We Pledge to:
What is our Purpose?
WE WORK TO STOP PROSTATE CANCER KILLING MEN IN GIBRALTAR
What do we Want?
The highest quality of Treatment and Supportive Care for MEN affected by Prostate Cancer and Prostate Related Diseases in Gibraltar.
What do we Do?
We vigorously campaign for the betterment of the health service in Gibraltar for Prostate Cancer and Prostate related diseases by supporting health professionals and the Gibraltar Health Authority.
To limit the impact of Prostate Cancer and Prostate related diseases to Men, their partners and families by providing information, support, advice and counselling.
Early Detection Saves Lives
This is our most important objective as an early detection of Prostate Cancer has proven to save lives.
The Charity highlights Prostate Cancer symptoms and the need for MEN to check their PSA regularly via a Social Media campaign. Judging from the statistics obtained from the 2019 to 2020 Awareness campaign the charity will continue to promote this objective via social media as it’s proven to be a most effective forum on which to inform the community of Gibraltar.
Every year, we set about constantly informing the local community about the symptoms of Prostate Cancer and of the need to check your PSA.
The Awareness Campaign is promoted in all the social media channels in targeting the local community.
This year, Henry and Priscilla Sacramento, two very well know personalities in Gibraltar took over Tito Vallejo in promoting the Movember Campaign and Prostate Cancer Awareness.
The Charity actively fund raises to pay the costs associated with making Awareness of Prostate Cancer more prominent in our community.
The Charity intends to purchase the Transperineal 3 D Fusion Targeted Biopsy medical equipment in 2021. The diagnostic capabilities of this diagnostic equipment are such that Urology Doctors are able to carry out biopsies even when cancer tumours are in a minuscule form. When compared to the Transrectal biopsies it has less discomfort during diagnosis, a reduced risk of infection, higher detectable rates and most important, it speeds up the diagnostic procedures.
The capital cost of this medical equipment is circa £185,000 paid on a 50:50 basis between the Kusuma Trust and PCG. The Gibraltar Health Authority (GHA) has agreed to cover the ongoing cost of providing the service. PCG expects the medical equipment to be delivered in 2021.
The Charity actively fund raises to be able to pay the costs associated with purchasing the latest medical equipment in the diagnosis and treatment of prostate cancer and related diseases.
Prostate Cancer Gibraltar will continue to pursue the various areas where improvements are required and needs addressing. These are as follows:
Prostate Cancer has provided detailed accounts of patient experience since having surgery; in highlighting the shortfall in the care and medical attention offered by the GHA.
Prostate Cancer Gibraltar will vigorously work towards putting in place a Memorandum of Understanding in order to have agreed protocols in place, which will enable suspected prostate patients to be diagnosed with 21 days.
The majority of urology referrals require a number of diagnostic investigations (flow rates, imaging, flexible cytoscopies, urodynamics). This often necessitates a number of clinic attendances, with a recognition that this requirement for multiple attendances lengthens the time to a definitive diagnosis and often leads to increased incidence of non attendance. A more efficient model of care delivery involves a ‘One Stop Clinic’ approach, aiming to undertake most of the investigations required in a single visit, allowing the majority of patients to leave with a diagnosis and potential management plan at the earliest opportunity. This is a more efficient model of care, and optimises clinic capacity and utilisation.
A multi-professional team approach to the provision and delivery of urological outpatient services potentially involves consultant clinicians, specialist nurses and clinic nurses. This model of care expands the capacity to deliver healthcare beyond the limiting factor of the number of clinician’s.
Currently due to restrictions on clinic space, staff numbers and equipment, the Urology department is not currently able to deliver an optimal level of care to the Community. Despite marked improvements in the patient experience of the service to date, we recognise there is the opportunity to improve and do more.
Our goal is to develop the urology department into an efficient, responsive and patient focused service. We aim to achieve this through replicating examples of best practice in the delivery of clinical care (The Urology One-Stop service at Guy’s Hospital) and adapting them to the health and culture needs in Gibraltar.
A dedicated diagnostic urology suite would allow the delivery of a One-Stop model of care, allowing flow rates, urodynamics, flexible cystoscopy and LA transperineal biopsies. An expansion of the clinical space available to the urology department, to also allow a CNS to undertake independent clinical activity, would further enhance and expand clinical capacity.
