Tuesday, 29 May 2012

Prostate Cancer Screening North of the 49th Parallel

The U.S. Preventative Services Task Force (USPSTF) recommendation against the use of Prostate-Specific Antigen (PSA) blood tests sets a dangerous precedent for all patients seeking preventative measures in the fight against cancer. Prostate cancer is the most common form of the disease, representing one quarter of all new cases diagnosed annually in Canada. A PSA test is the most common tool to detect prostate cancer when it is still localized and asymptomatic. All men should have the option to educate themselves about the merits and risks of PSA screening. The Task Force’s recommendation to deny discussion on this subject effectively removes this fundamental right from the patient. The Canadian Cancer Survivor Network (CCSN) is deeply concerned about the potential spillover effects of this recommendation on screening policies in Canada.

The Task Force’s report was recently touched upon on this side of the border by AndrĂ© Picard in the May 21st edition of the Globe & Mail. Mr. Picard is incorrect when “sadly” claiming that the recommendations of the Task Force will be ignored. They will most certainly not be, especially if Canada takes a page out of the Task Force’s book and aligns its own policies to match a U.S. health care system with a very different type of funding structure. Picard has effectively confused the qualities of a risk-adverse Canadian public with risk-adverse U.S. insurance companies.

While prostate cancer may not be the most lethal variant of the disease, it is damaging to simply label it as harmless. It can be gradual in its development, but there are no other means of detecting its existence prior to it metastasising. Prostate cancer will kill an estimated 4,000 sons, fathers, brothers and uncles in Canada this year.  But this figure doesn’t take into account the number of lives saved because of screening practices. Even if patients choose not to immediately act upon elevated PSA levels, they have an inherent right to establish the means by which to monitor those levels and respond accordingly. Over 90% of prostate cancer cases are curable when detected early.

The Task’s Force’s recommendations to eliminate screening will not sustain this success rate. While they claim that abandoning the PSA-test won’t have a huge impact on mortality rates, this statement is only true for patients well into their mid-70s. It does not reflect the reality facing young Canadians or males in the high risk 50-65 age range. This report does not take into account continuing observational studies occurring now, instead placing its weight behind several major studies with self-declared methodological limitations. There were also a number of major players not represented within the Task Force’s membership, including the American Urological Association and the American Cancer Society, both of whom strongly advocate for increased use of PSA tests on the grounds that other methods can’t detect the cancer until it spreads. It should also be noted that there are no prostate cancer patients or survivors on the Task Force.

PSA tests are currently covered by seven out of ten provinces in Canada for screening purposes, however the federal government’s decision not to renew the 2014 Health Accord could jeopardize coverage for PSA tests, as provinces will face continuing pressure to reduce their spending on health care. The CCSN encourages all concerned patients to contact their provincial Minister for Health to remind them of the importance that PSA tests play in ensuring the health and safety of all Canadians.

For more information on PSA tests, please visit Prostate Cancer Canada’s website at: http://www.prostatecancer.ca/Prostate-Cancer/About-the-Prostate/PSA

Thursday, 24 May 2012

Remembering Maureen Kelly, December 6, 1938 - May 17, 2012

Remembering Maureen

By Jackie Manthorne

Maureen died on May 17, 2012 after a valiant battle with pulmonary fibrosis. She was the loving mother of Natalie and her husband Brent Pilon, and Steve Kelly. She was the very proud and doting grandmother of Chloe Pilon and Mark and Ashley Dempsey. She was the beloved sister of Patricia McPoland and John McPoland, and was predeceased by her brother Peter and her sister Jacqueline.

Maureen and I worked together at a national cancer charity for ten years. Although I was her boss, over time we became friends. This doesn’t happen often, but Maureen was special. She cared about her work, the people she worked with, and especially the people she worked for – people just diagnosed or living with cancer.

When I look back, I think of Maureen as the “face” of that charity. She was the first person you saw when you came in the door, and she always greeted everyone with a smile and a good morning, and asked how you were doing. Her cheerfulness soothed the nerves of students just starting on their placement, welcomed the many volunteers, and gave consistency to the day for the people who worked there.

She was also the cheerful, welcoming “voice” that callers first heard, whether they were calling for information about a cancer group in their city or town or whether they had just been diagnosed and were afraid and upset.  When that happened, Maureen would put everything else aside and spend as long as needed listening and calming and reassuring them that someone cared, that someone was with them and that they could call back anytime. Many did.

