Website of the week
One of the many things I like about Bandolier articles is the language. This piece on begins: ‘It was John Maynard Keynes who commented that “in the long run we’re all dead”.’
These pages deal with the prevention of prostate cancer, and concentrates on finasteride.
If you read nothing else after the first paragraph, read the comment at the end. It concludes: ‘It’s all a question of how vaguely we are right.’
Why go there: because it is a joy to read.
Information from: Bandolier.
Screening for prostate cancer
This neat two-page PDF is aimed at patients, but GPs will find it useful, because it explains the rationale for the use of the PSA test as it could be explained to patients.
And this, after all, is exactly what we do. I’d be surprised if there is a GP in the UK who has not been asked by a male patient of a certain age if a PSA test could or should be performed.
On these couple of pages you will find the answers and how to respond appropriately to such requests.
Why go there: essential knowledge.
Information from: Cancer Research UK Primary Education Research Group
Aetiology of prostate cancer
This looks a touch hard going, because there are two pages of dense text. But if you just read the aetiology section, it should not take too long. Genetic factors, hormones and sexual habits are discussed, and occupation is also said to be relevant.
Did you know that high cadmium and other heavy metals increase the risk, as do low zinc levels? It would have been helpful if the author had given examples of the occupations where these situations are likely to occur.
Apparently, studies have suggested that farmers and workers exposed to radionuclides may be susceptible, as well as rubber and textile workers, printers, painters and mechanics.
I was particularly interested in the section on diet.
We know even more about this now than when this was written in 1999, but the list of foods to be encouraged and those to avoid is helpful. Patients are likely to ask questions about what diet they should follow to reduce their risk of prostate cancer, and it is handy to have an authoritative answer.
Fat is clearly a no-no, and although I don’t eat butter, burgers or processed foods, I do like my cheese. Oh dear.
Why go there: it’s an interesting read.Downside: needs updating.
Information from: The Pharmaceutical Journal Online.
Address: www.pjonline.com/ noticeboard/ credit/1999/199903_ aetiology.pdf
Treatment for prostate cancer
This is a wide-ranging topic and one that is constantly changing. That is why I am recommending this rather mish-mash of a page.
It does not give a simple dissertation on treatment, but has links to all the important and up-to-date sources a UK GP is likely to need to keep abreast of developments.
Issues discussed include docetaxel for metastatic cancer, high dose rate brachytherapy, cryotherapy, laparoscopic radical prostatectomy and gonadotrophin releasing hormones. Most, but not all, of this guidance is from NICE.
While those in primary care are not directly involved in such treatment, we do need to know what is on offer and why a particular treatment is being given to our patient.
And if we think a patient should have a particular treatment, we can ask questions based on a little knowledge.
Hats off to Cancerbackup for producing this excellent section especially for health professionals.
Why go there: to keep up to date.
Information from: Cancerbackup UK.
It won’t take you long to visit this site, because I would not inflict on my colleagues the task of reading all the technobabble, but it is worth a visit to see the clever pictures.
The authors describe a technique of three-dimensional colour ultrasound scans of the prostate that highlight suspicious areas with red pixels. Scroll down until you come to them. It’s remarkable stuff, and if needed I would want one of these, but there’s a fat chance of that on the NHS. Still, we can’t have everything.
Why go there: a diverting minute’s viewing.
Downside: interesting but impractical.
Information from: The Acoustical Society of America.