Tag Archive for: Movember

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A #RadOnc Movember

The #RadOnc Journal Club continued its success in Movember with over 700 tweets from 60 participants in a three-day discussion on smoking and prostate cancer radiation treatment outcomes. Thanks to the generosity of the BJUI (@BJUIJournal) and Prof. Prokar Dasgupta (@prokarurol), the study of a large retrospective cohort of localized prostate cancer patients who received external beam radiation treatment from Memorial Sloan Kettering (@sloan _kettering) was open-access and engaged a wide audience.

Background discussion started Friday and covered a variety of topics including limiting treatment toxicity:

Sharing best practices on the role of radiation treatment from around the world:

The state of tobacco use:

And smoking cessation from an interdisciplinary audience:

On Sunday, the community came together for a live discussion with study author Emily Steinberger (@easteinberger). Participants explored roles for radiation treatment and the reduction of side effects including hypofractionated treatment and current guidelines for IMRT:


Practice patterns in patient assessment stressed the importance of a tobacco history. These encounters created an opportunity for cessation counselling as opposed to guiding treatment decisions while recognizing the threat of information overload.


The conversation then moved to the study. Results showed current-smokers had a higher PSA relapse rate (HR 1.37 compared to former or non-smokers), more distant metastases (DM-free survival 72% vs. 87% in never-smokers), and higher cancer specific mortality (HR 2.25). There were a few surprises including finding no significant differences based on pack-years smoked and that only current as opposed to former smoking status mattered.

Study strengths included a large cohort of 2358 similarly-treated patients; 91% having documented smoking histories. Limitations included the retrospective design, especially considering the long natural history of prostate cancer and risk of development of confounding comorbidities. Also an important reminder:

Conversations concluded with considerations for future practice:


Research:


With a little #RadOnc humor in-between.

We recognize the quality contributions from all members of our community. For their leadership during this chat, congratulations to Dr. Jay Detsky (@JayDetsky) and Dr. Mohammad Alfayez (@alfayezmo) who received the Jerry Maguire Award for their evidence-based tweets. (“Show me the data!!!”) The Francis Peabody award went to Dr. Jonathan Livergant (@jpil) and Dr. Jarad Martin (@DocJarad) for the best clinical tweets. We will be looking forward to more lively conversations in the New Year!

The #RadOnc Journal Club was first proposed at the Yale Department of Therapeutic Radiology in April 2014 to leverage published evidence and stimulate discussion on key topics in radiation oncology. It became part of Radiation Nation – a community founded by Dr. Matthew Katz (@subatomicdoc) dedicated to improve cancer care through online collaborative conversations on education, medical practice, and quality and safety improvement for patients, caregivers, and medical professionals. Interest grew globally and in September, where we bridged cultural divides by encouraging conversations in multiple languages. Today, we routinely have participation from over 5 countries during the #RadOnc Journal Club and on Radiation Nation blog.

Ian Pereira is an R2 resident in Radiation Oncology at Queen’s University, Kingston, Canada. He believes that education is a basis for progress in health and care, and is interested in leveraging new technologies including social media in medical education.

 

Are You Teaming Up for Movember?

Urology, Social Media, and Prostate Cancer Controversies

The past couple of years have witnessed a rapid rise in the number of urologists engaging in conversation using social media. Urologists across the globe are now participating in the International Urology Journal Club on Twitter (#UROJC), tweeting at conferences, and using social media to build personal and professional relationships. As a result, providers with a passion for men’s health, who may never previously met in real life, are sharing ideas and experience with respect to issues in urology and patient care.

This uptick in the use of social media comes at a time when when prostate cancer screening and the optimal care of the prostate cancer patient are being hotly debated.  More research is clearly needed to settle many of the debates currently taking place both in traditional media and on social media. It, therefore, makes sense for the global urology community to partner with organizations that have a similar passion for advancing and promoting men’s health through scientific research.