Not that she was perfect: she had a liking for corny internet jokes and cartoons, more than a few of which she circulated to friends. She had a big aversion to filling out government forms which resulted in a bit of bother with the Canada Revenue Agency and I don’t know to this day if she ever did get her Old Age Security.

And I would be remiss if I didn’t mention the many men she made friends with: the postman, the postage meter repairman, the photocopy repairman, the phone system repairman, the fellows who fixed our cranky server, and so on. She was always pleasant and always patient with them even when equipment broke down often, so they always showed up promptly when she called

Most of all, Maureen cared about and was proud of her family, especially her grandchildren, and she told me more than once how wonderful it was to be living these past years with her daughter Natalie, son-in-law Brent and granddaughter Chloe.  She was a loving mother, grandmother, sister and mother-in-law through good times and bad.

Maureen was also a true friend to many, and we will miss her sunny personality and caring presence in all our lives.

At her memorial service last evening, a group of us who had worked with Maureen slowly congregated at one table. We drank coffee and ate sweets and caught up with each other’s lives and mostly we reminisced, with many a laugh and quiet moments filled with memories. It was the kind of coffee klatch Maureen would have loved.

God bless you, Maureen – may our prayers follow you to heaven.

Tuesday, 22 May 2012

Attend a Town Hall Meeting - Nine towns remaining in the Ontario Health Coalition’s Cross-Province Tour

This is a reminder of the upcoming town hall meetings near you. As you know, the recent "austerity budget" threatens more cuts to hospitals and health services all across Ontario. All concerned citizens are asked to take part in learning about cuts and their impact on local communities and to get involved in the fight to stop cuts to health care. 

To date, the town halls have been very successful and have attracted many concerned individuals to voice their own questions and concerns and to get involved in fighting back against cuts. Below, please find a list of the remaining town hall meetings. This is your chance to get involved and make a difference.    

Kingston - Wednesday May 23 at Regiopolis-Notre Dame Catholic High School, located at 130 Russell Street from 7-9 pm - with guest speakers Kathleen Lahey (Professor, Queen's University) Dennis Howlett (Canadians for Tax Fairness), Sara Labelle (OPSEU), Michael Hurley (CUPE/OCHU), Natalie Mehra (OHC), and ICU Nurse Peter Stroud as Emcee.

Cornwall - Thursday May 24 at the Navy Veterans Club, located at 30 6th St East from 7-9 pm - with guest speakers Dennis Howlett (Canadians for Tax Fairness), Ross Sutherland R.N., MA, Anne Clark (ONA), Natalie Mehra (OHC) and Elaine MacDonald (Cornwall City Councillor and co-chair of the Cornwall Health Coalition) as Emcee. 

Ottawa - Saturday May 26 at the Ottawa Public Library, Main Branch located at 120 Metcalfe St from 1-3 pm - with Dennis Howlett (Canadians for Tax Fairness), Marlene Rivier (OPSEU), Ross Sutherland R.N., MA, Anne Clark (ONA), Natalie Mehra (OHC) and Pauline Tam, health reporter for the Ottawa Citizen as Emcee. 

Matheson - Monday May 28 at the Floyd Hembruff Civic Centre located at 387 Hwy 11 from 7-9 pm - with Dr. Gayle Broad, (Associate Professor, Algoma University), James Moffat (retired, Sheet Metal Workers Union), Natalie Mehra (OHC) and Ben Lefebvre from the Northeastern Ontario Health Coalition as Emcee. 

Sault Ste. Marie - Wednesday May 30 at the Moose Lodge, located at 543 Trunk Road from 7-9 pm - with Dr. Gayle Broad (Associate Professor, Algoma University), Rob Giovagnoli (CAW), and Natalie Mehra (OHC)

Thunder Bay - Thursday May 31at the Waverley Resource Library, located at 285 Red River Rd from 7-9 pm - with Trish Hennessy (Canadian Centre for Policy Alternatives), Diane Parker (ONA), Kari Jefford (CAW), Mary Cory (OPSEU) and Natalie Mehra (OHC)

Kenora - Saturday June 2 at the Best Western Lakeside Inn, located at 470 First Avenue South from 1-3 pm -with Natalie Mehra (OHC), Michael Hurley (CUPE/OCHU) and Shelley Bujold of CJBN as Emcee. 

