The PCRI Conference: Standing in the Gap in a Woeful Medical Situation

MARK SCHOLZ, MD

September is prostate cancer awareness month. Every year the PCRI hosts a three-day educational symposium for patients.  “For patients?”  But people always ask, “What about doctors?”

In the cancer world, prostate cancer is the last bastion of surgeons (urologists).  Surgeons, as it happens, are the primary supervisors of this, the most common type of cancer in men.  Thirty years ago all cancers were managed by surgeons because back then surgery was the only available treatment. While the true cancer specialists of today—medical oncologists—have assumed primary responsibility for every other type of cancer, urologists continue to take primary responsibility of caring for men with prostate cancer.

Therefore surgeons tenaciously hang on to the “way it has always been done,” even though surgery is usually the least effective way to treat prostate cancer. In fact, despite tremendous improvement in other methods of treatment, the reliance on traditional surgery has been on the rise.  The excitement surrounding robotic surgery is probably the reason for the increase. Sadly, numerous scientific studies showing that older surgical techniques work just as well have not changed urologists’ minds.

The theme of this year’s PCRI conference—Quality of Life—naturally emphasizes alternatives to surgery.  Active surveillance, seed implants, IMRT and focal therapy all have survival rates at least as good as surgery, but with far fewer side effects.

This year the conference will feature its very first celebrity—actor Ryan O’Neal.  Mr. O’Neal had such excellent results from his focal therapy that he has volunteered to attend the conference and share his experience.  His story will be featured in the next issue of PCRI Insights which should hit the stands next week.  PCRI Insights is a free quarterly newsletter published by the PCRI.  You can sign up at the PCRI website and have it emailed to you.

Back to the question, “Why patients?”  Basically, Dr. Stephen Strum and I founded the PCRI to educate patients because unlike the surgeons, patients are highly motivated to learn and embrace new options in therapy, especially when the new therapy can convincingly be shown to be equally effective and less toxic.  A patient-orientated approach has proven successful, and the popularity of the conference continues unabated.

So far I have only been commenting on treatment issues related to the newly-diagnosed men with early stage disease. What about men with advanced disease?  Believe it or not urologists are still managing the majority of men with advanced disease, even when metastases are present, and despite the fact that in the last few years  five new products—all of which are proven to prolong life—have been approved for use by the FDA to treat advanced prostate cancer.

Do urologists know how to administer these new treatments?  Are they even aware of them? The complexity of managing advanced prostate cancer has increased exponentially due to the availability of these new treatment options.  The question is: How can urologists, who typically manage prostate cancer in their spare time, keep up with all these new developments when they also have to treat so many other serious issues—kidney stones, urinary incontinence, erectile dysfunction, kidney cancer, bladder cancer, testicular problems, urinary infections—in addition to the time they spend in the operating room  performing various types of surgery?

I would suggest that it is not safe to abdicate your health choices to a urologist. To inform yourself about your options, plan to attend the PCRI Conference on September 6^th, 7^th & 8^th at the LAX Marriott.  Tickets can be purchased on line at PCRI.org.