nhl alumni mcdonald, clark, carbonneau team up for prostate cancer awareness: 'the big thing is being proactive about your health'
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wendel clark and guy carbonneau share a laugh during the legends classic game at scotiabank arena on november 17, 2019 in toronto, ontario, canada.
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need to get men’s attention fast? get hockey legends wendel clark, guy carbonneau and lanny mcdonald talking in the spotlight.
the three former nhl stars are leading a national campaign and website, prostationcanada.ca, about a men’s health issue that needs to be discussed more openly – prostate cancer. it’s the most common cancer for men in canada and the second leading cause of death from cancer for canadian men.
“a good friend of mine, probably one of the healthiest people i know, works out every day, when he called to say he had prostate cancer, it was like, ‘you’ve got to be kidding,'” says mcdonald, whose 16-year professional career capped off with the calgary flames winning the first stanley cup in their history in 1989.
“prostate cancer comes out of nowhere so that’s why it’s so important to make sure you keep getting tested. it doesn’t discriminate, it happens. here i am at 70, trying to make sure not only for myself, but for a whole lot of other people that it is so important to get tested.”
even these guys, mcdonald, clark, 57, and carbonneau, 63 – elite athletes in one of the toughest sports going – know that prostate health has to be on the radar. they’ll be attending nhl games in toronto, montreal and calgary to help promote awareness.
new ways to screen for prostate cancer
according to the canadian cancer society, the disease claims nearly 5,000 lives every year and one in eight men will develop it in their lifetime. the incidence of the disease increases with age and lifestyle choices. it’s most often diagnosed in men in their 60s. advances in screening and early detection are helping men with prostate cancer live longer, better lives. however, when the disease is diagnosed late and may have spread to other parts of the body, only three in 10 people are expected to survive five years.
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“it’s just so important that men get tested and have conversations with their doctors to make the best decisions,” mcdonald says, adding he wants to stay well and active for his kids and eight grandchildren, and one of the most “phenomenal” jobs he’s had after retiring from playing pro sport. he’s chaired the board of the hockey hall of fame since 2015.
generally, prostate testing is recommended for men from age 50, unless you’re considered at high risk of developing prostate cancer where testing earlier is advised at age 40 to 45. black men, including those of african or caribbean ancestry, and those with a family history of prostate cancer or family history of brca2 genetic mutation (also widely known for its role in breast cancer for women and men) are considered to be at higher risk.
screening involves a prostate specific antigen (psa) test that measures the level of psa in the blood. the prostation campaign is also spreading the word about new advanced testing methods. prostate-specific membrane antigen (psma) and positron emission tomography (pet) have been developed to detect cancer progression and spread across the body.
so, if you are diagnosed with prostate cancer, these improved imaging tools will help tailor treatments to your particular case.
“psa and psma are both important biomarkers to tell us different things related to prostate cancer and prostate health,” says dr. steven yip, a frontrunner in prostate cancer research in the country. he is a medical oncologist at the tom baker cancer centre in calgary, alta. and precision oncology and experimental therapeutics lead. yip is also a clinical associate professor at the university of calgary.
“psa is the prostate specific antigen that is detected through a blood test, and it’s for individuals who have been either screened or diagnosed for prostate cancer. it also helps track the disease, and tell us the way it’s behaving, the way it might potentially be progressing,” he says. “psma, which is a prostate-specific membrane antigen, is a protein that can be present on various cells, but it is over-expressed in prostate cancer.”
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with the advanced pet scan imaging technology, psma creates a fuller picture of the extent of disease and also detects earlier if prostate cancer comes back after previous treatment. while the backbone of treatment for prostate cancer and other cancers remains surgery, chemotherapy and radiation therapy, these approaches come with possible collateral damage to normal tissue. for example, you can end up with bowel and sexual problems.
yip points out a key advantage to psma is that it helps specialists identify patients who could benefit from targeted radiopharmaceutical therapies, a new class of drugs that deliver radiation therapy directly and specifically to cancer cells. the last several years have seen game-changing research and clinical trials testing new radiopharmaceuticals.