Sudbury - Tuesday June 5 at the Legion Branch 76, located at 1553 Weller Street from 7-9 pm - with Dr. Gayle Broad (Associate Professor, Algoma University), Natalie Mehra (OHC), Manny Carvalho (SEIU) and Carol Mulligan of the Sudbury Star as Emcee. 

Windsor - Wednesday June 6 at the CAW 195/2458 Union Hall, located at 3400 Somme Ave from 7-9 pm - with Jim Stanford (straight-talking economist from the CAW) and Natalie Mehra (OHC).

Please stay tuned to facebook and twitter @OntarioHealthC for more updates as we tour the province. All interested individuals are asked to attend a meeting in their region and get involved in the fight back against cuts to health care. If you have any further questions, please do not hesitate to contact the Ontario Health Coalition by phone at 416-441-2502 or by email. 

ZYTIGA® Now Available for Eligible Patients in Nova Scotia and Newfoundland and Labrador

Provinces are fifth and sixth in Canada to reimburse new metastatic prostate cancer treatment
Toronto, ON (May 16, 2012) – Men living with metastatic prostate cancer in Nova Scotia and Newfoundland and Labrador now have access to a new treatment option, as these provinces have made the decision to include ZYTIGA® (abiraterone acetate) on their public formularies for the treatment of metastatic, castration-resistant prostate cancer.

Patients, caregivers and health care professionals are encouraged to learn more about the specific eligibility criteria for ZYTIGA® reimbursement in these provinces through the following links: http://www.gov.ns.ca/health/Pharmacare/info_pro/pharmacare-news.asp

In July 2011, ZYTIGA® was approved by Health Canada with prednisone for the treatment of men with metastatic prostate cancer (castration-resistant prostate cancer) who have received prior chemotherapy containing docetaxel.1 It is the first oral treatment that inhibits androgen production at all three sources – the testes, adrenal glands and in the tumour itself. Results of the pivotal Phase 3 study found that when ZYTIGA® is taken with prednisone, there is a 35 per cent reduction in the risk of death and a 3.9 month difference in median survival compared to placebo plus prednisone.

“I have seen firsthand how abiraterone has changed people’s lives; not only the men living with metastatic prostate cancer, but their partners and families as well,” says Dr. Lori Wood, Medical Oncologist, Queen Elizabeth II Health Sciences Centre in Halifax. “This treatment can dramatically improve the quality of life of these men with very little, if any, side effects, and also helps them live longer.”

Nova Scotia and Newfoundland and Labrador join four other provinces that have already made the decision to include ZYTIGA® on their public formularies: British Columbia, Alberta, Saskatchewan and Quebec.

Dr. Kara Laing, President, Canadian Association of Medical Oncologists and Clinical Chief, Cancer Care Program, Eastern Health in St. John’s feels the same way about the Newfoundland and Labrador government’s decision.

“So many of our patients have benefited from abiraterone and we have seen significant improvements in their health. As a physician, it’s exciting to now have this option available for our patients in Newfoundland and Labrador. I’m very pleased the government has decided to reimburse ZYTIGA®.”

Prostate Cancer in Canada
Prostate cancer is the most common cancer to afflict men in Canada and approximately 26,500 men are diagnosed with prostate cancer annually. According to Prostate Cancer Canada, prostate cancer is turning up in men in their 40s and on average, 73 Canadian men are diagnosed with prostate cancer every day. If prostate cancer is detected and treated early, it can be cured. Fortunately, death rates have been declining since the mid-1990s, likely due to early detection, better treatment or both.2

About Janssen Inc.
As a member of the Janssen Pharmaceutical Companies, Janssen Inc. is dedicated to addressing and solving the most important unmet medical needs in pain management, psychiatry, oncology, immunology, psoriasis, virology, anemia, attention deficit hyperactivity disorder, gastroenterology and women’s health. Driven by our commitment to the passionate pursuit of science for the benefit of patients, we work together to bring innovative ideas, products and services to patients around the world. 

