How Active Surveillance programs can reach 90%-plus of low-risk patients
Yet U.S. uptake for AS is only 60%
By Howard Wolinsky
The Active Surveillance Coalition, a collaboration of leading support groups for active surveillance (AS) for prostate cancer, is sponsoring a webinar at 9 a.m. Vancouver/12 p.m. New York/5 p.m. London/6 p.m. Amsterdam on Thursday, Nov. 17 to discuss how we can move the needle on AS, close monitoring of prostate cancer.
AS leaders from Sweden, Holland, the United Kingdom, and the state of Michigan’s MUSIC program will share their “secret sauce” for reaching AS rates of near 90% and above.
The free webinar is entitled “Moving AS to the next level: Can we help more patients?”
Register here:
https://zoom.us/meeting/register/tJAscuGspjMrH9LYgdTYDjmM4vvRadtnwsQM
The United States has lagged behind wealthy countries in AS though the approach started there and in Canada in the late 1990s. AS uptake with AS finally reached a majority of 60% in 2021 with the American Urological Association in 2022 setting a new goal of 80% In 2010, only 6% of patients qualified for AS opted for this approach.
Several European countries and the state of Michigan’s MUSIC (Michigan Urological Surgery Improvement Collaborative) program have reached AS uptakes of around 90% or higher.
Panel members will present their stories followed by a discussion and a Q&A involving the audience.
The panel includes:
--Dr. Mats Steinholtz Ahlberg, consultant urologist at Uppsala University Hospital in Sweden, is involved in major research on active surveillance in Scandinavia and the United Kingdom. Sweden has among the highest AS rates in the world, well above 90%. Ahlberg is involved in research on AS as a doctoral student at the department of surgical sciences at Uppsala University.
--Dr. Chris Bangma, professor of urology at Erasmus Medical Center in Rotterdam, is a leader in the introduction of active surveillance in Europe. He is the coordinator of PRIAS and GAP3 studies.
--Dr. Kevin Ginsburg, of Wayne State University in Detroit, and a prostate cancer leader in MUSIC (Michigan Urological Surgery Improvement Collaborative), which has achieved America’s highest AS rates for men with low-risk prostate cancer (91% vs. 60% nationally ) and also favorable intermediate-risk prostate cancer (45% vs. 20% nationally).
--Professor Vincent J Gnanapragasam, Professor of Urology at the University of Cambridge and Honorary Consultant urologist, U.K., will present the Prostate Predict algorithm which provides personalized estimates of the likelihood of prostate cancer death versus other causes of death over a 10-15-year period after a man is newly diagnosed. Dr. Gnanapragasam believes that the use of such algorithms is the key to increasing AS uptake and reducing variation in the information men are given on the value of radical treatment.
The Active Surveillance Coalition includes Active Surveillance Patients International (ASPI), the AnCan Virtual Support Group for Active Surveillance, Prostate Cancer Support Canada, Prostate Cancer Research Institute, and TheActiveSurveillor.com newsletter. Europa Uomo, the European confederation of prostate cancer groups, the Prostate Forum of Orange County, and the Walnut Foundation in Toronto have endorsed this webinar.
By Howard Wolinsky
Dr. Laurence Klotz, the “father” of Active Surveillance, is featured in the second video in the series “Active Surveillance 101” which will be presented at the Active Surveillance Patients International (ASPI) meeting at 12 p.m. ET on Oct. 29.
Register here.
AS 101 is a series of conversations between actual patients and their partners/spouses and leading prostate cancer experts covering essential questions.
The goal of this series is to reach all AS candidates, including those who have not yet been diagnosed with prostate cancer but have rising PSAs (prostate-specific antigen) blood levels to provide them with an introduction to AS.
We—The Active Surveillor was one of the organizers—want to provide the tools to help these patients formulate questions when they go to their family doctors, urologists, or oncologists.
(Nancy and Larry White, spouse/patient meet with Dr. Klotz in AS 101 video)
AS 101 also is aimed at newly diagnosed patients on AS and established AS patients who want a refresher.
The premiere of part 1 of AS 101 has just aired at the monthly meeting of ASPI. To view.
