, Drs. Wassersug, Robinson, and Walker have worked to develop educational initiatives for patients, partners, and health care professionals, to help patients prepare for and manage the changes associated with ADT. This book is the culmination of several years of their work.
This book is different from consultations with specialists or conversations with nurses and doctors: it is something you can take home, read, and work on at your own pace, on your own time. You can read it in whatever order is of interest, skipping sections that may not be significant to you at this time, or going back and reviewing specific sections later. Importantly, this book emphasizes the impact of ADT on partners, so if you have one, it is highly recommended that you read it with him or her. It turns out that ADT can profoundly affect your relationships, so it is critical to address all parties concerned, not just the one receiving ADT.
This is not just a book that you read; it is a book that you do. It will serve as a reference and will complement whatever your medical team has taught you. It will allow you and your partner to better understand what is going on, and why, and it will help you to better deal with some of the side effects of ADT. It is a fantastic resource for patients and their families that is long overdue. As Sir Francis Bacon said in 1597, “knowledge is power.” Get going on doing this book, and in the process take back the power that prostate cancer has been stealing from you. You’ll be glad you did.

Celestia (Tia) Higano, MD
Professor, Medical Oncology Division
University of Washington, School of Medicine
Seattle, Washington