Saturday, May 19, 2012

Hey there Guys,

Today I wanted to cover an important topic for all men. Prostate Cancer.

In Australia there has been a number of screening campaigns encouraging men to be checked for prostate cancers with some men confused and worried about when they should have their first test.

Today I wanted to help clarify this.

First it’s important to understand exactly who is more likely to have the risk of prostate cancer.

Prostate cancer is most common in men aged over 50 with 80% of new prostate cancer found in men over the age of 60.

Men who have a father or brother who has had prostate cancer are at a higher risk of also developing prostate cancer. There is emerging evidence if you have a mother or sister who has had breast or ovarian cancer there can be increased risk of prostate cancer in their immediate male relatives.

Majority of prostate cancers found grow very slowly without requiring treatment or surgery. There are some forms of prostate cancer that can grow and spread quickly. These are frequently found in younger men and there does seem to be a connection between the genes associated breast and ovarian cancer and this type of prostate cancer.

How do we test for prostate cancer?

Currently the first port of call for testing for prostate cancer is “digital rectal exam” or DRE AKA, “the finger up the bum”. This is combined with a blood test that checks for prostate specific antigen also called PSA testing

In 80% of prostate cancers there will be a raise in PSA but there is 20% of cancers that will not cause a rise in PSA. Because of the position of the prostate, examination with the finger is not able to feel all the prostate, if the cancer is small or out of reach it can be missed.

If either of these tests come back abnormal the next step is to have an ultrasound of the prostate and in some cases biopsies to examine for cancer cells.

Who should be tested for prostate cancer?

Current recommendations are that men aged 55 to 70 should consider testing if worried or have symptoms. If you are young and concerned or have a brother or father who has had prostate cancer it is suggested to have a single PSA test done at the age of 40 to help predict your potential risk of developing prostate cancer over then next 25 years.

Currently it is recommended to only do PSA testing on men who have symptoms of prostate problems. These include:

  • needing to pass urine on a frequent basis
  • difficulty starting or stopping the urine stream
  • poor urine stream and bladder emptying
  • post urination dribbling

If you do not have any of the symptoms mentioned then the current guideline suggest only getting testing done if you are particularly concerned. This is because the risk of harm from testing, ultrasounds and biopsy is high compared to the benefit of early cancer detection.

Of course if you have concerns your family doctor will be able to help answer your questions.

In summary the current guidelines suggest waiting till you are 55 before considering prostate cancer screening and even then if you don’t have symptoms it’s unlikely you are at immediate risk. Again, be sure to talk to your doctor if you have worries.

Yours in good health.

Dr George

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Hi there Guys,

Today I wanted to follow up on my recent post “Doctors In The Dark“.

After the this article was published I have been overwhelmed with not only amazing public support but also more than a handful of enquiries from a number of press agencies.

To bring a little context, the reason “Doctors In The Dark” resonated so well in Australia has been due to controversy with Victoria’s Deputy Chief of Psychiatry, Professor Kuruvilla George, his position as a member of the Victorian Equal Opportunity Board and also the Human Rights Commission.

When interviewed by the ABC, John Searle, Chairman of the Human Rights Commission said:

[wpse_b_box_solid width="87%" style="blue_light" shadow="yes"]Oh, I think the views that he expressed in his private capacity, as I said in his personal capacity which he is entitled to express, were probably at odds with some of the stakeholders of the commission. I think it’s fair people would recognise that there would be a different view held by the stakeholders of the commission and some people may not accept his views and some people may not agree with his views.[/wpse_b_box_solid]

 

Throughout this interview Mr Searle appeared to go to great pains to note that Dr Kuruvilla George expressed views that were of his own private capacity.

While there has been great rejoicing about Dr Kuruvilla George’s resignation from the Human Rights Commission he still holds his position as the Deputy Chief of Psychiatry here in Victoria.

Chief Psychiatrist of Victoria Dr Ruth Vine has also been in talks with Dr Kuruvilla George, stating to The Age Newspaper: “He did not seek to represent the views of the Office of the Chief Psychiatrist or the Victorian government”.

The problem is that despite these two statements to reassure the public that Dr Kuruvilla George was acting as a sole individual, that is clearly not the case. His signature was to the group “Doctors For The Family”, not “People For The Family” or “Individuals For The Family”. This group has purposely selected doctors to add weight to their argument, Dr Kuruvilla George has purposely used his qualifications as a doctor to bolster the strength of the submission that was made to the Australian Senate.