The video features a patient and spouse, Larry and Nancy White, a real couple from New Mexico, meeting with family doctor Dr. Stephen Spann, dean of the University of Houston College of Medicine, on a consultation about rising PSA, treatment options, and a referral to a urologist. The prostate cancer “journey” often begins in the office of a primary care physician like Spann to discuss rising PSAs and then moves on to other specialists, such as urologists like Klotz.
The ASPI program includes the video and a question-and-answer period with patients.
In part 2, the Whites meet with Dr. Klotz, who explains early-stage, low-risk prostate cancer. Again, there will be a Q&A.
Earlier this year, ASPI honored Klotz, of the University of Toronto, as the winner of the first Gerald Chodak Active Surveillance Pioneer Award. The late Dr. Chodak was Klotz’s mentor and also was ASPI’s first medical advisor.
In the new video, Larry White, a real prostate cancer patient and himself a physician, and his wife Nancy, who has been an AS advocate, interact with Klotz as in a simulation of a real patient-partner-physician visit.
AS 101 was created under the banner of the Active Surveillance Coalition, whose members include ASPI, AnCan’s Virtual Support Group for Active Surveillance, Prostate Cancer Support Canada, Prostate Cancer Research Institute and The Active Surveillor newsletter.
For more background on AS 101, go to the blog for the Society for Participatory Medicine.
Catch the latest installment of Martin Gewirtz’s AS Prostate Cancer Blog for Cancer ABCs:
https://www.asprostatecancer.blog/
To register: https://us06web.zoom.us/webinar/register/WN_SLm4gQGXRlCPJHf_hdkKxw
Prostate Forum of Orange County October 27, 2022 | 7:00 PDT
Go to: Zoom Link: https://us02web.zoom.us/j/86164783897
Your Genes, Prostate Cancer and the PROMISE Registry
The PROMISE (a Prostate Cancer Registry of Outcomes and Germline Mutations for Improved Survival and Treatment Effectiveness) Registry aims to help patients, doctors and researchers better understand an individual’s prostate cancer to improve treatment and outcomes.
Kathy Wiedemer (Director of Community Engagement) and Christina Tran (Project Manager) from the PROMISE Registry
The presentation will provide recorded information about why your genes matter in prostate cancer, what genetic testing is, and who should get it, as explained by PROMISE Investigators Dr. Heather Cheng, MD, PhD (Fred Hutchinson Comprehensive Cancer Center, University of Washington), Dr. Channing Paller, MD (Johns Hopkins University, Sidney Kimmel Comprehensive Cancer Center), and Genetic Counselor on Registry, Justin Lorentz, MSc, CGC (Sunnybrook Odette Cancer Centre). You will learn how understanding the specific inherited genetic factors, or mutations, in men with prostate cancer and being able to tailor a treatment to an individual’s specific genetic make-up could be a powerful tool in prostate cancer treatment options and outcomes.
For more background, go to The Active Surveiller: Let’s Spit for Science
Onn Tuesday, October 11th at 4:30pm PDT/7:30pm EDT, the Prostate Cancer Foundation will webinar hosted by PCF CEO Charles J. Ryan, MD. The topic is Shared Decision-Making and Treatment Regret in Prostate Cancer. Sign up to join here.
How do you make decisions about treatment for prostate cancer, at any stage of the journey? Patients can face many challenges when considering treatment options - whether for newly diagnosed, localized disease or for recurrent or advanced prostate cancer.
Shared decision-making, in which patients and providers work together to make decisions based on evidence and patient preferences, can make this process smoother. Related to this is treatment regret, which incorporates patients' feelings and experiences of anxiety and uncertainty.
Dr. Ryan will discuss shared decision-making and treatment regret in prostate cancer with medical oncologist Alicia Morgans, MD, MPH (Dana Farber Cancer Institute) and urologic oncologist Matthew Cooperberg, MD, MPH (UCSF; San Francisco VA Medical Center). Learn what shared decision-making looks like, how to engage with your provider, and what you can do if you're feeling regret about past treatment decisions. The webinar is free and open to all.