Up Coming Events Canadian Urological Association 61st Annual Meeting June 25 - June 28, 2006 World Trade & Convention Centre Halifax, NS Canadian Nurse Continence Advisors Association 5th Biennial Conference A Publication of the Urology Nurses of Canada PSA Screening for Prostate Cancer “Challenges of Continence... Applying Best Practice” May 5 – 6, 2006 Inn at the Forks, Winnepeg, MB E-mail: [email protected] Website: www.cua.org Urology Nurses of Canada at the CUA meeting Monday, June 26, 2006 16.00 - 18.00 hrs Casino Nova Scotia Hotel Halifax, NS Phone: 204-235-3505 E-mail: [email protected] Website: www.membersshaw.ca/cncawinnepeg Sue Hammond, RN The Pipeline is a publication of the Urology Nurses of Canada. Call: 902-473-2570 E-mail: [email protected] Website: www.unc.org Website: www.cpcn.org 19th Urological Excellence Conference “Up Where We Belong” October 26 - 28, 2006 Marriott Chateau Champlain Montreal, QC Society of Urologic Nurses & Associates Annual Symposium March 16 - 18, 2006 Marriott Marquis, New York, NY, USA Call: 519-934-1934 ext: 35657 E-mail: [email protected] Website: www.unc.org Association Quebecoise des Infirmieres et Infirmiers En Urologie 13e Journee Scientifique November 3, 2006 Montreal, QC E-mail: AQIIU@ videotron.ca and sponsors and is also located at www.unc.org. The Pipeline is looking for articles for publication about new initiatives in urology, latest technology, clinical research and evaluation, local chapter activities, patient and community resources. Call: 888-827-7862 E-mail: [email protected] Website: www.suna.org Deadline for next issue: Society of Urologic Nurses & Associates 2006 Annual Conference October 27 – 30, 2006 Hyatt Regency Crown Center, Kansas City, MO, USA Contact the Call: 888-827-7862 E-mail: [email protected] Website: www.suna.org Estimates show that this year more than 20,500 Canadian men will be diagnosed with Prostate Cancer and over 4,300 will die from it. The gold standard for Prostate Cancer screening is the Prostate Specific Antigen (PSA) blood test accompanied by a digital rectal exam (DRE). Since the introduction of PSA testing in the late 1980s there has been much controversy and debate over its use in wide spread screening programs. The Pipeline is published each winter and summer for UNC members Canadian Prostate Cancer Network 3rd Annual Meeting July 30 - August 1, 2006 Calgary, AB December 2005 May 1, 2006 Prostate Specific Antigen is a member of the kallikrein gene family and functions as a serine protease secreted into the seminal fluid to help with seminal liquefaction. It is only produced in any significant quantity by the prostate epithelium and the periurethral glands. PSA appears in both free and complex molecular forms in the blood. The complex PSA binds to alpha-1-antichymotrypsin and is higher in men with prostate cancer Several factors that affect PSA are: Prostate cell number Prostate size Recent ejaculation - effected 6-48 hours Prostate manipulation Vigorous massage – effected 1 week Cystoscopy – effected 1 week Prostate Biopsy – effected 4-6 weeks Prostatitis Acute – effected 3-6months Chronic Drugs: Finasteride (Proscar) effected 3-6 months lowers PSA for as long as the patient is on the medication Pipeline Editor: Sue Hammond: Tele: 709-368-0101 Email: [email protected] When screening is undertaken some general principles apply. A population for whom screening is appropriate must be defined. Sensitivity and specificity should be high and there should be a prevalence of the disease with a high fraction of undesirable consequences. The natural history of the disease should be known. Treatment must prevent the unfavorable consequences of the disease and costs and benefits reviewed. There are 3 types of screening at present: Screening – this involves testing of the total population Early Detection – screening on request of the well informed Opportunistic screening – this screening is done outside given protocol in randomized trials and can be a contaminate in results. Continued on page 2 Page 8 Page 1 Continued from page 1 CPCN Conference Dr G, Duffy, 2005, Prostate Cancer PSA screening usually starts at age 40-45 with a family history of first degree www.columbia.edu/news/press_releases/PSA_test.html If there is no family history of prostate cancer then screening starts at 50 and continues to 75 or when a patient has less than a 10 year life expectancy. www.unc.org/may5.htm Prostate Cancer risk factors need to be taken into account when interpreting PSA results. These include age, race, family history, hormone profiles and concomitant medical conditions. Age-Specific Reference Ranges for PSA Age and Race Specific PSA Serum PSA (ng/ml) PSA Density is determined by dividing the PSA by the volume of the prostate (measured by the TRUS). The larger a man’s prostate is the more likely he is to have a higher PSA reading. Age (yr) 40-49 50-59 60-69 70-79 PSA Velocity is defined as the monitoring of the rate of change of a PSA over time. At least three measurements over a period 18 months are needed. Whites Japanese African American 0-2.5 0-3.5 0-4.5 0-6.5 0-2.0 0-3.0 0-4.0 0-5.0 0-2.0 0-4.0 0-4.5 0-5.5 Why the controversy? Reduction of Prostate Cancer mortality