Transcript Prostate Cancer The Holistic Approach 26th Congress SIU

Management of
Senior Adults with
Prostate Cancer
Patients’ Perspectives
Louis Denis - Europa Uomo
Milan, 27.03.08
Cancer Facts for the Senior Adult
Male
• The scare is there:
BPH symptoms labeled as PCa
Patient Scaring Antigen
Peak incidence PCa 70 & death 76 y.
• Co-morbidity is a fact of life: CVD, lung,
diabetes + 50%
Milan, 27.03.08
Cancer Diagnosis
• Is still seen as a death sentence by
patient and doctor alike.
• The doctor wants to cure by optimal,
medical treatment.
• The patients wants cure but also
holistic care with quality of life.
Milan, 27.03.08
The PCa Conundrum
• The PCa trinity:
– 1/3 latent, indolent no treatment
(overdetection – overtreatment)
– 1/3 long medical history of 15 years
– 1/3 a lethal disease
(underdetection – undertreatment)
Milan, 27.03.08
The lost patient
Tsunami information
(Professionals, media, friends)
Outcome results
Statistics
PANIC
Loss of personality
The medical
labyrinth
EBM Guidelines
Nomograms
Milan, 27.03.08
Treatment Senior Adult Men
• Few if any clear guidelines mainly for
curative attempt.
• Age is taken as a cut-off for treatment
rather than health status.
• Cancer control is acceptable for
survival and quality of life.
Milan, 27.03.08
Europa Uomo stands for
1. Develop individualized prostate
cancer treatment based on optimal
medical treatment and personalized
cancer care.
2. Help reduce overtreatment in indolent
cancer.
3. Help reduce undertreatment in lethal
disease.
Milan, 27.03.08
Solving the Problem in the Senior
Adult Males
1. Clear distinction into low risk and high
risk prostate cancer.
2. Treatment selection on health status and
life expectancy.
3. Effective, palliative chemotherapy is not
the end but the beginning where hope is
key to the balance of treatment vs. care.
Milan, 27.03.08