Anticipated requirements for this to be delivered include:
Prostate Cancer Gibraltar will campaign for the betterment of the health service and fund raise to introduce these service enhancements in the GHA to allow for a locally delivered Urological Diagnostic Centre of Excellence.
A patient, no matter how tough that person may be, in almost all cases, find their world will cave in, when they hear that their diagnosis is you have Prostate Cancer. The patient may find it difficult to come to terms with his diagnosis or find that he has to make a difficult treatment choice.
The charity provides a Buddy Support Group whereby a recently diagnosed patient can talk to a Buddy who has been through a similar experience before and can be of great help and support.
The Charity will continue to organise meetings at the Cancer Relief Centre every 2nd Thursday of every month.
Prostate Cancer Gibraltar will continue to support all recently diagnosed patients with the Support Buddy programme.
Last week the Gibraltar Financial Services Commission held their annual “FreetheKnee” event in favour of the Prostate Cancer Group and a total of £1,772 was collected. The Beach Volleyball tournament was held at the Nuffield Pool on the 23rd and 24th June and was a great success. So much so that several teams that had wanted to take part had to be declined due to lack of time and space in the busy match fixtures. About 200 people turned up on the first evening to play or support the event, creating a carnival-like atmosphere. This is proof enough of how committed, aware and generous the young members of our community are!
The PCG Committee turned up on both evenings to support the organisers and to present the prizes.
1st Place: Setting Ducks
2nd Place: AMS
3rd Place: Sets on the Beach
A great time was had by all, PCG received a big donation, and most importantly, the event went a long way towards creating awareness of prostate cancer.
This article is designed to give you as much information as possible regarding penile rehabilitation following your robotic radical prostatectomy.
Please do not start any of the treatments mentioned in this leaflet without discussing it with the urologist. Make sure to inform him about any medication you take.
Following a Robotic Radical Prostatectomy, erectile dysfunction is a common consequence and erectile function may take 6-24 months to return, even if bilateral nerve sparing technique has been used. Sexual dysfunction is a common quality of life issue following prostate surgery.
Neuropraxia of the cavernosal (erectile tissue) nerve leads to hypoxia and fibrosis of the tissue of the penis. Neuropraxia is usually a result of trauma sustained by the cavernosal nerves during surgery and is almost impossible to avoid. Even minor trauma will lead to short term erection problems. Cavernosal smooth muscle is dependent on oxygenation of the tissue for normal function. If there is lack of sufficient oxygenation due to neurological and arterial trauma this leads to fibrosis and collagen formation, making the recovery of erections more difficult, as well as the possible resultant reduction in penile length and circumference.
The aim of penile rehabilitation is to prevent fibrosis from occurring and to maximise the recovery of erectile function. There is some evidence to suggest that the longer a man goes without erections, the more tissue damage may take place leading to more difficulty in restoring the erections. The outcome of successful penile rehabilitation is measured by the ability to achieve a spontaneous erection that is rigid enough form successful penetrative intercourse.
Penile rehabilitation should ideally be started at around 6 weeks post-surgery, however this will depend on the recovery of each individual and whether you feel ready. The rehabilitation program does require time and dedication in order to achieve the best possible results. Research suggests that the sooner rehabilitation is started the better the outcome is likely to be.
There are 5 medical treatments available for erectile dysfunction and each of these has a place in the rehabilitation programme.
PELVIC FLOOR EXERCISES
Pelvic floor exercises are traditionally taught to aid in the recovery of continence following surgery. There is evidence to suggest that they are also an important part of penile rehabilitation. Performing pelvic floor exercises promotes the delivery of oxygenated blood to the injured nerves as well as helping to remove deoxygenated blood, which together improves healing. With regular exercise the pelvic floor muscles remain toned and this can help you achieve a better quality of erection and assist in sustaining your erection.
You will be taught pelvic floor exercises as part of your preparation for surgery and should begin to practise these as soon as it is comfortable to do so (usually after the catheter is removed). It is important that you perform at least two to three sets of exercise per day in order to benefit from them and that you continue to do them for the rest of your life. Quality is more important than quantity however.