has not been proven at a level of certainty. No randomized trials have been completed although two are underway. Urine Spectrum Urology Nurses of Canada Review Board has recently endorsed The Urine Spectrum, a color chart developed by Jill Jeffery and Joyce Slater from Victoria, BC. The Prostate, Lung, Colon, and Ovary Cancer Screening Trial (PLCO) and the European Randomized Study of Screening for Prostate Cancer (ERSPC) both started in 1993. Data may be available by 2008. This chart was developed to provide visual reference and create consistent language when referring to urine color in any care setting. There is also a continuous bladder irrigation(CBI) troubleshooting chart with Suggested Nursing Actions according to urine color. They are marketed in kits that come with color strips and a chart with the colors and corresponding interventions. The screening procedure of PSA testing and test intervals are uncertain. Over-diagnosis in screening is a significant issue and how to distinguish the indolent versus the aggressive is still a major question. The Canadian Urological Association suggests that patients be made aware of the early detection of Prostate Cancer afforded by the use of PSA. There are no formal suggestions as to when or how much. In spite of all the debate, accumulating data indicates that PSA testing is still the best test for early detection of Prostate Cancer. PSA screening appears to be doing what it’s supposed to be doing, finding tumors earlier. Prof F. Schroder, 2005, New Developments in Screening and Early Detection of Prostate Cancer The standing ovation was saved for Irene LangeMechlan, the director of the Prostate Centre at TSRCC. She touched everyone with her very personal story of how she became the sole palliative caregiver when her husband was diagnosed with prostate cancer. She strongly recommended that men should talk about their diagnosis and seek the needed support from family and friends. The conference was not only about listening to medical experts. Two concurrent workshops facilitated by Ron Benson and Jim Moran of the Man to Man Prostate Cancer Support group were held. These involved group discussions covering topics which benefit all support groups. Dr Chodak from Chicago gave a general overview of all known treatment options and emphasized the importance of patients getting involved in their own care. He was followed by Dr Toguri who gave a talk about BPH and Drs Cook and Morgan, who covered all aspects of Brachytherapy. Dr Finelli gave a presentation on Laprascopic Radical Prostatectomy and had the delegates fascinated with a video of the surgical procedure. A new treatment called HIFU High Intensity Focused Ultrasound - was discussed by Dr Woods. Calgary will host the 2006 CPCN Conference and UNC will continue to send representatives. We encourage UNC chapters to assist support groups in their areas. Corporate Sponsors IMPORTANT NOTICE Urology Nurses of Canada Corporate Sponsors for 2005/2006 The UNC has experienced an error with membership this past year. The colors are very accurate and there should be no trouble having the interventions approved by Nursing Practice Committees and Urology Departments. The cost is very reasonable. Each year Urology Nurses of Canada acknowledges and thanks our national Corporate Sponsors for their continued support. One nurse states "I have had nurses from other floors asking where they can get the color strips". For the year 2005/2006 they are: For further information please contact Jill Jeffery - e-mail: [email protected] Sources In August a representative from UNC attended the second CPCN conference held in Toronto. She was in awe of the support and enthusiasm displayed by both presenters and delegates. Once again about 150 men, some accompanied by their spouses, gathered from across the country to learn more about Prostate Cancer and the treatments available. They were also there to share their experiences and the value of the support groups they are involved with. It has come to our attention that some new members have not been receiving the Urologic Nursing journal or the Pipeline. If you had sent your membership in for the year 2005 and have not received your journals please contact Susan Freed at [email protected] Please remember that the new membership year is from December to December. Titanium Level AstraZeneca We apologise for any inconvenience. Our members are very important to us. Silver Level Pfizer Drs R. Gallagher/ M. Gleave, 2000, What is the Value of PSA Screening in Prostate Cancer Page 2 Page 7 The Prostate “Rise to the Occasion: Overflow to the East” UEC - 2005 Dr. Allan Arneil Halifax was the location of the Urological Excellence Conference for 2005. About 150 delegates from across the country converged on the Maritimes for our annual UNC conference entitled "Rise to the Occasion: Overflow to the East". Following the warm welcomes by Dr Norman, Chief of Urology Department and Susan Freed, UNC President, Dr Bell discussed Prostate Cancer surgery and its complications. He stated that our goals should be cancer control, bladder control and sexual control. The concurrent sessions were all very good and I found it hard to choose. The keynote address