“the idea of precision oncology is trying to identify targets to understand the disease, so the right patient gets the right treatment at the right time. these special novel therapeutics are on that cutting edge of medicine in both diagnostics and treatment.”
men don’t like to talk about prostate cancer
but here’s the thing: though prostate cancer is a common diagnosis and medical advances are increasingly life-changing, prostate health is not something men like to talk about, experts agree. the prostate is in a delicate part of the body. what starts out as the size of a walnut enlarges naturally with age. it can become the size of a plum that potentially puts pressure on the urethra causing sexual difficulties or urinary incontinence.
“as guys, we don’t want to talk about stuff or we say, ‘i’ll handle it,’” says clark, a fan favourite in toronto where he captained the toronto maple leafs from 1991 to 1994 and is now a team ambassador at public events. “but we’re not doctors, so get tested so the people that are there to help you have a baseline to go from.”
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clark says he remembers retired nhl players who battled prostate cancer and beat it and recognizes that athletes are always aware of their bodies by profession and “the grind” of intense training and play.
“i was injured a lot, so you do get to know your body,” he says. “it was second nature as a pro athlete because that’s what you relied on is your body to play well, so it’s just carrying it forward to life in that as men, we have to get checked and stay on top of it. anything that you catch early with today’s technology is usually very treatable. but if you wait too long, it is very hard.”
statistics canada reports that just over two-thirds of the prostate cancer cases from 2010 to 2017 were diagnosed among men aged 55 to 74 years old. over half of the prostate cancers (51 per cent) were diagnosed at stage two, while 21 per cent were at stage one. the five-year net survival was close to 100 per cent for men diagnosed with prostate cancer at each of the first three stages, then it declined to 41.1 per cent at stage four.
early detection of prostate cancer is the key to survival
prostate cancer is one of the most survivable cancers because of its slow-moving progression. most are diagnosed when the cancer is only in the prostate. stage 4 prostate cancer happens when cancer spreads beyond the prostate to other parts of the body, like the bones, lymph nodes, adrenal gland, liver and lungs, making it more challenging to treat.
as the canadian cancer society also notes, 23 to 42 per cent of prostate cancers that are found with psa testing may never need to be treated. men can discuss the option for active surveillance, so no medications, radiation and surgery are used. it means periodic tests check for signs the cancer is growing. while this can be a mental strain, it avoids unnecessary treatments and surgery, and possible side effects of infection, erectile and bladder problems.
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“health is a priority for professional athletes who have to be in top shape and every little detail is important,” says carbonneau, who played until he was 40 years old and won the stanley cup with the montreal canadiens in 1985-1986 and then repeated the feat in 1992-1993 as team captain. “as a hockey player you don’t want to be in the stands, you want to be on the ice. sometimes it’s hard, sometimes it’s impossible,” he says. “i had both my hips done and i have screws in my shoulders. i broke a few bones. everybody plays with pain, it is what it is. that’s the beauty of sport.”
carbonneau lives in montreal where he is a tv commentator and analyst, and also serves on the board of the nhl alumni association where he gets to talk to retired players who, like everyone else, with aging are at increasing risk of developing prostate cancer. “at some point everyone is going to come across someone who has it,” he says.
when it comes to prostate cancer prevention, talking to your healthcare provider is a critical starting point. there’s also research that supports healthy eating and the benefits of regular physical exercise – that doesn’t have to be intense skating and stickhandling to get to the playoffs – for protection, as johns hopkins medicine notes.
carbonneau plays a lot of golf and cycles, including competing in road cycling races. clark works out in his home gym in muskoka doing cardio and weights three or four mornings a week, and mcdonald plays hockey with his older brother and friends in a league that used to be called the old-timers but now is referred to as “legends” which mcdonald says has a much nicer ring to it.
as clark sees it, “it’s not so much about being in perfect shape, because none of us are, but keep everything active and you’ll feel better. as we age, everything kind of falls asleep, so we have to wake it up. the big thing is being proactive about your health.”
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to learn more about prostate cancer, visit the canadian cancer society.
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