JABLONSKI DEBATES PSA TESTING

Transcription

1 The JABLONSKI DEBATES PSA TESTING Getting Prostrate for the Prostate

2 The JABLONSKI DEBATES Learning has never been this much fun (just like walking through a field littered with land mines.)

3 The JABLONSKI DEBATES DISCLOSURES

4 CFPC COI Template - Slide 1 Faculty/Presenter Disclosure Faculty/Presenter: Ted Jablonski Relationships with commercial interests: Grants/Research Support: Principal Investigator in clinical studies funded by Pfizer, Lilly Speakers Bureau/Honoraria: Abbott Laboratories, AstraZeneca, Bayer, Boehringer-Ingelheim, Bristol-Myers Squibb, Edelman, Eli Lilly, GlaxoSmithKline, Janssen-Ortho, Lundbeck, Merck Frosst, Novartis, Paladin Labs, Pfizer, Sanofi- Aventis, Schering, Shire, Solvay, Takeda, Valeant, Watson Consulting Fees: Not applicable Other: Not applicable Faculty/Presenter: Eric Jablonski Relationships with commercial interests: Grants/Research Support: Not applicable Speakers Bureau/Honoraria: Not applicable Consulting Fees: Not applicable Other: Not applicable

5 CFPC COI Template - Slide 2 ACFP 60 th ASA Disclosure of Commercial Support This program has received financial support in the form of sponsorship from: Alberta Medical Association RHS Canada/The Snore Centre Aspen Pharma Scotiabank Purdue Pharma VitalAire University of Calgary Health Quality Council of Alberta Alberta Health Services ereferral Janssen Eli Lilly This program has received in-kind support from The Rimrock Resort Hotel in the form of a contribution to food/beverage at the Thursday Research Poster Presentations and Welcome Reception. Potential for conflict(s) of interest: Those speakers/faculty who have made COI disclosure are noted in the 60 th ASA Program and on the Salon A/B slide scroll.

6 CFPC COI Template - Slide 3 Mitigating Potential Bias ACFP: The ACFP s Sponsorship Guidelines apply to ASA Sponsorship. The ACFP abides by the Canadian Medical Association s Policy Guidelines for Physicians in Interactions With Industry and the Rx&D Association s Rx&D Code of Ethical Practices. As a non-profit organization, the ACFP complies with Canada Revenue Agency regulations. When considering acceptance of sponsorship, the ACFP considers and accepts sponsorship only from those whose products, services, policies and values align with the ACFP vision, values, goals and strategies priorities. ASA Planning Committee: Consideration was given by the 60 th ASA Planning Committee to identify when an speaker s personal or professional interest may compete with or have actual, potential or apparent influence over their presentation. Material/Learning Objectives and/or session description was developed and reviewed by a Planning Committee composed of experts/family physicians responsible for overseeing the program s needs assessment and subsequent content development to ensure accuracy and fair balance. The 60 th ASA Planning Committee reviewed Sponsorship Agreements to identify any actual, potential or apparent influence over the program. Information / recommendations in the program are evidence- and / or guidelinesbased, and opinions of the independent speakers will be identified as such

7 Dr. Ted Jablonski BSc Med, MD, CCFP, FCFP Clinical Assistant Professor University of Calgary, Department of Family Medicine Medical Lead, Calgary Foothills Primary Care Network Family Physician and Partner, Crowfoot Village Family Practice, Calgary Medical Director, Jablonski Sexual Health and Wellness & Clinical Associate, Men s Sexual Health Clinic, Southern Alberta Institute of Urology, Rocky View Hospital, Calgary

8 Graduate of University of Calgary Clinical Assistant Professor University of Calgary, Department of Family Medicine Member of Calgary Rural Primary Care Network Family Physician Foothills Family Medical Centre in Black Diamond Family, AB Dr. Eric Jablonski BSc, MD, CCFP

9 PSA TESTING Getting Prostrate for the Prostate OBJECTIVES

10 PSA TESTING Getting Prostrate for the Prostate OBJECTIVES - Review the basics of the prostate gland - Explain the science of PSA Testing - Explore PSA test for case finding /dx abnormalities - Review PSA Testing for prostate cancer screening - DEBATE the Pros & Cons of PSA Testing in 2015 and provide a rational clinical guide to its potential use

11 PRE- NEEDS ASSESSMENT Polling the Audience

12 DO NO HARM! When all is said and done, we all want to do what is RIGHT for our patients and the more I learn, the harder it gets

13 Tom W. Longstanding patient sent in by his wife to get his prostate checked 55 year old healthy male, co-worker just diagnosed with metastatic prostate cancer No known FH of prostate cancer, nonsmoker, generally healthy lifestyle Has urinary complaints with occasional frequency and urgency, nocturia 2-3 / night, no incontinence, rare episodes of hesitancy and poor stream

14 Tom W. He states I guess you re going to have to give me a finger up the butt and a blood test and just one finger please, I don t need a second opinion just yet You roll your eyes and say.

15 Tom W. 1. you re right, so let s get on it 2. EBM (Evidence based medicine) has clearly stated that you need neither a DRE, nor a PSA test, so relax. 3. I will perform a DRE but not a PSA test 4. You need a PSA test but not a DRE 5. Sorry, before we do anything what are you concerned about? and how much do your current symptoms bother you?

16 Tom W. These symptoms are actually really bothering me a lot! And of course I am worried that I could have prostate cancer, I ve recently talked to Brett Wilson (my boss is well connected)

17 Tom W. So what do you do say? What do you do? THINK ABOUT THIS CASE as we go through presentation and hopefully the answer will become a bit clearer

18 PROSTATE GLAND mano a mano

19 PROSTATE GLAND GLAND gone WILD

20 PROSTATE GLAND Reining in the beast

21 PSA TEST WTF