Transcript Christian Ligensa

Access to Care for
Prostate Cancer Patients
A Patient`s Perspective
Some Myths
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Only a few old men are affected
No - It affects 190,000 men and kills 75,000 in Europe per
year.
It is not a social problem
Yes it is - 80% of the men in their 80s have Prostate Cancer,
the detected incidents are increasing due to PSA-Tests
It is only an old men`s disease
No - Prostate Cancer has been known to affect men even in the 30
- 40 age group, the death rate is higher among younger men still
productive in the economy
There are only Surgery, Radiation or Wait and See available
No - Increasing evidence for hormonal therapy supports a new
role in treatment of Prostate Cancer or Active Surveillance
Prostate cancer needs to be cured
No - you can live and die with prostate cancer, not from it
Urologists have a clear perception what to do
No - No real consensus on diagnosis and treatment - until now…..
THE PALETTE OF TREATMENTS HAS
MANY COLOURS
CHEMODRUGS PHYSICAL
HORMONES
AGENTS
HIFU
CRYO
RADIATION
W.W.
EBRXT BRACHY
SURGERY
LAPAROSCOPIC
OPEN
The Doctor‘s Consultation
I
can offer you three options, like a
manu in a restaurant :
 Radical prostatectomy
 Radiation Therapy.
 Watchful Waiting
You have to decide
Consequences:
Anxiety and Insecurity
Doctors !
Audio Visual Media
Print Media
Experimental Therapies
Complementary Therapies
Congresses
Alternative Therapies
PCa Support Goups
PC-SPES
Savior
Psycho Market
Internet
The Patient
in the middle of a field of
tensions and stress
due to too many and
overwhelming
information sources
How Men Use Tools
The one who has,
very often can see only nails.
The one who has
will…
The one who has a linear accelerator
wants to ...
In the middle of an emergency
situation the patient becomes a
customer, the target of high
efficient salesmen!
He realises that there are information und
communication problems and that there is an
asymmetric communication
with those whom he turned to for help.
The only way out is he has is to become an
empowered patient
Reality in Europe
PCa is a European Health Problem
and a Social Disgrace
- Low public awareness
- Low government priority
- Difference outcomes rich vs poor.
- Gap between knowledge and real care
- Effective Medication (Hormone Treatment
and/or Chemo) not available in all countries
- Potentially curable, but certainly treatable if
diagnosed early enough.
- Early detection (PSA-Test) strongly criticised
- Gap between prevention/treatment.
Partially from OCA, 2003
I had a dream
The Expedition into the Future of
Urology
Interdisciplinary Network
The Crew:
Patient – Urologist –Oncologist -Radiation Specialist - General
Practicioner - ……
M.D
Clinics,
Universities
Health Ins.
Patient
Industry
Cancer Societiest
Politics
Research
We, the Patients call on you,
the Politicians
Each patient should have the right
 to receive an interdisciplinary consultation in
a centre of competence
 to have the chance to receive his individually
preferenced primary therapy
 to receive the best therapy without a
dependency of his personal budget
 to be taken care of on a humanitarian basis,
not by medical sales men