PCRI: Prostate Oncology for the Masses

BY MARK SCHOLZ, MD

Dr. Steven Strum and I, medical oncologists who specialize in prostate cancer, founded the Prostate Cancer Research Institute (PCRI) in 1996. I still support the PCRI by donating my services as Executive Director. Through its conferences, helpline, newsletter and website, PCRI helps patients learn about optimal prostate cancer therapy.

Why is the PCRI important? “Modern” prostate cancer treatment, which is inherently biased toward surgery, is actually a throwback to the past. Prostate cancer is the last remaining type of cancer to have surgeons (urologists) directing care. Thirty years ago, because surgery was the only type of treatment available, cancers­ such as breast, colon, lung, pancreas and bone, for example, were supervised by surgeons. Now, every cancer (except for prostate cancer) is handled by medical oncologists—cancer specialists trained in a multimodality approach.  “Multimodality” means that all treatments (or treatment combinations) get equal consideration. Medical oncologists are trained to tailor therapy to the individual characteristics of each patient’s disease.

The problem is there are less than 100 prostate oncologists in the United States to serve more than three million prostate cancer survivors. That works out to a ridiculous ratio of 30,000 patients per prostate oncologist. To give you an idea of what a manageable patient-to-doctor ratio would be, at Prostate Oncology Specialists where I work with two other full time prostate oncologists, we have 1,600 active patients, a little more than 500 patients per oncologist.

Is prostate cancer an unusually simple cancer to manage?  No. It’s actually quite complex. What we term “prostate cancer” varies between extremes. There are low-grade forms that can be safely monitored; more serious types that require combinations of radiation and hormones; and “in-between” types that defy easy answers.  For men with the advanced, metastatic type of prostate cancer, the FDA has approved four new treatments in the last two years, more than I have seen in my last 20 years as a prostate oncologist.  Sequencing, timing, and combining these new treatments require skills few surgeons have time to master.

Sadly, simply providing up to date and accurate information to patients is not enough. Prostate cancer is not only complex, it is emotional. Patients and their families are all too often so frightened they need to be “talked down” from their emotionally charged state with professional support and encouragement. They can’t even begin to analyze their situation clearly until they calm down.

Also, when suddenly diagnosed with prostate cancer, many men have serious misconceptions that even professionals struggle to counteract. Three fallacies make men easy prey to a “just cut it out” mentality. First, men logically assume prostate cancer is just as dangerous as other cancers (see my October2012 blog, “The Un-Cancer”).  Second, men think the doctor who did their biopsy, their urologist, is a cancer expert. Third, they believe they need to make a quick decision before the cancer spreads. These mistaken beliefs mean men are at a severe disadvantage when seeking the truth.

PCRI tries to counter these problems by providing expert “one on one” support thorough its helpline and the online Blue Community. The PCRI has also recently initiated a new Mentor Program providing in-depth education for leaders of support groups.  We want everyone to understand their situation from the perspective of a prostate oncologist.  However, the magnitude of the task is daunting.  Every year almost a quarter of a million men— 650 men daily—get the shocking news that they have prostate cancer.

Even though this is my 17^th year serving the PCRI and the prostate cancer community, I am more energized, more focused and more determined than ever to make sure men with prostate cancer have the opportunity to get the best possible treatment.

However, the PCRI mission always needs financial support. PCRI heavily utilizes graphics, editing, internet and video to fulfill its mission. We also have expenses for bookkeeping, fundraising and grant writing. Every year PCRI undergoes a stringent “GAP” audit, documenting that more than 90% of dollars donated go to fund programs while less than 10% go to administrative or fundraising expenses.

If you are in a position to support the PCRI mission, your help would be greatly appreciated. Every donation increases our ability to get out much needed information to the prostate cancer community.