This was a shocker in the prostate advocacy world : Mike “Bing” Crosby, founder and CEO of Veterans Prostate Cancer Awareness Inc. (VPCa), announced Tuesday evening in a detailed note to his supporters that he has suspended operations of his important organization.
I consider Crosby a former U.S. Navy aviator whose prostate cancer was caused by his service, a major success story in lobbying Congress to raise awareness aboutr prostate cancer and representing veterans, a high-risk population who developed prostate cancer from exposure to Agent Orange, burn pits, radiation exposure, and other sources while serving.
He said: “After much reflection and assessment of the current environment, I have made the very difficult decision to suspend all operations of VPCa indefinitely. This includes the cessation of our educational initiatives, outreach efforts, promotion of new technologies, and industry partnerships. The only remaining efforts will be the maintenance of a basic website and possibly limited social media platforms.”
Crosby was diagnosed with prostate cancer in 2015 and has done much to advocate with veterans, especially minority members members, with prostate cancer. In December 2016, he formed VpCa, a nonprofit 501(c)(3) organization “focused on raising awareness and educating our nation’s heroes about prostate cancer, the No. 1 diagnosed cancer within the VA System.” He is a 1983 graduate of the United States Naval Academy with a Bachelor of Science in Applied Science. He is also a graduate of the U.S. Navy Fighter Weapons School “TOPGUN” and the NATO Allied Air Forces Central Europe “Tactical Leadership Program.”
Crosby is throwing up his hands in frustration: “For years, we have worked tirelessly to advocate for risk stratified early screening for prostate cancer, particularly in high-risk populations such as African Americans, men with a family history of the disease, and veterans who must now deal with the results of exposure to toxic substances, radiation sources, and other chemical exposures. Unfortunately, despite the overwhelming data showing that early detection can save lives, we have consistently and even more so recently faced resistance from large segments of the medical and healthcare community in the promotion for the need to screen early and consistently.”
“This is particularly troubling because we know that high-risk groups like veterans are presenting an extremely high rate of metastatic disease on first diagnosis. The number is 14% of new prostate cancer diagnosis in the Veterans Healthcare Administration are metastatic, twice our nations SEER data. We also clearly know the cost of treating a veteran with a late-stage diagnosis is orders of magnitude higher than an early detection. The reluctance to embrace early screening—whether due to outdated guidelines or an unwillingness to shift focus from late-stage treatment—has made it difficult for us to make the necessary impact.”
Crosby is disenchanted with physicians, who treat PCa patients.
He said: “One of the most disheartening aspects of our journey has been the lack of engagement from many primary care physicians, oncologists, and urologists. While some have been wonderful partners in this cause, too many have declined to participate, or claim not to have the time or interest in supporting our efforts. Whether due to an overwhelming workload, financial incentives tied to late-stage cancer treatment, or a lack of concern for early intervention, we’ve found that our calls for increased physician involvement in promoting early screening have often gone unanswered or ignored.
“Despite the ethical responsibility physicians hold to prevent suffering where possible, we’ve encountered significant resistance to screening high-risk groups earlier. This reluctance leaves vulnerable populations like veterans at an even greater disadvantage. The disconnect between financial incentives and patient-centered care is deeply concerning, and it’s something that requires urgent attention if we are to truly prioritize patient health over profit.”
(Mike “Bing” Crosby.)
Crosby described disappointments in fund-raising from public and corporate sectors.
“The broader lack of engagement—particularly from larger institutions that could help drive change—has left us with limited resources to continue our mission at the scale required. It has become clear that without a greater commitment from the healthcare industry, corporate partners, and government agencies, the uphill battle to advocate for early screening, the promotion of new technologies, and help with veterans’ access to care will continue to be too steep for a small organization like ours to overcome,” he said.
“I must remind each of you (over 130 companies) receiving this note I’ve heard at least 90% of you state the patient advocacy budgets are being reduced within your company and you apologize for not being able to help more.”
I don’t know if Crosby will agree wth me, but I have observed far more interest in trying to develop silver-bullet medications to treat advanced prostate cancer—a small segment of the 300,000 men who will be diagnosed this year with prostate cancer—than in helping the 30% of men with low-risk cancers who should consider avoiding aggressive treatment and its potential side effects.