VACUUM CONSTRICTION DEVICE (VCD)
The British Society for Sexual Medicine Guidelines of 2007 recommends a VCD as a first line treatment option for erectile dysfunction following prostatectomy. VCDs are very effective in inducing erections no matter what the cause of the erectile dysfunction is; therefore they can be used in penile rehabilitation while the nerves are healing. The recommendation is to use the VCD at least 3 times a week as an exercise tool to encourage blood supply to the penis. This can also be done on a daily basis if it is practical.
According to research done using a VCD early in the rehabilitation programme (usually recommended to start at around 6-8 weeks post operation) include:
Using the VCD in conjunction with a PDE-5 inhibitor has been shown to increase efficacy and satisfaction.
It is important to note that it will usually take about 2 weeks of regular use to become familiar with and comfortable with the use of the VCD.
There are 3 PDE-5 inhibitors available on the market, all in tablet form. They are safe to use if they are obtained on prescription and taken as prescribed. There are certain medical conditions and medications you may take which may preclude you from using these but this will be discussed with your urologist. The oral tablets are:
There are studies which show that using PDE-5 inhibitors in penile rehabilitation promotes improved blood flow to the penis and this may enhance the return of spontaneous erections following prostatectomy. Emerging research continues to support the early use of these agents for penile rehabilitation. Studies have shown that in order to obtain maximum effectiveness the drug of choice should be taken on a regular basis for a minimum of 3 months, but possibly for longer.
Cialis has the longest lasting effects (36 – 48 hours) and therefore taking a tablet once every 2 – 3 days (ie 3 times a week) is sufficient to produce the required effect. Usually the largest dose of 20mg is recommended.
Viagra may be taken as a small dose (25 – 50mg) on a daily basis. The effects of Viagra usually last for around 6 hours.
Levitra may be taken as a 3 tablets a week dose although the effects do not tend to last for more than 24 hours. The dosage is usually 20mg although in some cases you may be advised to take 5mg or 10mg daily.
It is very important to remember that you will be using the tablets as part of the rehabilitation programme and it is extremely unlikely in the first few months that they will actually work to get you an erection suitable for penetrative intercourse on their own.
INTRAURETHRAL ALPROSTADIL (MUSE)
MUSE is a small “pellet” which is inserted into the urethra (water pipe) where it dissolves, allowing the medication to be absorbed locally into the penile tissue. There is some evidence that suggests it may be useful as part of penile rehabilitation. It has the added benefit that it may produce an erection sufficient for penetrative intercourse. When trying MUSE it is important to consider that even if you are unable to achieve an erection suitable for penetrative intercourse, the act of using the MUSE is likely to have a positive impact on the rehabilitation programme and long term outcome. MUSE is available as 250, 500 and 1,000 micrograms. In the first year following prostatectomy men are more likely to experience some pain following administration of MUSE at the higher doses, therefore you will usually be started on a 500 microgram dose initially.
INTRACAVERNOSAL PENILE INJECTION
There are various medications available, which, when injected into the side of the base of the penis causes the blood vessels of the penis to dilate, leading to penile engorgement.
The benefit of using injection therapy is that it has a very high and proven rate of producing an erection sufficient for penetrative intercourse. For most men the idea of injecting into the penis stops them from trying injection therapy, however the process of injecting is in itself not painful. You will need to attend a supervised session with a urology nurse to be taught how to inject safely.
Although penile implants are not strictly part of the rehabilitation programme they have their place in the process of regaining erections following prostate surgery and are the treatment of choice for some men. Most urologists who specialise in this however would not consider placing an implant within the first year following the prostate surgery and certainly not prior to other forms of treatment being attempted first. It should be remembered that implants cause permanent damage to the erectile tissue of the penis and therefore if they fail or are unsuitable it will be impossible to regain normal erections if they are removed.
There are two types of implant available:
Malleable implants consist of two “rods” which are inserted into each corpora cavernosa forming a “permanent” erection. The penis can be bent away when not in use and bent forward in order to have sexual relations.
Inflatable implants consist of two “rods” which are inserted into each corpora cavernosa and a reservoir and pump which is placed within the scrotum. The rods are inflated using the pump and the fluid is drained out again by a release mechanism. The implants work extremely well but men do require full counselling before going ahead with this type of surgery.