If you look at his electronic submission in the “Doctors For The Family” Senate document you can see he has gone to great pains to make sure all the letters of his qualifications are included. Not only as a doctor but also as a psychiatrist. Unfortunately both the Australian Medical Association and the Royal Australian and New Zealand College Of Psychiatrists condemned this submission.

This is not the submission of an individual, this is the submission of a highly qualified doctor. A highly qualified doctor holding a position of great responsibility as the Deputy Chief of Psychiatry in Victoria. A role that includes:

  • review of the administration of electric convulsion therapy, ECT
  • provision of advice and consultation to the public and consumers of the mental health services
  • investigation of complaints from consumers and carers
  • state wide review of mental health services

This is a high powered and important job.

As I have previously reported, Australian research show that gay and lesbian people have higher rates of mental health issues. The rates of suicide, depression and anxiety are significantly higher within our community. As a result of this it is understandable that indeed the homosexual community may well be higher users of mental health services under the care of Dr Kuruvilla George.

These are the same homosexuals condemned by “Doctors For The Family”. The lobby group to which Dr Kuruvilla George was happy to sign his name, while its spokesperson, GP Lachlan Dunjey, vaguely promised to shield from public scrutiny the doctors who signed.

Clearly there is a conflict of interest for Dr Kuruvilla George to continue in his role as Deputy Chief Of Psychiatry while his name is indelibly tied to a band of doctors with clear homophobic aims. Dr Kuruvilla George has already acknowledged this by his resignation from the Human Rights Commission, despite the excuses he has offered.

While I congratulate him for taking this step, I believe that this is not enough. Something needs to change. He either leaves his position as Deputy Chief of Psychiatry or revokes his connection with “Doctors For The Family”, acknowledging that their sole role is as a homophobic hate group, using medical qualifications as a battering ram for their hateful agenda.

Within our society being a doctor is a position of privilege and great responsibility. All doctors must do their utmost to live up to that responsibility.

I agreed to live by the Hippocratic Oath, and that oath is 24/7, not just when I’m seeing patients or when it’s convenient for me. Dr Kuruvilla George would have agreed by this same oath as well. Now it’s time for him to be called upon to live by it.

For this reason I have started a petition urging Dr Kuruvilla George to be removed from his position as Deputy Chief of Psychiatry in Victoria. This conflict of interest cannot continue.

The gay and lesbian consumers of mental health services have a right to be represented fairly, equally and 100% without bias. I worry Dr Kuruvilla George is not currently in a position to be able to offer this level of representation.

I urge you to please consider electronically signing the following petition to the Minister Of Mental Health Victoria, Mary Wooldridge:

Stand down Dr Kuruvilla George as Deputy Chief of Psychiatry Victoria

I urge you to click the link above and have your voice heard. A voice that demands equal care for all consumers of mental health services, no matter what their sexual preference.

Yours in good health.

Dr George Forgan-Smith

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Doctors in the Dark

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Openly Gay, Dr George Forgan-Smith Pic Cred: Collecting Melbourne

Hey there Guys, Today I thought it was important to declare a few things… Firstly I am an openly gay man. What you see above is what you get. Secondly I am a doctor, a very proud doctor and I 100% believe and live by the Declaration of Geneva, in particular: [wpse_b_box_solid width="87%" style="yellow"]“I will [...]

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Can A Daily Truvada Tablet Replace Condoms?

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Aspirin May Be Helpful Beyond Heart Attacks?

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Two Interesting Health Promotions Ideas

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Hey there Guys, Today I wanted to share a couple of interesting new health sharing ideas that I’ve noticed over the weekend. First is a fun game released by the Terrence Higgins Trust: Man Up. This interactive facebook game has been designed to engage gay men and offer a message that encourages regular sexual health check-ups. [...]

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A Fantastic Fast Food Idea

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Hey there Guys, I have just come across this great idea by dietician Tamara Brown. As an educator on how to eat healthy, she noticed there was a gap between people understanding how to eat well and actually doing it. I can 100% understand the problem. After a hard day at work I admit that [...]

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Are We Ready For A Elderly Gay Population?

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Hey there Guys, Not sure you have seen this video recently but it seems to have taken on a rather “viral” quality. With more than 900,000 views I have to ask the question why? Is it that there are 900,000 pensioners keen to learn about new “hip friendly” sex positions or is it that the [...]

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