Movember – Raising Awareness and Funding for Men’s Health Initiatives

Movember is a movement that began in Melbourne, Australia, in 2003. Since that time, it has spread to more than 20 other countries around the world. Each November, participants raise awareness and money for men’s health by growing a moustache. As the month goes on, and the mustache takes shape, these men become walking and talking men’s health billboards. Participants use their mustache to facilitate conversations about a wide variety of men’s health issues including prostate cancer, testicular cancer, and men’s mental health. They also actively raise money for the Movember Foundation by asking family and friends to donate to their efforts.

Movember is not just for men. Women (Mo Sistas), through encouragement, conversation, fundraising, and, in some cases, sheer tolerance, are a critical part of Movember’s success. Mo Sistas do everything Mo Bros do – they just don’t grow a moustache. Since Movember started, more than 4 million Mo Bros and Mo Sistas around the world have participated. In the process over $556 million dollars has been raised for the Movember Foundation.

Funding Cancer Research in Urology

 

Since its very inception, the Movember Foundation has supported ongoing research in men’s health. Currently the Movember Foundation is funding more than 832 men’s health programs worldwide. In 2010, Movember created a Global Action Plan to improve the clinical tests and treatments used for men with prostate and testicular cancer. Currently, Movember is funding prostate cancer research in four areas:

1. Developing more accurate blood, urine and tissue tests to differentiate between low risk and aggressive forms of prostate cancer.

2. Developing new imaging techniques that enable the earlier detection of metastatic prostate cancer.

3. Optimizing the management of men with low risk prostate cancer.

4. Understanding how increasing physical activity might improve the quality of life and survival of prostate cancer patients.

Movember’s criteria for research support encourages national and international collaboration. Working collaboratively, research groups are able to pool experience, streamline cost, and avoid duplication, in an effort to accelerate the  bench-to-bedside development of new investigations and treatments.

Disrupting the Status Quo

In the past, many different men’s health initiatives have come and gone. Movember’s innovative approach is unique in that each year, for a full month, the movement puts important men’s health issues – such as prostate cancer, testicular cancer and men’s mental health – back into the public spotlight.  The effect of the movement has been to not only energize men, but also healthcare, and even government.

One great example of this is the Prostate Cancer of Australia Specialist Nurse Program. The program, initially funded by Movember in 2011 with AU $3.6m, placed full time specialty nurses in every Australian state to help fill a gap in prostate cancer support and delivery. The pilot program was so successful that the Australian government invested AU $7.2m to allow the program to further expand. Movember has also created a variety of unexpected domino effects in the men’s health community. This year, our American colleagues, Dr. Jamin Brahmbhatt and Dr. Sijo Parekattil, inspired in part by the success of the Movember movement, started the Drive for Men’s Health. There are likely many others who, if asked, would tip their hats in the direction of Movember for their inspiration.

When Urologists Participate, Patients Benefit

Urologists by their very nature are both competitive and cooperative. The Movember movement is a unique opportunity for urologists across continents to join with other individuals and organizations that are passionate about improving the health and quality of life of men.  Movember is also an opportunity for colleagues, who may have only met via social media, to cooperate and/or compete all in an effort to raise awareness and money for men’s health research.  Last year, for example, Canadian urologist Dr. Rajiv Singal, assembled an international Movember team of Canadian and American urologists, patient advocates, and other healthcare providers to raise money and awareness for men’s health. Working together, the team raised nearly CA $50,000 dollars for the Movember Foundation.

An Invitation to Team Up

In the spirit of collaboration and friendly competition, this November we invite our urology colleagues from around the world to start their own local Movember Team, or to join our international team as we attempt to better our fundraising performance from last year.

 

Movember: The power of the Mo!

The word Mo is Australasian slang for a moustache and whilst not a northern hemisphere phrase this hasn't prevented rapid dissemination across the globe. Although originally an innovation solely in Australia and New Zealand for its first 6-7 years, Movember is now taking the world by storm with the UK and Canada leading the way. Staggeringly last year in the UK more than 363,000 men grew a hairy upper lip and in doing so raised over £27 million.

The Movember foundation donates the proceeds to men's health charities which is primarily (around 70%) prostate cancer but also donates to charities supporting mental illness and this year will contribute to the orchid trust for testicular cancer. Money raised from the UK campaign goes to Prostate Cancer UK, which received £14.6m for the year to April 2013, and the Institute of Cancer Research, which received £299,891 for the same period.