Friday, 18 May 2012

ZYTIGA™* (abiraterone acetate) receives Health Canada approval for treatment for metastatic prostate cancer

First Oral Treatment for Metastatic Prostate Cancer That Inhibits Androgen Production at All Three Sources

Toronto, ON, July 28, 2011– Janssen Inc. announced today that after a priority review, Health Canada has approved ZYTIGA™ (abiraterone acetate), an oral medication for the treatment of men with metastatic prostate cancer. ZYTIGA™ is indicated with prednisone for the treatment of men with metastatic prostate cancer (castration-resistant prostate cancer) who have received prior chemotherapy containing docetaxel.1

“This approval is an important advancement in the treatment of metastatic prostate cancer,” said Dr. Scott North, Medical Oncologist, Cross Cancer Institute, University of Alberta. “For these patients, the efficacy and safety of ZYTIGA™ will fill an important unmet medical need for additional treatment options. Most importantly, clinical trial results demonstrate extended overall survival and improved pain relief. I believe these benefits provide improved quality of life for many patients.”

ZYTIGA™: Unique Mechanism of Action

Androgens are hormones that promote the development and maintenance of male sex characteristics; however, in prostate cancer, androgens can help fuel tumour growth. Androgen production primarily occurs in the testes and adrenal glands; in men with prostate cancer, the tumour itself is an additional source of androgen. ZYTIGA™ is an androgen biosynthesis inhibitor that inhibits the CYP17 enzyme complex, which is required for the production of androgens. It is the first oral treatment for metastatic prostate cancer that inhibits androgen production at all three sources.

Results of the pivotal Phase 3 study (N=1,195) showed that at the pre-specified interim analysis, treatment with ZYTIGA™ plus prednisone resulted in a 35 per cent reduction in the risk of death (14.8 months vs. 10.9 months [hazard ratio (HR) = 0.646; 95 per cent CI: 0.543, 0.768; p<0.0001]) and a 3.9 month difference in median survival compared to placebo plus prednisone. In an updated analysis, results were consistent with those from the interim analysis with a 4.6 month difference between the two arms in median survival (15.8 months vs. 11.2 months [HR = 0.74]). The study was conducted in 147 centres in 13 countries, including 12 centres in Canada; 154 Canadian men participated in the study, which represents approximately 13 per cent of the study population.

“This new treatment is important to me because the oral dosage is very manageable and convenient and I spend less time in treatment,” said Richard Pokorny, who has been living with prostate cancer for 11 years. “I also feel stronger and have more energy, allowing me to do day-to-day tasks and enjoy quality time with my loved ones as we face this disease together.”

About Metastatic Prostate Cancer

Metastatic prostate cancer occurs when cancer has spread beyond the prostate and disease progresses despite serum testosterone below castrate levels.2

Prostate cancer is the most common cancer to afflict men in Canada, excluding non-melanoma skin cancer.3 Approximately 25,500 men are expected to be diagnosed with prostate cancer in Canada in 2011, and one in seven Canadian men will develop prostate cancer during his lifetime.3 The incidence rate of prostate cancer has been increasing since 1980, likely due to an increased rate of early detection and the aging population since the chances of developing prostate cancer increases with age.3 However, according to Prostate Cancer Canada, prostate cancer is turning up in men in their 40s.4

Pivotal Study

ZYTIGA™ with prednisone was evaluated in a Phase 3, randomized, placebo-controlled, multi-centre clinical study in patients who had received prior chemotherapy containing docetaxel (N = 1,195). Patients were randomized 2:1 to receive ZYTIGA™ 1 gram daily plus prednisone 10 milligrams (mg) daily or placebo in combination with prednisone 10 mg daily (control arm).

The most common adverse reactions observed with ZYTIGA™ were myopathy, joint pain or discomfort, peripheral edema, hot flush, diarrhea, hypokalemia (low serum potassium), urinary tract infection and cough. Serious adverse reactions with ZYTIGA™ included urinary tract infections, bone fracture and hypokalemia.1

About Janssen Inc.

As a member of the Janssen Pharmaceutical Companies, Janssen Inc. is dedicated to addressing and solving the most important unmet medical needs in pain management, psychiatry, oncology, immunology, psoriasis, virology, anemia, attention deficit hyperactivity disorder, gastroenterology and women’s health. Driven by our commitment to the passionate pursuit of science for the benefit of patients, we work together to bring innovative ideas, products and services to patients around the world.

Monday, 14 May 2012

New Medication to Reduce Bone Complications Now Available in Ontario

Patients with advanced prostate cancer gain access to first-in-class treatment
OTTAWA, April 25, 2012 /CNW/ - Canadian Cancer Survivor Network (CCSN) is today congratulating the Ontario government for providing access to XGEVA® (denosumab) for the prevention of debilitating bone complications, known as skeletal-related events (SREs), in men with advanced prostate cancer which has spread to the bone.

