In Dr. Denis’ mind, there are several stakeholders in prostate cancer management: (i) the government, (ii) insurance agencies, (iii) health professions (research and clinical), (iv) industry (Pharma and technology), (v) consumers (economics), and (vi) most importantly the patients. Dr. Denis sees modern and future cancer management as the adoption of precision medicine. This includes a balanced integration between several items that affect treatment and community, including balancing individualized and personalized medicine, physical treatment and psycho-social community care, as well as evidence-based treatment and quality of life/cost-efficacy.
When a patient is diagnosed with prostate cancer, Dr. Denis calls this the acute phase of prostate cancer. The grief and disbelief of a prostate cancer diagnosis is accompanied by an overwhelming amount of information, from professionals, social media, friends, etc. Subsequently, there is the chronic phase of prostate cancer, which is a constant deluge of uncertainties, anxiety, fatigue, pain, side-effects, as well as financial and psycho-social problems. To Dr. Denis, optimal medical treatment is holistic patient care.
The challenge to optimal treatment is the ever-increasing workload, administrative duties, decreasing budgets, and lack of solidarity. Currently, Dr. Denis notes that we are lacking communication and team building (between nurses, technicians, etc), and we need global/consensus guidelines, coordinated research and health-related quality for professionals in order to provide care at the highest level. The challenges to holistic care include a lack of integration of treatment care, social support, and organized patient support groups. Furthermore, we need clear, simple, updated, repeated info flyers on all procedures/diagnoses, recognize our claim to survivorship and quality of life research/aspects, correct cost/efficacy, and deal with integrative medicine.
Dr. Denis concludes with several closing remarks, (i) the patient should come first (secondary to co-morbidity), and his prostate cancer second; (ii) we need to keep an eye on the holistic care following/preceding the acute phase of treatment; (iii) request patients’ rights but request obligations in return; (iv) patients expect the best quality service from professionals enjoying excellent well-being and quality of life.
Speaker: Louis Denis, Oncology Centre Antwerp, Antwerp, Belgium
Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre
Twitter: @zklaassen_md at the EAU - Update on Prostate Cancer – September 15-16, 2017, Vienna, Austria