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Prostate Cancer Coalition of NC
A statewide collaborative effort by concerned organizations and individuals to
support awareness, early detection, and “best practices” care for men who are,
or will someday be, prostate cancer survivors.
www.pccnc.org
Learning Objectives
1.
Risk benefit discussion
2.
Screening and prostate health
3.
Early detection to support clinical treatment
guidelines for patients that opt to screen
4.
Tools to support informed pre-treatment
consult for your patients
Risk Benefit Discussion

Risk Assessment
Physical Exam & Baseline PSA
 Careful review of personal health and
family history


A Thorough Understanding of the
Diagnostic and Decision Making
Process
Risks


Screening can help identify, but is not specific
to, prostate cancer.
65% of elevated PSA is caused by:





other prostate health conditions
activity known to artificially elevate PSA
Screening can be normal even when a man has
prostate cancer.
Abnormal screening is NOT a cancer diagnosis.
Every man diagnosed with prostate cancer
should know to consider personal health,
priorities, and how aggressive his cancer is prior
to evaluating treatment options.
Benefits

Can help identify several non-cancerous
conditions.

can become uncomfortable if left untreated

Only known method of detecting prostate
cancer during its early stages.

Better options, and often more time to
research and consider those options.
Evidence Based Healthcare
Best
Research
Evidence
Clinical
Expertise
Patient
Values
Johns Hopkins/ Cochrane Collaboration course, "Understanding evidence-based healthcare: A foundation for action."
PCP Clinical Practice Guidelines



Reflect NCCN guidelines
applicable in a primary
care setting
A convenient, evidencebased reference for
evaluating screening
results
Reviewed and supported
by NC’s 3 National Cancer
Institute (NCI)-designated
Cancer Centers (Duke,
UNC, and Wake Forest)
Referral Discussion Guide


Reflects American
Urological
Association “best
practices”
guidelines for
follow up
Facilitates patient’s
ongoing education
and shared
decision making
Newly Diagnosed Tutorial
Helps patient understand prognostic
factors at diagnosis
Supports patient involvement and
a multidisciplinary analysis of
treatment options
Localized Pilot Program

Radiation
Oncology

Patient
Urology
Medical
Oncology
Multi-disciplinary
consultation
encouraged and
supported
Forms to support
multi-institutional
collaboration
Collaborate to Provide Leading Edge
Research and the Best Possible Care for
those Affected by this Disease

Radiation
Oncology

Patient
Urology
Medical
Oncology
Difficult cases
discussed at local
GU tumor board
When necessary,
engage with
academic centers
Moving Forward: Goals
Reduce the prostate cancer death
rate
 Continue to address gaps in patient
education
 Support personalized care
 Facilitate informed / shared decision
making

Conclusion: practical strategy




Avoid under-detection of aggressive/
potentially fatal cancers
Manage over-detection with the guidance
of modern clinical treatment guidelines
Empower patients to be actively involved
in treatment choice
Primary care physicians, urologists and
oncologists work together