Hard choices of prostate cancer helped by new program

When Charles Reid was diagnosed with prostate cancer in 2011, his cancer was small and growing slowly. On his doctor's advice he chose "active surveillance," closely monitoring it without treatment. For three years this worked very well for the 57-year-old Ladner businessman and father of three grown children.

Charles Reid is focusing on exercise and healthy eating while undergoing active surveillance for his prostate cancer. 

Charles Reid is focusing on exercise and healthy eating while undergoing active surveillance for his prostate cancer. 

Earlier this year, however, tests showed his cancer was growing. "Suddenly I was agonizing over what I should do. My kids are saying: 'Dad, just get it out!' But I have been really uncertain about the best treatment option. There are so many choices and all have significant pros and cons," explains Reid.

Trying to make a decision was stressful for both him and his wife, Julie. She had witnessed her father die from metastasized prostate cancer, an outcome they feared. They felt they must make a treatment decision, but also thought they lacked enough information to make an informed choice about something that was sure to impact their quality of life for the next 20 to 30 years.

Dr. Larry Goldenberg, Director of Development and Supportive Care, at the Vancouver Prostate Centre notes prostate cancer is the most common cancer for men in BC, with some 3,500 men diagnosed each year. "Because of advances in both diagnosis and treatment, men are diagnosed much earlier with the disease now, and live on average three times longer than they did just 20 years ago. But that means they must live much longer with the side effects of treatment, which potentially can be substantial," said Goldenberg.

Charles and Julie found both relief and information from a new program run by the Vancouver Prostate Centre, called the Prostate Cancer Supportive Care Program. The first of its kind in Canada with an emphasis on the partner as well the patient, the program is much more than a support group. It consists of five distinct modules providing clinical services and education presented by experts. It provides patients and their partners with the skills needed to cope when first diagnosed and to help manage the stresses associated with primary treatments and their side effects. It has even helped the Reids decide NOT to do treatment right away, but to continue to monitor his slow growing cancer.

These integrated modules also deal with sexual function, pelvic floor physiotherapy to help with any post-treatment incontinence, lifestyle management with diet and exercise, and androgen deprivation therapy to slow any cancer spread.

The program was established with funding from the Specialist Services Committee, a joint committee of the Doctors of BC and the Ministry of Health, and is supported by the Prostate Cancer Foundation BC. It recently received a $1 million grant from the BC Government for further development.

"If there were just one recommended therapy for prostate cancer we wouldn't need our lead-off module on treatment options," explains Richard Wassersug, PhD, an adjunct professor in the Department of Urologic Sciences at the University of British Columbia. Wassersug is not only one of the co-founders of the program, but himself a prostate cancer survivor. The inclusion of the patient's partner is also one of the program's particular strengths, he says.

The Reids earlier this year attended an “Introduction to Primary Treatment Options” session with two other couples. Wassersug set the tone of the intimate atmosphere, with relevant input of his own cancer journey. Diagnosed 16 years ago, his path has encompassed the gamut of treatments; including surgery, radiation, and hormone therapy. "And I am still here!" smiles Wassersug, to the visible relief of his small audience.

During the session couples heard from urologist Dr. James Huang, who described the pros and cons of active surveillance and surgical options. Then they heard from the BC Cancer Agency’s radiation oncologist Dr. Mira Keyes, who described the pros and cons of radiation therapies.

Dr. Keyes notes, "While support, information and medical expertise are available at the BC Cancer Agency, this program provides an additional coordinated approach for the patients and their partners to help them cope with all aspects of the disease and treatments."

Each couple then met privately with Huang and Keyes together to discuss their specific pathology report. "It was incredibly helpful and reassuring," said Reid, who was told by the specialists that his slow growing cancer gives him lots of time to make a decision. He can still watch and wait.  Reid has decided to focus on getting as healthy as he can through regular exercise and healthy eating. Says Julie Reid, "I’m not scared anymore."

Goldenberg notes the program is unique in not only having the medical consultation with two specialists at the same time, but also in providing a safe place for men and their partners to talk and share concerns. "I think that physicians have to be cognizant that prostate cancer and its treatment is a major psychological trauma. Addressing the quality of life ramifications is just as important as the primary treatment for the disease."

The program is offered in Vancouver. For more information see www.prostatecentre.com/PCSC