The information in this article has been obtained from various sources. Further information can be accessed at:
What can the PSA test tell me?
A raised PSA level can be a sign of a problem with your prostate. This could be:
– an enlarged prostate
– prostate cancer.
Other things can also cause men’s PSA levels to rise. If you have a raised PSA level, your GP might do other tests to find out what’s causing it, or they may refer you to see a specialist at the hospital.
The PSA test and prostate cancer
A raised PSA level can be a sign of prostate cancer. But many men with raised PSA levels don’t have prostate cancer. And some men with a normal PSA level do have prostate cancer.
You may be more likely to get prostate cancer if:
– you are aged 50 or over, or
– your father or brother has had it, or
– you are black.
Additionally, if you have any questions feel free to call our dedicated & anonymous hotline on 58009161.
We will be happy to answer any questions and assist. Or email email@example.com.
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Annually for the past five years, the GFSC has been raising awareness and support for the Prostate Cancer Gibraltar (PCG). During this time, the GFSC has built a strong relationship with the charity and driven a huge amount of awareness and help towards the charity’s objectives. “Free the Knee” has become a staple event during the summer period in the business calendar year.
As part of this year’s fundraising event, the GFSC has organised a Charity Volleyball Tournament. All funds raised from this event will be donated to the charity.
Wednesday 23rd June 2021. 6.30pm-9.00pm;
Thursday 24th June 2021. 6.00pm-9.00pm
*Please note that fixtures will be released following the deadline for registration. Teams will not be required to stay for the full time period.
*Mixed teams allowed and no previous experience required!
To sign up, please email firstname.lastname@example.org with the following information by Friday 11th June 2021:
Please note that soft drinks and snacks will be provided on the days of the tournament courtesy of our sponsors, Restsso and Ramsons. The winning team will be presented with a trophy courtesy of our additional sponsor, Marble Arc Gibraltar.
We thank you for all your support during previous years and hope we can all make this event a success!
GFSC Staff Committee
Prostate Cancer Gibraltar
Prostate cancer is the most common cancer in men. It usually develops slowly, so there may be no signs for many years. Prostate cancer affects 1 in 12 men during their lifetime, and 1 in 2 men will develop benign enlargement of their prostate. The charity acts as a support group and is active in helping men survive this terrible disease. Awareness of the disease is key to survival and an early detection increases men’s chances of longevity.
On Thursday, 13th May the Committee held a social evening with the Buddies and invited Dr Paul Hughes to give a talk. This took place in the patio of the Casino Calpe and the weather was just right for an open air evening meal in which food and drink flowed and the Buddies were able to meet up and see old friends and make new ones.
Before the serious drinking and eating began, Derek presented a short video clip which highlighted the fact that Transperineal biopsies were now being made available to patients in Gibraltar. This video would be published on social media to make sure that all patients were fully aware of this significant development.
Dr Paul Hughes began his talk by explaining the main differences between the Transperineal and Transrectal biopsy and emphasised that the latter was no longer the only option for patients in Gibraltar. However, Transperineal biopsies would need to be performed in either Spain or the UK, as the equipment that had already been purchased by PCG had still not been commissioned. He pointed out that the equipment that had been purchased was cutting edge and would achieve significant cost savings to the GHA in the short term.
Dr Hughes went on to explain the strategies that he and his team were introducing to improve the flow of information between patients, consultants, nurses and GPs in an effort to make the experience of patients less stressful. Some of the questions asked by those present were based precisely on the poor communication that had existed up to the present, mainly as a result of the high turnover of consultants. Dr Hughes emphasised that the overarching aim of his team was to make procedures and systems as similar to the UK as possible.
There were a number of questions that referred to the Urolift treatment, which was relatively new in Gibraltar and Dr Hughes explained the rationale and the context surrounding this procedure.
Derek concluded the “Question and Answer” session by encouraging all those present to continue to create awareness by “Liking” and “Sharing” all our posts on Facebook and all the other PCG online media. He also highlighted all the other issues that the Committee were campaigning for and ended by saying that the Group would continue to work tirelessly for the benefit of all prostate patients in Gibraltar until the end of time!
All in all, a very enjoyable and informative evening was had by all! Make sure you don’t miss the next one!