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The Prostate Cancer Continuum. The Changing Face of Disparity: Taking Health into Our Own Hands. The real voyage of discovery consists not in seeking new landscapes but in having new eyes. - Marcel Proust. Pca is a Global Concern.

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The prostate cancer continuum l.jpg
The Prostate Cancer Continuum

  • The Changing Face of Disparity:Taking Health into Our Own Hands


The real voyage of discovery consists not in seeking new landscapes but in having new eyes l.jpg

The real voyage of discovery consists not in seeking new landscapes but in having new eyes.

- Marcel Proust


Pca is a global concern l.jpg
Pca is a Global Concern landscapes but in having new eyes.

  • Highest incidence of male cancer in U.S.; 2nd greatest cause of death; declining overall but increasing in minority populations(2)

  • #1 diagnosed cancer in Europe; deaths have increased by 16% since 1995(1) ”despite widespread use of PSA testing...”

    • Sources: (1) World Health Organization; (2) American Cancer Society


Why we must be concerned l.jpg
Why We Must Be Concerned landscapes but in having new eyes.

  • 1 in every 6 men get Prostate Cancer

  • 1 in every 4 Black men get Prostate Cancer

  • Latinos have the 3rd highest incidence rate

  • Blacks and Latinos are diagnosed at advanced disease stages at a 144% greater rate than whites

  • The 5 year survival rate for Blacks and Latinos is worse than for whites and getting worse

  • Black men die at a rate 240% higher than whites


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National Healthcare Quality Report - 2007 landscapes but in having new eyes.

  • “Preventive healthcare lags significantly behind other gains in healthcare.”

  • Access to care and information varied widely between racial/ethnic groups and by socio-economic status

    • Source: www.ahrq.gov


Healthcare costs represent an increasing of gdp 650b more for cancer treatment l.jpg
Healthcare Costs represent an increasing % of GDP landscapes but in having new eyes.- $650B more for Cancer Treatment


U s world s best medical care new york times 12 august 2007 l.jpg
U.S. - World’s Best Medical Care? landscapes but in having new eyes. - New York Times, 12 August 2007

  • 37th in W.H.O. health system performance (France #1, Italy #2)

  • Last in overall quality: lack of coordination of care/access for preventive and critically ill

  • Only major industrialized country without universal health coverage

  • Life expectancies near the bottom of other industrialized nations

  • Worst Infant Mortality stats of any developed nation

    • Sources: Commonwealth Fund, Centers for Disease Control, W.H.O.


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Exacerbating the Problem landscapes but in having new eyes.

  • Increasing employee cost burden

  • Regulations on employers => increasing costs => decreasing competitiveness

  • Insurance compensation standards

  • Medicare reimbursement changes


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American Cancer Society Disparity Study - 2007 landscapes but in having new eyes.

  • Cancer patients with private insurance are much more likely to be diagnosed early, increasing their long-term survival

  • Those uninsured patients or those with Government insurance are more likely to be diagnosed with advanced stage disease at first treatment


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“Baby Boom” Impact landscapes but in having new eyes.

Estimated Per Capita Health Expenditures

by Age and Sex, 1995


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Service Provider Impact landscapes but in having new eyes.

  • Continuing nurse shortage

  • Resistance to greater use of nurse practitioners

  • Decline in doctors entering into Primary Care Medicine

  • Resistance to “Convenient Care” clinics


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Population Impacts landscapes but in having new eyes.

  • 12 million cancer survivors alive in the U.S. today

  • 3 out of 4 American families will have a family member diagnosed with cancer

  • 25% of American families living with cancer have children under the age of 18 living at home

  • More than 28% of children in America will be living in poor households

    • Sources: American Cancer Society, Institute of Medicine, World Health Organization, The Policy Press


Treatment impact l.jpg
Treatment Impact landscapes but in having new eyes.

  • Skeletal impacts of ADT

  • Cardiovascular issues related to hormone therapy

  • Conflicting preventive therapeutic recommendations

    • SELECT

    • Finasteride

    • PLCO Study

  • Emerging technologies with minimal curative benefit

  • Positive benefit of drug therapies

    • Targeted disease management


  • Lifestyle impact l.jpg
    Lifestyle Impact landscapes but in having new eyes.

    • Meat becoming more popular in diets globally

      • 10.4% in the U.S.

      • 25% more in Korea

      • 49.7% in China

      • >2% in India

  • Higher birth weights in emerging countries

    • strong cancer association

      • Sources: Food & Agriculture Organization of the United Nations, AICR


  • Business of medicine l.jpg
    Business of Medicine landscapes but in having new eyes.

    • The System often has other issues:

      • Equipment investment

      • Revenue production

      • Pharmaceutical alliances

      • Pay-for-Performance

    • Patients MUST become their own advocates


    Complicating the issue l.jpg
    Complicating the Issue landscapes but in having new eyes.

    • Women vs. Men

      • Comparable incidence and mortality

      • Research funds - 3X for breast cancer

      • Public health staffing - inconsistent

      • Government commitment - no agencies

      • Media focus - inordinately female focus

      • Men don’t communicate


    Why prostate cancer prevention l.jpg
    Why Prostate Cancer Prevention? landscapes but in having new eyes.

    • Significant public health risk

      • 186,000 new cases and 29,000 deaths yearly (2008)

    • Risk factors (age, race, genes) are not modifiable

    • Benefit of screening on mortality is controversial

    • Therapy is associated with morbidity

      That Leaves Prevention


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    Phase III Chemoprevention Trials landscapes but in having new eyes.

