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EditorialEditorial

The sounds of silence

Diane Kelsall
Canadian Family Physician February 2008, 54 (2) 163;
Diane Kelsall
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  • Re: The sounds of silence
    Ray Duriez
    Published on: 23 April 2008
  • Re: The sounds of silence
    John Wagontall
    Published on: 11 March 2008
  • Potential Years of Life Lost
    Deborah Watson
    Published on: 11 March 2008
  • Another Cause For Noise
    Kempton Hayes
    Published on: 22 February 2008
  • RE: Potential Years of Life Lost
    Dr. Diane L. Kelsall
    Published on: 15 February 2008
  • Potential Years of Life Lost
    Elisabeth Gold
    Published on: 13 February 2008
  • Published on: (23 April 2008)
    Page navigation anchor for Re: The sounds of silence
    Re: The sounds of silence
    • Ray Duriez

    Having read your report titled "The Sounds of Silence" about prostate cancer vs. breast cancer, I can no longer remain silent on this issue. Those words are exactly my sentiments.

    I am a three-year prostate cancer survivor. I had yearly screening with PSA and DRE for 10 years before my prostate cancer was discovered. However, it was too late. The cancer was advanced and had spread extensively outside the prosta...

    Show More

    Having read your report titled "The Sounds of Silence" about prostate cancer vs. breast cancer, I can no longer remain silent on this issue. Those words are exactly my sentiments.

    I am a three-year prostate cancer survivor. I had yearly screening with PSA and DRE for 10 years before my prostate cancer was discovered. However, it was too late. The cancer was advanced and had spread extensively outside the prostate. I had a radical prostatectomy, immediately followed by hormone therapy (ADT) and radiation. As a consequence of the therapy, I have been left permanently impotent.

    I have felt like an outcast of society with this disease, because no one wanted to talk about it. I had quite a bit of difficulty finding out where to go for support and help in dealing with the complications and side effects of treatment. Thankfully, the American Cancer Society directed me to several websites that I have found helpful:

    1. www.ustoo.org

    2. www.prostatepointers.org

    3. www.phoenix5.org/menustories.html

    Overall, the message I have received over the years is that prostate cancer is a disease of old men and not important. As long as this attitude continues in society, we will never obtain funding for support, research and promotion of awareness of this disease.

    Show Less
    Competing Interests: None declared.
  • Published on: (11 March 2008)
    Page navigation anchor for Re: The sounds of silence
    Re: The sounds of silence
    • John Wagontall, Alberta, Canada

    I was diagnosed with prostate cancer in December of 2004. I was 46 at the time. After my diagnosis I talked openly about my prostate cancer. I found that guys just didn't seem to feel comfortable talking about prostates and testing. I worked as a FireFighter for just over 20 years and had always noticed that fact at work. Because of that, and the fact that prostate cancer seems to be more prevalent amongst FireFighte...

    Show More

    I was diagnosed with prostate cancer in December of 2004. I was 46 at the time. After my diagnosis I talked openly about my prostate cancer. I found that guys just didn't seem to feel comfortable talking about prostates and testing. I worked as a FireFighter for just over 20 years and had always noticed that fact at work. Because of that, and the fact that prostate cancer seems to be more prevalent amongst FireFighters, I rode across Canada to try to raise awareness and to get guys to talk about the disease.

    I really appreciate your article. It is something my wife and I have talked about extensively. We always see and hear about breast cancer (which is great), but we do need to do the same for prostate cancer.

    I will keep trying to convince the men I talk to, to talk openly about prostate cancer, testing and the importance of early detection.

    Thanks so much for bringing these facts to the forefront.

    Show Less
    Competing Interests: None declared.
  • Published on: (11 March 2008)
    Page navigation anchor for Potential Years of Life Lost
    Potential Years of Life Lost
    • Deborah Watson, Retired Teacher

    While I recognize that breast cancer has an earlier average age of onset than does prostate cancer, it would seem unfair if women's higher life expectancy were to be taken into consideration when calculating potential years of life lost (pyll). Should men be penalized, or prostate cancer be regarded as less devastating than breast cancer, because men as a group are already penalized by shorter average life expectancy tha...