that sparked the most interest was "Sexuality and the Teen". Nova Scotia’s new youth sexual health resource, "Sex? – A Healthy Sexuality Resource" is the product of a three year-long development process Nova Scotia has a wonderful Cancer Patient Navigator service and nurses from this expanding program gave an informative talk about this success story. "Reaching for Gold with Neobladder Surgery – What does nursing have to offer?" by Jean Brown an Enterostomal Therapist gave many useful nursing tips. Involving focus group work with over 500 youth, parent/teacher focus groups and input from national and provincial experts in the field of sexual health/sex education. The speakers reviewed the resource, gave opportunity for questions and each delegate was given a copy. Frankie Bates discussed the taboo topic of Stress Urinary Incontinence and the need for advocacy groups to improve the lives of women with SIU. Dr Dianne Heritz gave a comprehensive presentation on Interstitial Cystitis discussing prevalence, genetics, etiology, diagnosis, treatments and management strategies. Once again hard work on the part of the organizing committee paid off. They are to be thanked and commended for their efforts. We still have the Urology Song pinned on our notice board at work to remind us of our travels and the urology nurses of Nova Scotia. What I'd really like to know Is why my prostate has to grow? When I was young it had its day But now these days have passed away I thank my surgeon and the rest A team I know will do their best I hope my verse will raise a smile And ease your efforts for a while Annoying things I must endure And sad to say they're hard to cure I swallowed pills, and herbals too Yet good results were all too few The doctor took some blood from me A PSA it was to be If reading high there is a care The cancer might be hiding there It's like a door that shuts up tight With symptoms always worse at night As best I can I push and strain In hopes the flow will start again It was not high, it was not low In between, I'd have to know Higher than it was last year A warning sign I guess I fear Sometimes the bladder will not go And other times it's very slow And then at times it leaks away Just why or when I cannot say What we shall do is sit and wait And test again at later date If it is down then that is great But if it's up what then's my fate? I must be sure a toilet's near When running water I can hear Because the fact is surely true That soon I will be "running" too The tinkling sound as well I know Will make my bladder want to flow A surgeon's knife, spare me the thought It maybe cure - or maybe not Already I have lost some bits Resulting in great benefits Female drugs will slow things down But bigger breasts could make me frown What size bra should I obtain To keep my bosoms free from strain? Of all the drugs, I've run the race And now a surgeon's knife I face Although in truth I must admit The knife is not attacking it Radiation too can cure Or will it? I'm not too sure I know it makes one bald and sick But maybe it would do the trick In fact it is a tender spot A private part the surgeon's got I'd rather it was left alone My reproductive hidden zone Left alone they're often slow These cancer cells to live and grow There's quite a chance they would not kill Ere death ensues from other ill It does not fill my soul with glee To have a tube stuck into me. Though I'm assured it soon will go Indeed I hope that that is so! Page 6 No doubt you think I'm being morose But what's to come no person knows I trust my prostate is benign And I will live on till ninety-nine Page 3 UNC Info Urology Nurses of Canada The Urology Nurses of Canada extends an invitation to all nurses and allied health interested in urologic nursing to join the association. The Urology Nurses of Canada is a National Association whose mandate is to enhance the specialty of urologic nursing in Canada by promoting education, research and clinical practice. The activities of the Urology Nurses of Canada are designed to enrich members’ professional growth and development. The UNC hosts an annual conference each fall and convenes for an educational meeting at the Canadian Urological Association annual meeting each June. Membership in the UNC now entitles you to receive 4 issues of Urological Nursing Journal, 2 issues of Pipeline, Annual Urological Excellence Conference information and discount on registration, UNC Membership Directory, UNC Constitution, UNC: Standards of Urologic Nursing Practice and your personal access to UNC reports on the web. UNC Representatives 2005 - 2006 UNC Executive The Urology Nurses of Canada is managed by an executive board composed of: President: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Susan Freed Past President: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sue Hammond Vice-President West: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colleen Toothill Vice-President East: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Emmi Champion Vice-President Central: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Fran Stewart Membership: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Gina Porter