When cancer metastasizes to the bone, a number of serious complications can occur. These may include broken bones, spinal cord compression, as well as the need for radiation and/or surgery to the bone. In people with advanced prostate cancer, SREs are associated with increased disability and even death.
"We congratulate the Ontario government for providing access to XGEVA to treat the complications that can arise when prostate cancer, the leading cancer among Canadian men, spreads to the bone," said Jackie Manthorne, President and CEO, CCSN. "We hope that other provinces across Canada follow in the footsteps of Ontario andQuebec in making this innovative treatment available to patients."

CCSN provides a voice for people affected by cancer. It believes that all Canadians battling all types of cancers must have access to new treatments, both for the cancer itself and complications arising from the cancer, such as SREs. Further, its mandate is to ensure that Canadians have access to all of the approved medications they need for optimal care.
The Ontario Public Drug Programs will reimburse XGEVA under the Exceptional Access Program and through Cancer Care Ontario's New Drug Funding Program for patients with prostate cancer who meet the following criteria:
·         Treatment of bony metastases for patients with hormone refractory prostate cancer as determined by an elevated PSA level, or evidence of progressive bony disease1, despite castrate serum testosterone levels (<1.7nmol/L or <50ng/dL).

1Progressive bony disease should be demonstrated by progressive changes in radionucleotide bone scan or clinical signs of disease progression (e.g., pathological fracture or increasing bone pain).
Note: Patients who have undergone orchidectomy do not need to provide a serum testosterone level.
Dose: 120 mg SC every four weeks

About bone metastases 
One of the most common places for prostate cancer to spread is to the bone. In fact, Up to 90 per cent of men with advanced prostate cancer develop bone metastases throughout the course of their disease.1,2,3
Once cancer has spread to the bone, a number of serious complications can occur, known as SREs. Approximately 50 to 70 per cent of all cancer patients with bone metastases will experience debilitating SREs, such as fractures or spinal cord compression, which necessitates procedures like major surgery and radiation.4,5,6,7 Such complications can profoundly impact a patient's quality of life and cause disability and pain. In people with advanced cancer, SREs are associated with increased illness and death, and can place a significant economic burden on the healthcare system.8
While there are currently no treatments to prevent or delay the spread of cancer to the bones, treatments like XGEVA, for the complications of bone metastases, helps prevent or delay broken bones, spinal cord compression, or the need for surgery or radiation from occurring.
About Canadian Cancer Survivor Network (CCSN)
The Canadian Cancer Survivor Network is a national network of patients, families, survivors, friends, families, community partners and sponsors. Its mission is to work together by taking action to promote the very best standard of care, support, follow up and quality of life for patients and survivors. It aims to educate the public and policy makers about cancer and encourage research on ways to alleviate barriers to optimal cancer care in Canada. Follow CCSN via their blog at http://jackiemanthornescancerblog.blogspot.com.
 Tannock IF, de Wit, R, Berry WR, et al. Docetaxel plus Prednisone or Mitoxantrone plus Prednisone for Advanced Prostate Cancer. N Engl J Med 2004; 351:1502-12.
 Scher HI, Morris MJ, Kelly MK. Prostate Cancer Clinical Trial End points: "RECIST"ing a Step Backwards. Clin Cancer Res 2005:11:5223-5232. Published online July 20, 2005.
 Petrylak DP, Tangen CM, Hussain MHA, et al. Docetaxel and Estramustine Compared with Mitoxantrone and Prednisone for Advanced Refractory Prostate Cancer. N Engl J Med 2004;351:1513-20.
 Coleman, RE. Skeletal complications of malignancy. Cancer. 1997; 80 (suppl): 1588-1594.
 Dictionary of Cancer Terms - spinal cord compression. National Cancer Institute website.http://www.cancer.gov/dictionary. Accessed Aug. 31, 2010.
 Saad F. Impact of bone metastases on patient's quality of life and importance of treatment. Eur Urol. 2006; 5(suppl): 547-550.
 Janjan NA. Radiation for bone metastases. Cancer. 2000:80:1628-1645.
 Schulman K and Kohles J. Economic burden of metastatic bone disease in the U.S. Cancer. 2007: 109 (11):2334-2342.

