Special Edition: Get Checked Update from The Prostate Conditions Education Council

Get Checked Update

Prostate Conditions Education Council

October 2010

PCEC is pleased to release a
Policy Position on Detection and Treatment Guidelines

Prostate cancer is the second leading cause of cancer death in American men; and, unfortunately, controversies around early detection and treatment guidelines are on the rise.

Over the past few years, new research regarding the value of prostate cancer screening via the Prostate Specific Antigen (PSA) test has raised questions about the PSA's true impact on prostate cancer diagnosis, treatment and survival. However, these studies have produced conflicting results, leaving consumers and healthcare professionals confused about their application.

Studies that show a screening benefit:
The European Randomized Study for Prostate Cancer (ERSPC) showed a 20% reduction in prostate cancer mortality in men who underwent routine screening.

The Swedish Goteborg study confirmed a mortality benefit with a 50% reduction in prostate cancer mortality in men 50-64 who received routine prostate cancer screening.

Studies that show no screening benefit:
The National Cancer Institute (NCI)-led Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) study reported no mortality benefit.

The unclear and inconsistent interpretation of these studies creates confusion about prostate cancer screening. Many men are unclear about whether they should be screened, what the risks are, if biopsies and treatment are necessary and even the seriousness of the disease.

Beyond the survey debate, there is a lack of clearly defined treatment guidelines for men diagnosed with prostate cancer. Currently, men must consider and choose from a variety of treatment options including watchful waiting, radiation, and surgery or hormone therapy. Choosing the appropriate treatment method depends on a man's age, general health and willingness to deal with side-effects. Unfortunately, there is very little long-term data comparing treatment methods and identifying the best treatment practices for individuals.

Tools to Improve Early Detection and Treatment Guidelines
Given the current environment, new tools are necessary to provide clarity around how and when detection and treatment are best used. The following mechanisms can lead to a better understanding of the issues around early detection and treatment guidelines.

Research Funding - new research is needed to explore the value of existing diagnostic tests and treatments. Additionally, there is a strong need for new and improved diagnostic tests and treatments. Research can help shed light on which treatments are best for which tumor and for which patients. However, none of this will be possible without designated funding.

Screening Access & Coverage - detection of prostate cancer at an early stage offers the best opportunity for successful treatment and, until better tests are identified, it is important for men to have continued access to screening methods like digital rectal exam and PSA tests.

Prostate Health Quality Measures - measures are a way to find out which healthcare services are likely to result in the desired health outcome. Evidence-based measures, as well as the public reporting of a health center's adherence to the measures, can lead to a better understanding of what the most effective treatment is, as well as an assurance that all men are receiving the right care.

PCEC's Position on Detection & Treatment Guidelines
PCEC supports initiatives and programs designed to improve early detection and treatment that are consistent with the following principles:

1.    Until a more accurate and reliable diagnostic tool exists, the PSA test should remain accessible to all men and they should be encouraged to know their PSA level.

2.    Over-diagnosis and over-treatment of prostate conditions should be addressed through the development of more accurate and reliable prostate condition diagnostic tests, as well as greater doctor-patient communication regarding appropriate diagnostic options and treatments to determine the right action based on the patient.

3.    There is a need for nationally-recognized quality measures that will encourage uniformity of the diagnosis and treatment of prostate conditions.

Based on these principles, PCEC supports and encourages:

1.    Financial reimbursement and free or low-cost access to baseline PSA testing (and subsequent testing and treatment, as appropriate for all men starting at 40 years of age and at 35 for men at high risk for the disease).
·      PCEC supports coverage for annual screening for prostate cancer through Medicare and private insurance starting at age 40
·      PCEC supports provisions regarding guaranteed coverage for patients that are enrolled in clinical trials provided for within the Patient Protection and Affordable Care Act

2.    Increased funds to Centers for Medicare & Medicaid Services (CMS), Department of Defense (DoD) and that National Institutes of Health (NIH) to invest in prostate cancer screening and treatment studies.
·      PCEC supports the inclusion of prostate cancer diagnostic and treatment research and comparative effectiveness studies by the Patient Centered Outcomes Research Institute as provided for within the Patient Protection and Affordable Care Act.

3.    The development of evidence-based quality measures certified by the Agency for Healthcare Research & Quality (AHRQ) that will dictate appropriate prostate health management by a primary physicians, urologists and/or oncologists as well as patient-friendly language to be shared with patients and their families to increase understanding of the care that they should be receiving.

Conclusion
PCEC is aware of the complexities associated with the ongoing debate around prostate cancer screening and treatment guidelines, but believes more research is critical to improving patient care for men with prostate cancer. We also believe the landscape of detection and treatment guidelines, as discussed above, can and will be improved to better address the needs of patients and their caregivers. We look forward to opportunities to support these mechanisms as they are put into practice.

Prostate Cancer Awareness Week 2010
A Huge Success!

Prostate Cancer Awareness Week is just wrapping up and we wish to thank all of the hospitals, clinics, physician's, nurses, coordinators and countless volunteers, for all of your hard work and dedication. Thanks to all of you for making Prostate Cancer Awareness Week a tremendous success this year!!!!! It's never too early to start planning for September 18 -24, 2011 (PCAW 2011), so please contact PCEC for help planning your next Prostate Health Screening Event!

Set the Pace!

SET the PACE this fall for your health! With great success, PCEC hosted the 1st Annual SET the PACE Race for Prostate Cancer in Denver, CO. With community support we ran, walked and jogged for prostate cancer and made quite an impact on Denver. Join us as we continue our efforts and raise awareness and education across the nation at the fall PACE Race's:
To register visit: http://www.pacerace.org

SET the PACE
2010 Dates

PACE Race for Prostate Cancer    Kirkland, WA              October 10th
The F.A.S.T PACE Race                Cumming GA   October 23rd
PACE Race                                    Kirkland, WA              October 10th
Run For All Ages                            Boston, MA                November 6th
US Half Marathon                           San Francisco, CA    November 7th
Founders' Day                                Orlando, FL               November 14th

For more information please visit us at http://www.pacerace.org