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Home » EU Health, Health, Healthcare Policy, Prostate Cancer

Integrating patient preference into treatment decisions prove crucial

Submitted by on 14 Jul 2017 – 09:25

Director of the European Cancer Patient Coalition, Dr Lydia Makaroff, writes that patients should be partners in their own treatments, as well as empowered to offer insights and practical recommendations to improve policy

The rates of prostate cancer have increased substantially over the last two decades. While effective treatments exist if the cancer is detected early, outcomes are worsened by delays in diagnosis and treatment.

Outcomes can be improved by effective screening programmes, treatment in line with current guidelines, as well as faster authorisation, pricing and reimbursement decisions. Effective action for people with prostate cancer depends on a coherent multi-stakeholder European strategy, with a united approach to marshalling and integrating limited resources. Patients and patient organisations must be involved in developing policies that result in improved survival and quality of life for people with prostate cancer (2).

The complexity of selecting treatment options can lead to people with cancer feeling uncertain about which option to choose, especially when each option has different risks and benefits. Treatment discussions and decisions should be patient-centred, based on the needs and preferences of the person diagnosed with cancer. However, many people with prostate cancer report that they lack information, and are unable to communicate what is important to them during discussions with health professionals. Improving patient-clinician engagement through tools such as web-based decision support technology can help patients to become better informed, resulting in higher levels of patient satisfaction (1).

To ensure a truly patient-centred approach, people with prostate cancer should be provided with information on multidisciplinary treatment plans, to allow them to make an informed decision, based on their individual profile. A strong collaboration of health professionals is needed, including urologists, nurses, oncologists, psychologists, nutritionists, sexual therapists, physiotherapists, and experts in supportive care. Patients, patient representatives, and patient organisations are also important resources for both people with cancer and their informal carers (2).

There is also a need to increase the awareness of the potential of personalized medicine and support research into this area. To work towards this objective, the European Cancer Patient Coalition is partnering with the European Association of Urology, the European Prostate Cancer Coalition (Europa Uomo), and the European Alliance for Personalised Medicine to ensure that policymakers are aware of the need to continue to invest into research in personalised medicines.

For many cancer survivors, prostate cancer becomes a chronic disease, with late effects that cause many emotional and social problems. These effects may have a substantial impact on everyday life, work, social life, and sexuality. Proper follow-up should be included in a personalized cancer survivorship plan, to empower individuals and ensure that each person has as much control as possible over their life. For example, prostate cancer survivors should be encouraged to engage in walking and other forms of non-vigorous physical activity to improve their quality of life (3). Furthermore, as secondary and tertiary prevention are essential for all cancer survivors, necessary measures should be addressed in the cancer survivorship plan.

The European Cancer Patient Coalition was involved in the production of the European Association of Urology’s White Paper on Prostate Cancer (2). This white paper has six main policy recommendations:

1. European institutions and member states should ensure that people with prostate cancer receive high quality, standardized, and integrated care with a focus on a patient-centred multidisciplinary approach.

2. The EU and its member states should also guarantee equitable access to novel technological tools that enable better diagnosis, treatment and research.

3. Access to innovative treatments and personalised medicines should be made fast and equitable for all people with prostate cancer who can benefit from them.

4. Prompt and consistent Health Technology Assessment should be performed on all new screening, diagnostic, therapeutic and rehabilitation technologies in order to provide the base for effective and efficient, targeted and optimised allocation of resources in urology and specific prostate cancer services.

5. Awareness campaigns should be sustained at both European and national level

6. The EU and its member states should promote the implementation of survivorship cancer plans, to facilitate the return to a normal life for all European cancer patients.

Implementing these policies at a European and national level will result in earlier diagnosis, more equitable care, and improved quality of life for people diagnosed with prostate cancer.

References:

1. Davison J, Szafron M, Gutwin C, and Visvanathan K. 2014. Using a web-based decision support intervention to facilitate patient-physician communication at prostate cancer treatment discussions. Canadian Oncology Nursing Journal. 24(4): 241-247

2. European Association of Urology. 2017. Prostate cancer: Recommendations to lower the risk and mortality rate of the most frequent cancer in men. Arnhem: European Association of Urology

3. Phillips SM, Stampfer MJ, Chan JM, Giovannucci EL, and Kenfield SA. 2015. Physical Activity, Sedentary Behavior and Health Related Quality of Life in Prostate Cancer Survivors in the Health Professionals Follow-up Study. Journal of Cancer Survivorship. 9(3): 500–511