Participate in Ontario Budget Hearings!

As you know, the government did not hold pre-budget hearings as is normally the case, even though it was planning an extremely harsh budget that will result in major health care cuts.

These hearings usually happen in January and are held across the province before the Ontario Budget is finalized and introduced in legislation. They are the public's opportunity to give input. But the government did not hold them this year.

The hearings are held by the Standing Committee on Finance and Economic Affairs which is comprised of MPPs from all the political parties. Because this is a minority government, the government does not necessarily have a majority on the committees -- indeed, the Finance & Economic Affairs Committee has 4 Liberals (including the chair), 3 Conservatives and 2 NDP MPPs.

The committees have power to pass amendments to Bills (legislation). Then the amended Bill goes to the Legislature for final reading and passage. So committees are important, particularly in a minority government.

Now, the Budget Bill (Bill 55) is currently in Second Reading in the Ontario Legislature. In a week or two, when Second Reading is complete, it will be referred to the Finance Committee for hearings. NDP Finance Critic, Michael Prue is pushing for full hearings, particularly since there were no regular pre-budget hearings this year. The Committee has not yet determined how many hearings and where they will be.

If you would like to make a deputation to the Finance Committee on the provincial budget, please call or email the Clerk's office and let her know that you would like to be added to the list for standing. She will need your name, organization (if applicable), address, phone and email. You need to tell her it is regarding Bill 55 -- the Budget Bill. Please do this soon.

You can reach the Clerk at:

Clerk Valerie Quioc Lim
99 Wellesley Street West Room 1405, Whitney Block Queen's Park Toronto, ON M7A 1A2

Participate in survey on workplace absenteeism and health conditions

Fred Ashbury of Piceps Consultants is working with some colleagues at the University of Wollongong (Australia) on an international research project to design and implement an online survey. The survey focuses on two issues. First, the survey measures the extent of workplace absenteeism and presenteeism (i.e., being at work, but due to a health-related condition are working at a level lower than usual). Secondly, it measures the unique contributions of self-reported health conditions (e.g., diabetes, headache) and non-health factors (e.g., work stress, work engagement, burnout) to the occurrence of presenteeism and absenteeism.

It would be very helpful if you would take part in the survey and forward this invitation to others in your groups (and ask them to forward it to those in their networks as well). All information provided by anyone who participates in the survey will be anonymous. All answers are self-report, and because it is an online survey anyone can withdraw at any time without consequence.

People who finish the survey have an opportunity to register for a draw to win a free IPAD3. Three IPAD3s will be awarded. To register for the draw the person needs to click on the link at the end of the survey that launches them into a new and unrelated browser window to complete a brief form that asks for their name and email address. This information is necessary so the winners of the draw can be contacted and arrangements made for delivery of the IPAD3. Please be assured that data on the registration form cannot be associated with the survey data as they are completely separate activities. Furthermore, only the project team members will know who completed the form to enter the draw. The data from the online entry forms will be destroyed following the draw to be held on June 30, 2012.

Your participation in this research project is very much appreciated. Please also consider forwarding this invitation to those in your LinkedIn network so we can optimize the number of completed surveys. To enter the survey, please click on the link below. Thank you for participating in the research project.

Sunday, 13 May 2012

Ontario men gain access to new medication to reduce bone complications from prostate cancer

Ontario men with advanced prostate cancer now have access to an innovative treatment, XGEVA® (denosumab), for the prevention of debilitating bone complications, such as broken bones, spinal cord compression, or the need for radiation or surgery to the bone.

Ontario is the second province to provide access, following Quebec’s decision earlier this year.

Bone complications can occur when cancer spreads from the prostate to the bone (a common area for the cancer to spread in advanced disease), profoundly impacting a person’s quality of life and causing disability, pain and hospitalization.

Unlike most bone-targeted therapies, which are given intravenously, XGEVA is given as an injection under the skin once every four weeks. It is not cleared through the kidneys so dose adjustment for kidney impairment is not needed.

The Ontario Public Drug Programs and Cancer Care Ontario will make XGEVA available to patients with hormone refractory prostate cancer as determined by an elevated PSA level, or evidence of progressive bony disease, despite castrate serum testosterone levels (<1.7nmol/L or <50ng/dL).

If you have advanced prostate cancer and bone metastases, speak to your doctor about which treatment is right for you.