    Show More

    While I recognize that breast cancer has an earlier average age of onset than does prostate cancer, it would seem unfair if women's higher life expectancy were to be taken into consideration when calculating potential years of life lost (pyll). Should men be penalized, or prostate cancer be regarded as less devastating than breast cancer, because men as a group are already penalized by shorter average life expectancy than women? A ratio of pyll to average life span would seem more appropriate in calculating the relative impact.

    I hope that if the pyll calculation is used as a factor in determining relative need or the merits of funding or research that men will not be at a further disadvantage because of women's greater longevity.

    Show Less
    Competing Interests: None declared.
  • Published on: (22 February 2008)
    Page navigation anchor for Another Cause For Noise
    Another Cause For Noise
    • Kempton Hayes, Family physician (retired)

    Let's talk about prostate and breast cancer:great. But let's talk longer and louder about osteoporosis, the complications of which kill more Canadian men than prostate cancer and more Canadian women than breast, uterine and ovarian cancers combined. Patients with these complications (notably fractures) also tie up operating rooms, lengthen wait times for elective orthopedic procedures, occupy acute care beds waiting f...

    Show More

    Let's talk about prostate and breast cancer:great. But let's talk longer and louder about osteoporosis, the complications of which kill more Canadian men than prostate cancer and more Canadian women than breast, uterine and ovarian cancers combined. Patients with these complications (notably fractures) also tie up operating rooms, lengthen wait times for elective orthopedic procedures, occupy acute care beds waiting for admission to homes for special care, and occupy nursing home beds.

    Most of these complications are preventable. Bone mineral density measurement provides accurate diagnosis. Safe, cheap and effective medication is available - fracture risk is reduced between fifty and sixty -five per cent in the first year.

    In Nova Scotia, hip fractures occur at an average of two per day. The cause of this high rate is multifactorial, but surely a significant factor is lack of knowledge of the disease. It's entirely likely that most people with osteoporosis don't know they have it - until disaster strikes.

    We need to make more noise about osteoporosis: our profession, departments of health, Osteoporosis Canada. Yet how many family doctors, particularly when confronted by a senior with multiple problems, have either the time or the mindset to talk about bone densitometry.

    So let's talk about osteoporosis along with breast and prostate cancer - it's a worse killer than either of them.

    Show Less
    Competing Interests: None declared.
  • Published on: (15 February 2008)
    Page navigation anchor for RE: Potential Years of Life Lost
    RE: Potential Years of Life Lost
    • Dr. Diane L. Kelsall, Editor,

    Thank you for your letter. There are potentially many factors contributing to the difference in impact between breast cancer and prostate cancer. I agree that potential years of life lost (PYLL) can be a major factor in this difference, reflecting the later average age at initial diagnosis in prostate cancer and the aggressivity of breast cancer that can occur particularly in younger women.

    The PYLL for female b...

    Show More

    Thank you for your letter. There are potentially many factors contributing to the difference in impact between breast cancer and prostate cancer. I agree that potential years of life lost (PYLL) can be a major factor in this difference, reflecting the later average age at initial diagnosis in prostate cancer and the aggressivity of breast cancer that can occur particularly in younger women.

    The PYLL for female breast cancer deaths (rate per 100,000) in Canadian women between 0-74 years of age in 2001 (based on a three year average) was 334.5 (1). The PYLL for prostate cancer deaths over the same time period was 56.6 (2).

    1. http://www.statcan.ca/english/freepub/82-221- XIE/2007001/maps/dt_maps/de1pyo2c.pdf (accessed February 15, 2008)

    2. http://www.statcan.ca/english/freepub/82-221- XIE/2007001/maps/dt_maps/de1pyo2d.pdf (accessed February 15, 2008)

    Show Less
    Competing Interests: None declared.
  • Published on: (13 February 2008)
    Page navigation anchor for Potential Years of Life Lost
    Potential Years of Life Lost
    • Elisabeth Gold, Family Physician

    I appreciate your comparison and contrast of the impact of breast and prostate cancers. Perhaps potential years of life lost for each would be helpful numbers to add to this discussion.

    Competing Interests: None declared.
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Canadian Family Physician: 54 (2)
Canadian Family Physician
Vol. 54, Issue 2
1 Feb 2008
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The sounds of silence
Diane Kelsall
Canadian Family Physician Feb 2008, 54 (2) 163;

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