When working in urology clinics where one meets up to 20 new patients a day that's many conversations about this issue helping to raise awareness and hopefully directing people to the website to donate to the UK Movember site.

Prokar Dasgupta outside the BJUI offices in Movember 2012

 

So Mo brothers and sistas let’s keep up the good work and prepare for another bumper crop of upper lip hair! 

Ben Challacombe
Associate Editor, BJUI 

Movember and the Importance of Patient Advocacy

In October 2009 the resident on my service was Dr Dean Elterman. I have had many residents and fellows over the years and have always felt that as much as they hopefully learn something from me I probably learn more from my time with them. The concept of ‘drilling down’ to make lasting connections with leaders of the next generation is not something that is always intuitively grasped in the hierarchy of surgical life. As it was, in late October of that year Dean mentioned Movember to me and asked whether I would like to participate. At that point, not knowing what he was talking about I proceeded to tell him to consult his spell-check. Having once before sported facial hair in my early 20s to very little acclaim I had not entertained the thought since. My immediate reaction was dismissive. Nevertheless after some further discussion it became obvious to me that the whole concept of Movember is not simply to raise money for men’s health and prostate cancer research but to generally shine a brighter light on the nature of the disease, the work we do as urologists and to start a dialogue. This grassroots movement, started in 2003 in Australia by Adam Garrone has quickly grown into a worldwide phenomenon. That fall I anchored Dean’s team of residents and we broke into the top 20 of small teams worldwide.

Last year I set up a local team at Toronto East General Hospital with tremendous success. On an individual level I raised $46,000 in support of men’s health, the seventh highest individual total worldwide. While that certainly was nice, as the month wore on what became increasingly clear to me was the larger role that my involvement in Movember had created in engaging patients, other healthcare providers and society at large. The quirky nature of the campaign lends itself to a fun, easy discussion about an important topic. Having a dialogue around prostate cancer including how to screen as well as when and when not to treat is very important. The significant emotional and physical consequences of treatment deserve attention. A particularly great example by the terrific @docmikeevans illustrates the space that Movember now inhabits. The role that urologists in particular have as advocates of men’s’ health is very clear. 

It is with this last thought in mind that I call upon my colleagues in Canada and around the world to take up the charge. In recent years, much of the progress that we have made in treating prostate cancer is at risk of being undermined. The confusing and rather opaque nature of screening guidelines have increasingly promoted prostate cancer as an indolent disease not worth having a discussion about. I certainly have previously written about this and recently a group of experts met in Melbourne and attempted to better make sense of screening and stratify risk. Prostate Cancer Canada, an important advocacy group in Canada has also done a great job this fall with their #knowyournumber campaign. I was proud to be a part of it. Their CEO Rocco Rossi has embarked upon a terrific campaign of support by walking the Camino to Santiago de Compostella this month. All leaders must actively embrace the role of advocacy for our patients. Movember to me is a great vehicle for this. Will you look silly and unprofessional in the clinic during Movember? Absolutely not. In reality, every patient in the clinic is immediately reassured that their urologist walks along beside them, although perhaps not as far as Rocco. 

It is in this context that I would call on all of my urological colleagues to stop shaving in Movember, start a team, create a network and share this experience with our brave patients and their partners for a month. The amount raised is really secondary. Having that visible presence is crucial. With epidemiologists, policy makers and many others expressing expert opinions about a disease that we treat every day don’t you think we should also embrace that role? Movember is the forum where the most important group, our patients, will be having that conversation for a month. Join them. Simply caring for them after diagnosis or waiting for a research grant to materialize is not good enough. My female colleagues can join as ‘mo-sistas’. You can certainly follow my ‘progress’ and support my venture as well. I look forward to seeing my colleagues from around the world and the self-described #urotwitterati that contributes regularly on #urojc in particular to join in the fun. I expect to be pushed on the leaderboard.

Dr Rajiv Singal is a Urologist at Toronto East General Hospital and an Assistant Professor in the Department of Surgery at the University of Toronto

Follow him on Twitter at @DrRKSingal

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