Sponsorship: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sandra Rowan Treasurer: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Lisa Lynch Secretary: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Brenda Bonde UNC Provincial Representatives British Columbia: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Jill Jeffery Alberta: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Laurel McDonough Sasketchewan: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Judy Pare Manitoba: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Betty Kirk Ontario: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Nancy Bauer Ontario: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sylvia Robb Quebec: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Raquel de Leon Quebec: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Carol-Anne Lee New Brunswick: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nancy Carson Nova Scotia: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Liette Connor Newfoundland and Labrador: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sue Walsh Urology Nurses of Canada Awards The winners of the UNC Awards Program were announced at the Urological Excellence Conference 2005 which was held in Halifax, NS during October. These awards are made available through unrestricted educational grants given via our Corporate Sponsorship Program. At each Urological Excellence Conference awards are given by Urology Nurses of Canada for the best short paper presentation and the best poster. The winners of the award for best Short Paper Presentation was Lorna Butler/Sue Marsh from Halifax, NS reporting on research to develop a questionnaire for accurate measurement of men’s sexual health. These men have had prostate cancer and it is hoped that the questionnaire will be used in future clinical trials. The winner of the Male Sexual Dysfunction Award was Getty Vasista from Halifax, NS. The corporate sponsor was Pfizer. The winners of the Poster award were Anne Crowell and Susan Whalen from Halifax. The winner of the Editorial Award was Louise McIntosh from Gloucester, ON for her article entitled "The Role of the Nurse in the Use of Vaginal Pessaries To Treat Pelvic Organ Prolapse and/or Urinary Incontinence: A Literature Review". It was published in Urologic Nursing – February, 2005 The corporate sponsor was AstraZeneca. The title of their poster was "Education and Documentation of Self catheterization in the Ambulatory Setting for Women Undergoing Tension Free Vaginal Tape Procedure". We congratulate the winners. Descriptions of each position are available in the UNC Constitution. Information on UNC news, programs and reports can be located at www.unc.org Local Chapter News info: www.unc.org Victoria Edmonton Calgary Kingston Ottawa Montreal Halifax New Brunswick Newfoundland Info: Info: Info: Info: Info: Info: Info: Info: Info: Sandra Rowan Liz Smits Colleen Toothill Sylvia Robb Susan Freed Carol-Ann Lee Emmi Champion Gina Porter Sue Hammond Tel: Tel: Tel: Tel: Tel: Tel: Tel: Tel: Tel: 205 381-3747 780-407-6154 403-943-3748 613-549-6666 ex 4778 613-721-2000 ext 3900 514-842-1231 ext 35214 902-473-2570 506-632-5720 709-368-0101 How to form a local UNC Group For more information about UNC, contact: Gina Porter, Membership Coordinator at [email protected] or visit www.unc.org. Corporate Sponsor Award Winners 1. Contact nurses and allied health in your area interested in Urologic Nursing. 2. Pick a topic and a speaker (for the initial meeting). 3. Book meeting room. 4. Contact local sales rep for potential support of meeting. 5. Advertise meeting and distribute information about the UNC. 6. Create local executive e.g. chairperson, secretary, treasurer. 7. Organize educational meetings/events. 8. Contact UNC provincial representative regarding local business meetings. 9. Encourage submissions of articles and upcoming events to "Pipeline". Help Wanted! UNC Award of Merit Every year Urology Nurses of Canada seeks nominations for the Award of Merit. This is an award, which honors a nurse who has not only contributed to Urology Nurses of Canada but has shown leadership to her local colleagues and demonstrated a high level of nursing skills. Awards, Awards Is there some research in the field of urological nursing you wish to do? This year's winner is Emmi Champion from Halifax, NS What about developing some educational material? Emmi was the Provincial Rep for Nova Scotia for a year and has been Vice-President East since 2000. She has chaired the hosting committee of UEC-2005 and been very involved in the Halifax UNC Chapter since 1995. She has spoken at past Urological Excellence Conferences. Emmi works in the Urodynamics Clinic at the Halifax Infirmary Emmi is a certified Nurse Continence Advisor. Is there some further education you wish to pursue? Start thinking about applying for next year's awards. The awards are Research, Editorial, Male Sexual Dysfunction and Scholarship. The UNC invites you to participate with some of the UNC initiatives including: • Authors for Pipeline articles • Submission of Abstracts for UEC-2006 Concurrent/Scientific Papers/Posters Page 4 Congratulations Emmi! Page 5
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