Prostate cancer in America today: what should be top of mind?

For the patient who has prostate cancer, and for his family, things are very personal. These patients have important clinical needs that we must try to meet. But when we talk about prostate cancer more generally — to our friends, to our family members, to our state and federal legislators and public health officials, it is critically important that we all try to focus on some simple and general messages that convey priorities that will lead to: earlier detection of clinically significant disease, focused research that will permit the development of better therapies soon, and access issues that will ensure that all men can get good quality care as and when it is needed.

America’s Prostate Cancer Organizations have just finalized a series of key talking points that we hope will be helpful to a wide range of people in talking about prostate cancer. They relate most specifically to the legislative agenda outlined in a media release on April 6, 2009, but they are also simple statements that anyone can use to explain “where we are” today with regard to the state of prostate cancer care and research.

The simple facts are as follows:

  • Prostate cancer is a complex and problematic disease that affects not only the male patient but also his wife or partner and other family members over many years.
  • Each year about 28,000 Americans die from prostate cancer — often a slow and painful death as the cancer spreads to their bones and other organs. (Only lung cancer causes more cancer-related deaths in American men each year.)
  • In addition, every year, up to 70,000 men learn that they have potentially incurable forms of prostate cancer that severely impact quality of life and may lead to their deaths.
  • By 2020 the number of men being diagnosed with prostate cancer may be as high as 320,000 per year because of aging-related demographics of the American population.
  • African-American men have one of the very highest rates of incidence and death from prostate cancer anywhere in the world. They are 1.6 times as likely to be diagnosed with prostate cancer and 2.4 times as likely to die of this disease as (non-Hispanic) Caucasian-American men.
  • In nearly every state in America, men who are un- or under-insured are at very high risk for diagnosis of advanced or late-stage prostate cancer.
  • Despite recent data and media coverage about PSA testing and prostate cancer mortality, the early detection and appropriate treatment of clinically significant prostate cancer remains a critical priority, especially among men at high risk because of family history, ethnicity, or other factors that define such risk.
  • We urgently need better tests for early stage prostate cancer – tests that can discriminate between potentially aggressive cancers that need prompt treatment and indolent cancers that can potentially be managed with non-invasive treatments.
  • Continuing innovation is imperative if we are to meet the urgent need for treatments that can save the lives and prevent the progression of this disease in men with aggressive and advanced forms of prostate cancer.
    • No form of treatment has ever been shown to extend the survival of patients with advanced forms of prostate cancer by more than a few months.
  • Every man has the right to know whether he is at risk for clinically significant prostate cancer that might lead to his death.
  • Regardless of his age, every man should discuss his individual risk for prostate cancer with his doctor (i.e., his primary care physician and/or his urologist), and request the appropriate use of PSA and DRE tests until better options are available.
    • Guidance issued by the American Urological Association in April 2009 (a) emphasizes that “The decision to use PSA for the early detection of prostate cancer should be individualized” and (b) suggests a “baseline” PSA test for well-informed men at age 40.
    • Many other professional organizations, as well as the American Cancer Society, encourage discussion about PSA testing between a man and his doctor(s).

The above talking points have been approved by and are issued on behalf of America’s Prostate Cancer Organizations:

About America’s Prostate Cancer Organizations: Prostate cancer is the most prevalent form of cancer among American males. This group of independent, not-for-profit organizations cooperates to foster the development of policies that support the early detection of clinically significant prostate cancer, the effective treatment of men with this disease, and the appropriate education of all men at risk for this disease.

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