1. 2nd Health Education Day Cancer 18th June 2011
Slainte an Chlar
2nd Health Education Day
Cancer
18th June 2011

2. IRISH RADIOTHERAPY CENTRES
2004: Five centres
Dublin(3)
Belfast(1)
Cork (1)
2008: Eleven Centres
Dublin (5)
Galway (2)
Belfast (1)
Limerick (1)
Waterford (1) 2

3. Galway University Radiation
Opened 15th March 2005 to end 2010
Patients assessed: 7117
Filmless and paperless work environment
Innovative in use of technology
Excellence in teaching
SpR, therapy, physics, nursing: training accredited nationally
Research/protocol based patient care

4. Number of new patients (First OPD) in Radiotherapy 2005 – 2009
Number of new treatment starts in Radiotherapy Department

5. Breast Patients New Starts-EBRT 2005-2009
Prostate Patients New Starts- EBRT

6. Brachytherapy Seeds Prostate Patients
Endometrium & Cervix
On target for 79 patients in 2010
On target for 56 patients in 2010

7. 7

8. Conventional Radiotherapy
Radiation doses
Photon
IMRT Photon
Proton
Conventional Radiotherapy
IMRT = Intensity
Modulated
RadioTherapy 8

9. Radiation doses 100 60 10 PROTONS X-RAYS
Low or No Energy Released Here
High Energy Released Here
PROTONS
100 60 10
X-RAYS 9

10. BALLOON CATHETER ‘MAMMOSITE’
MammoSite device
Inflatable Balloon Placed In Lumpectomy Cavity At Surgery
HDR brachytherapy
34 Gy in 10 fractions
40,000 cases treated 10

11. DELIVERY OF RADIATION (5 DAYS)11

12. BRACHYTHERAPY 12

13. 13

14. FLUORO – ALL SOURCES PLACED
Perform the cystogram … to provide a learning process / comfort 14

15. Prostate cancer Very common
Over 2500 men diagnosed per year in Ireland
Over 500 deaths
Very treatable!

16. Trends in prostate cancer mortality 1995-2005

17. Trends in prostate cancer incidence 1994-2005

18. Prostate Cancer Ireland vs USA
USA: 186,320 per year, and 28, deaths (2008)
Crude death rate 15.3 %
Ireland: per year, and 520 deaths ( average)
Crude death rate 30.8% UK
An Irish man diagnosed with CaP is at least twice as likely to die of his disease than his US counterpart…
Source: SEER database; Cancer in Ireland

19. Prostate Cancer in the UK
New British Analysis
The new British data come from an analysis of 50,066 men diagnosed with prostate cancer between 1997 and 2006 from the Thames Cancer Registry, which covers a population of 12 million in South East England. Subjects were followed to the end of 2007.
During that period of time, there was little uptake of PSA testing in asymptomatic men in the United Kingdom.
The situation is different in the United States, where there is a high uptake of PSA testing, and has been for some time, lead researcher Simon Chowdhury, MD, consultant oncologist at Guy's and St Thomas' NHS Foundation Trust in London, United Kingdom, told Medscape Medical News.
Dr. Chowdhury presented the findings at the 2011 Meeting of United Kingdom Association of Cancer Registries and National Cancer Intelligence Network (NCIN), held in London.
The analysis found that prostate cancer was the cause of death in 49.7% of the men who had been diagnosed with the disease. The other causes of death were cardiovascular disease (17.8%), other cancers (11.8%), pneumonia (7.5%), and other causes (13.25%).

20. Prostate cancer incidence 2004-2006 by County

21. What is your prostate and why should you care?
Secondary sex organ (see breasts)
Produces seminal fluid
Commonest male cancer
DRE
PSA
Evaluation
Treatment options

22. Are we looking for prostate cancer?

23. Annual number of PSA tests

24. Percentage of men over 50 having a first PSA test

25. New and suspected prostate cancer cases seen by hospital
Ireland
Hospital
New prostate cancer cases diagnosed in 2006
New prostate cancer cases diagnosed in 2007
Suspected prostate cancer cases seen in 2006
Suspected prostate cancer cases seen in 2007
Benign:
malignant
ratio 2007
AMNCH
327
273
797
676
2.5:1
Beaumont
151
179
530
453
CUH
186
210
340
382
2:1
Limerick Regional
112
104
301
311
3:1
Mater
220
240
1000 (estimate)
1200(est)
5:1 (est)
MUH
145
171
304
274
1.6:1
St James’
101
105
Unknown
280
2.6:1
St Vincent’s
180
335
UCHG
272
365
820
1100
Waterford
107
150
1.4:1

26. Testing for the spread of the cancer
An MRI Machine…and image
A Bone scan Machine…
and image
                                                                                 

27. Treatments for Prostate Cancer
Radical surgery
Open prostatectomy (retropubic/transperineal)
Laparascopic prostatectomy
Robotic laparascopic prostatectomy (“DaVinci”)
External Beam Radiation Therapy (EBRT)
Conventional
3D conformal
IMRT
Image guided hypofractionated IMRT
Brachytherapy
Permanent low dose Temporary HDR
Combinations
Hormone treatment
Novel drugs for hormone resistant prostate Cancer badly needed

28. Take home message Prostate cancer very common and very treatable
Early warning devises are available
Report any symptoms
Check with your doctor
Multiple treatment options…one size definitely does not fit all!
Be aware….

29. Update since last year Clare Cancer Support – Congratulations!
Prostate Rapid Access Clinics
GUH 1000 men, 50% cancers
Prostate Cancer Institute - operational
National Cancer Control Program
National Cancer Screening Service
Standard setting committees
Diagnostic/treatment recommendations

30. PCI Inauguration 1st April 2011