On Tuesday 12 November a new campaign "Let’s talk prostate cancer" was launched. An EU multi-stakeholder expert group on prostate cancer came together to set out recommendations on how the care for people affected by prostate cancer across Europe can be improved.
“My life has changed in unimaginable ways since being diagnosed as a prostate cancer patient”, explained Robert Greene from the European Cancer Patient Coalition (ECPC) during his speech at the launch of the ‘Let’s Talk Prostate Cancer campaign’. Despite catching prostate cancer at an early stage, and with a positive diagnosis of the condition being manageable for the time being, Greene still finds life is full of ‘what ifs’. What if his recent MRI scan reveals progression of the disease? What if he suddenly suffers from sexual dysfunction or loss of libido? What if he becomes incontinent?
These sorts of questions are rarely openly discussed in EU policy forums. Compared to cancers such as lung, colorectal, cervix or breast cancer, prostate cancer is relatively low down the political and policy agendas in the EU and its member states.
That is why Astellas asked a number of experts on prostate cancer to join together to formulate a policy platform to talk openly about prostate cancer, with a focus on advanced prostate cancer, and to develop some recommendations to the EU.
In the European Union over 2 million people are living with prostate cancer, the most frequently diagnosed cancer in men. More men die from prostate cancer than women from breast cancer and, in men, prostate cancer mortality ranks second after lung, and before colorectal cancer. Around 450,000 new cases were diagnosed in Europe in 2018, compared to an estimated 345,000 in 2012. Each year, prostate cancer accounts to around 25% of all new cancers and 10% of male cancer deaths, with over 107,000 people estimated to have died from the disease in 2018.
Unfortunately, prostate cancer is increasingly diagnosed at an advanced stage with studies showing an increasing proportion of individuals diagnosed with metastatic or late stage disease. Given the decrease in quality of life especially in later stages of the disease, it is crucial that the needs of people with prostate cancer are addressed at the earliest opportunity.
Prof. Hein Van Poppel was invited to present the new campaign and used his talk to stress the necessity of screening programmes. Although the early stages of the disease are without symptoms, PSA testing can be used in parallel with a number of clinical tools to diagnose prostate cancer early and at a manageable stage. The EAU has gold standard clinical guidelines on PSA testing agreed by all 28 EU member states and beyond. However, instead of using this tool, EU member states are using PSA less, leading to a worrying trend of men being diagnosed with advanced stage prostate cancer becoming the norm.
Prof. Van Poppel blamed the rise in men being diagnosed with advanced stage prostate cancer on the ‘propaganda’ against PSA testing. The criticism on PSA testing has been focused on the problems with over-treatment, which, although having been a problem 20 years ago, are no longer inhibitors due to the combined use of new diagnostic tools, such as multiparametric MRI and active surveillance strategies. Van Poppel warned that less PSA screening will inevitably lead to higher numbers of patients that need to be treated for advanced an metastatic disease in the years to come.
Hopefully, with implementation of well-structured screening programmes these numbers and the prostate cancer mortality will come down dramatically.
The ‘Let’s Talk Prostate Cancer’ initiative was introduced by Tiemo Wölken who is the MEP leading this campaign. He said: “As one of the most pressing health issues of our time, the fight against cancer unites us all – no matter where we live or what language we speak.” In the next mandate of the European Commission, the EU Health Commissioner, Stella Kyriakides has been tasked with drawing together a European plan to beat cancer. The EAU will be working tirelessly to ensure that prostate cancer gets the prioritisation and attention it deserves.