    RRR = 22.5%

    RRR = 23.5%

    PCPT

    REDUCE


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    5ARIs for Biochemical Recurrence landscapes but in having new eyes.

    Andriole et al, Urology 45:491, 1995


    Pcpt and reduce what did we learn l.jpg
    PCPT and REDUCE landscapes but in having new eyes.What did we learn?

    • Consistency of effect

    • Similar magnitude of risk reduction across all risk groups

    • No longer any grade issues

    • Conclusion

      • Use of 5-alpha reductase inhibitors is an effective primary prevention strategy


    Healthcare disparity l.jpg
    Healthcare Disparity landscapes but in having new eyes.

    • Disaffected classes

      • racial/ethnic minorities

      • high risk populations

  • Socio-economic impact

    • lack of/limited insurance

    • breaking the “social contract”

  • Equal Access:

    • education

    • preventive mechanisms

    • care


  • Slide22 l.jpg

    Moving the Bar Forward: landscapes but in having new eyes.

    Success Stories and Templates for Change


    Technology for change l.jpg
    Technology for Change landscapes but in having new eyes.

    • 71% of the people in North America are online

    • 113 million Americans seek health information online

    • Almost half of adult users and 84% of teens will be on social sites

    • 40% of self-classified “non-users” became direct or indirect users after a cancer diagnosis

      • Sources: Internet World Stats, Pew Internet & American Life Project


    Social network integration l.jpg
    Social Network Integration landscapes but in having new eyes.

    • Credible peer-to-peer communications

      • “New” Prostate Cancer Infolink

      • “Pints for Prostate”

      • Prostate Cancer Internet Alliance

      • FaceBook


    Slide26 l.jpg

    Opciones de Tratamiento landscapes but in having new eyes.

    Investigación Traslacional

    Toma de Decisión Informada

    Hormonas

    Gleason 7: ¿Una Nueva Categoría de Riesgo?

    Diagnósticos

    Terapia Citotóxica

    ¿Está considerando un Ensayo Clínico?

    Quimioterapia

    Medicina Alternativa / Complementaria

    Espera Alerta

    Terapias de Ataque

    Soluciones Quirúrgicas

    Manejo de Efectos Colaterales

    Soluciones Oncológicas de la Radiación

    Cuidado Paliativo

    Manejo del Dolor

    Fuentes de Información

    Servicios de asistencia pacientes

    Este sitio se ha producido con la ayuda de la familia de Roberto "Tito" Warat y una concesión educativa de la oncología de Sanofi-Aventis


    Reinforcing the message l.jpg
    Reinforcing the Message landscapes but in having new eyes.

    • “In The Know” newsletter

    • Hard Copy - 29M circulation

    • Online supplement - > 100M

    • Broad spectrum content

    • Audience diversification

      • consumers/patients

      • advocates

      • professionals

      • researchers

      • international


    Media syndication l.jpg
    Media Syndication landscapes but in having new eyes.

    • Mass impressions

    • Minimal cost

    • Increase reach


    Slide29 l.jpg

    PodCasting for Health landscapes but in having new eyes.

    • Reinforce the print message

    • Portability for consumers

    • Viability for diverse situations:

    • personal

    • public health

    • clinical

    • research


    Slide30 l.jpg

    Cell Casting for Health landscapes but in having new eyes.

    • Enhanced consumer interactivity

    • Opt-in network

    • 1.877.2CHECKNOW

    • Customized content

    • Applications for:

    • clinicians

    • researchers

    • public health


    Going to the barbershop empowering communities through risk communication l.jpg
    Going to the Barbershop: landscapes but in having new eyes.Empowering Communities Through Risk Communication


    Barbershop based health awareness initiative l.jpg
    Barbershop based Health Awareness Initiative landscapes but in having new eyes.

    • Project BHAI (Brother):

      • 48 shops in Jharkhand and Orissa Provinces - India

      • cancer prevention and tobacco control

        • enhance knowledge

        • enhance healthy behavior

        • create a sustainable environment

        • build on existing networks and partnerships

        • expand to co-morbid disease


    Research partnerships l.jpg
    Research Partnerships landscapes but in having new eyes.


    Creating a new network l.jpg
    Creating a New Network landscapes but in having new eyes.

    The Prostate Net

    Core Distribution:

    80,000+ Website visits/month

    1,200 Patient Support Group Leaders

    1,000+ Public Health Workers

    ~ 6,000 Medical Oncologists

    > 4,000 Urological Specialists

    > 2,000 Cancer Researchers

    American/National

    Medical

    Ass’ns.

    > 5,000 Doctors

    Sponsors

    Participating

    Medical/Research

    Centers

    > 300

    National Ass’n.

    of Barber Boards

    of America

    ~ 200,000 Barbers

    Community


    Create heroes l.jpg
    Create Heroes landscapes but in having new eyes.

    • Meet James

    • He came to a Health Fair

    • On HIS BIRTHDAY!!

    • To give himself The Gift of Life!!

    • Warren brought his son to a Pca screening

    • To educate him about being responsible for his health


    Slide38 l.jpg

    Why is all this needed?! landscapes but in having new eyes.

    To Eliminate the Suffering and Death from Cancer

    “If You’re Not the Lead Dog, the View Never Changes”

    - Mike Ditka


    Thank you l.jpg
    Thank You! landscapes but in having new eyes.

    WWW.THEPROSTATENET.ORG

    1.888.477.6763


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