“Prostate cancer is a real threat to U.S. Service members, as 80% of the active duty population are men. According to the Defense Health Agency (DHA) Medical Surveillance Monthly Report (MSMR), 8,973 new cancers were diagnosed among active duty members of the U.S. Armed Forces between 2005 and 2014, and of these, 1,046 (11.7%) were prostate cancer diagnoses,” the program states.
I was a consumer reviewer for this program and found there deliberately no interest in low-risk cancer and Active Surveillance, even as I pointed out research that could help men on AS along with the rest of the PCa population.
PCRP stresses in list list of missions:”Develop new treatments or improve upon existing therapies to improve outcomes for men with lethal prostate cancer.”
I have been told the program used to help men with low-risk prostate cancer. But no more.
Or take the Prostate Cancer Foundation, which emphasizes research on meds for advanced prostate cancer. I have asked PCF repeatedly what proportion of their funding goes for low-risk and Active Surveillance. They answer repeatedly they don’t keep their numbers that way.
(As Prostate Cancer Awareness Months winds down in the next few days, if you feel moved to donate to a prostate charity and you’re on AS, before handing over the money, ask the organization, “What have you done for patients on AS like me lately?)
I asked Crosby, who I first met in 2017 at the Prostate Cancer Research Institute meeting in LA, via email whether we can discuss his concerns and what he sees on the road ahead as we face a predicted surge in prostate cancer in the next few years.
This is a terrible loss to the cause of helping men with prostate cancer.
Active Surveillance for prostate cancer – the past, the present, and the future
Peter Carroll, MD, MPH, of the University of California, San Francisco, one of the pioneers of Active Surveillance for low-risk prostate cancer, in the late 1990s, will be speaking to Active Surveillance Patients International at noon Eastern on Saturday Sept. 28, 2024.
His program is entitled “Active Surveillance for prostate cancer – the past, the present, and the future.”
Carroll is the 2024 recipient of Active Surveillance Patients International’s Chodak Award honoring pioneers in the development of the Active Surveillance approach to managing lower-risk prostate cancer. The award is named for the late Gerald Chodak, MD, of the University of Chicago, he laid down the fundamentals for a more conservative approach to managing these patients. Chodak was ASPI’s first medical advisor.
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It has been a frustrating experience working in the healthcare industry to see that third party payers and government regulators such as CMS prefer to pay the high cost for treating a disease once it reaches the critical stage, but cannot see the benefit of early detection and treatment.
I feel for Mr. Crosby but he’s been mislead by those in the business of prostate cancer. Sadly, his statement that there's overwhelming data showing that early detection can save lives is misguided and a falsehood.
In fact, there is zero irrefutable and reproducible data showing that early detection and early treatment saves lives. Instead, studies show that;
> PSA testing FAILS to save significant numbers of lives
> radical surgery FAILS to save significant numbers of lives
> at 15 years NO treatment has similar survival to surgery or radiation, but without all the complications
These results are hardly surprising when the Gleason 6 is a bogus cancer and most other cancers grow sluggishly taking some 40 years to get to 1 cm in size after mutation. Essentially, it's the 10 to 15 percent of high-grade cancers that are potentially deadly and many of these make a little or no PSA. This is the real prostate cancer awareness.
It has been a frustrating experience working in the healthcare industry to see that third party payers and government regulators such as CMS prefer to pay the high cost for treating a disease once it reaches the critical stage, but cannot see the benefit of early detection and treatment.
I feel for Mr. Crosby but he’s been mislead by those in the business of prostate cancer. Sadly, his statement that there's overwhelming data showing that early detection can save lives is misguided and a falsehood.
In fact, there is zero irrefutable and reproducible data showing that early detection and early treatment saves lives. Instead, studies show that;
> PSA testing FAILS to save significant numbers of lives
> radical surgery FAILS to save significant numbers of lives
> at 15 years NO treatment has similar survival to surgery or radiation, but without all the complications
These results are hardly surprising when the Gleason 6 is a bogus cancer and most other cancers grow sluggishly taking some 40 years to get to 1 cm in size after mutation. Essentially, it's the 10 to 15 percent of high-grade cancers that are potentially deadly and many of these make a little or no PSA. This is the real prostate cancer awareness.