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Published on : Feb 24, 2014
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Slide 1 - The Prostate Cancer Continuum The Changing Face of Disparity: Taking Health into Our Own Hands
Slide 2 - The real voyage of discovery consists not in seeking new landscapes but in having new eyes. - Marcel Proust
Slide 3 - Pca is a Global Concern Highest incidence of male cancer in U.S.; 2nd greatest cause of death; declining overall but increasing in minority populations(2) #1 diagnosed cancer in Europe; deaths have increased by 16% since 1995(1) ”despite widespread use of PSA testing...” Sources: (1) World Health Organization; (2) American Cancer Society
Slide 4 - Why We Must Be Concerned 1 in every 6 men get Prostate Cancer 1 in every 4 Black men get Prostate Cancer Latinos have the 3rd highest incidence rate Blacks and Latinos are diagnosed at advanced disease stages at a 144% greater rate than whites The 5 year survival rate for Blacks and Latinos is worse than for whites and getting worse Black men die at a rate 240% higher than whites
Slide 5 - National Healthcare Quality Report - 2007 “Preventive healthcare lags significantly behind other gains in healthcare.” Access to care and information varied widely between racial/ethnic groups and by socio-economic status Source:
Slide 6 - Healthcare Costs represent an increasing % of GDP- $650B more for Cancer Treatment
Slide 7 - U.S. - World’s Best Medical Care? - New York Times, 12 August 2007 37th in W.H.O. health system performance (France #1, Italy #2) Last in overall quality: lack of coordination of care/access for preventive and critically ill Only major industrialized country without universal health coverage Life expectancies near the bottom of other industrialized nations Worst Infant Mortality stats of any developed nation Sources: Commonwealth Fund, Centers for Disease Control, W.H.O.
Slide 8 - Exacerbating the Problem Increasing employee cost burden Regulations on employers => increasing costs => decreasing competitiveness Insurance compensation standards Medicare reimbursement changes
Slide 9 - American Cancer Society Disparity Study - 2007 Cancer patients with private insurance are much more likely to be diagnosed early, increasing their long-term survival Those uninsured patients or those with Government insurance are more likely to be diagnosed with advanced stage disease at first treatment
Slide 10 - “Baby Boom” Impact Estimated Per Capita Health Expenditures by Age and Sex, 1995
Slide 11 - Service Provider Impact Continuing nurse shortage Resistance to greater use of nurse practitioners Decline in doctors entering into Primary Care Medicine Resistance to “Convenient Care” clinics
Slide 12 - Population Impacts 12 million cancer survivors alive in the U.S. today 3 out of 4 American families will have a family member diagnosed with cancer 25% of American families living with cancer have children under the age of 18 living at home More than 28% of children in America will be living in poor households Sources: American Cancer Society, Institute of Medicine, World Health Organization, The Policy Press
Slide 13 - Treatment Impact Skeletal impacts of ADT Cardiovascular issues related to hormone therapy Conflicting preventive therapeutic recommendations SELECT Finasteride PLCO Study Emerging technologies with minimal curative benefit Positive benefit of drug therapies Targeted disease management
Slide 14 - Lifestyle Impact Meat becoming more popular in diets globally 10.4% in the U.S. 25% more in Korea 49.7% in China >2% in India Higher birth weights in emerging countries strong cancer association Sources: Food & Agriculture Organization of the United Nations, AICR
Slide 15 - Business of Medicine The System often has other issues: Equipment investment Revenue production Pharmaceutical alliances Pay-for-Performance Patients MUST become their own advocates
Slide 16 - Complicating the Issue Women vs. Men Comparable incidence and mortality Research funds - 3X for breast cancer Public health staffing - inconsistent Government commitment - no agencies Media focus - inordinately female focus Men don’t communicate
Slide 17 - Why Prostate Cancer Prevention? Significant public health risk 186,000 new cases and 29,000 deaths yearly (2008) Risk factors (age, race, genes) are not modifiable Benefit of screening on mortality is controversial Therapy is associated with morbidity That Leaves Prevention
Slide 18 - Phase III Chemoprevention Trials RRR = 22.5% RRR = 23.5% PCPT REDUCE
Slide 19 - 5ARIs for Biochemical Recurrence Andriole et al, Urology 45:491, 1995
Slide 20 - PCPT and REDUCEWhat did we learn? Consistency of effect Similar magnitude of risk reduction across all risk groups No longer any grade issues Conclusion Use of 5-alpha reductase inhibitors is an effective primary prevention strategy
Slide 21 - Healthcare Disparity Disaffected classes racial/ethnic minorities high risk populations Socio-economic impact lack of/limited insurance breaking the “social contract” Equal Access: education preventive mechanisms care
Slide 22 - Moving the Bar Forward: Success Stories and Templates for Change
Slide 23 - Technology for Change 71% of the people in North America are online 113 million Americans seek health information online Almost half of adult users and 84% of teens will be on social sites 40% of self-classified “non-users” became direct or indirect users after a cancer diagnosis Sources: Internet World Stats, Pew Internet & American Life Project
Slide 24 - Social Network Integration Credible peer-to-peer communications “New” Prostate Cancer Infolink “Pints for Prostate” Prostate Cancer Internet Alliance FaceBook
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Slide 26 - Este sitio se ha producido con la ayuda de la familia de Roberto "Tito" Warat y una concesión educativa de la oncología de Sanofi-Aventis Opciones de Tratamiento Investigación Traslacional Toma de Decisión Informada Hormonas Gleason 7: ¿Una Nueva Categoría de Riesgo? Diagnósticos Terapia Citotóxica ¿Está considerando un Ensayo Clínico? Quimioterapia Medicina Alternativa / Complementaria Espera Alerta Terapias de Ataque Soluciones Quirúrgicas Manejo de Efectos Colaterales Soluciones Oncológicas de la Radiación Cuidado Paliativo Manejo del Dolor Fuentes de Información Servicios de asistencia pacientes
Slide 27 - Reinforcing the Message “In The Know” newsletter Hard Copy - 29M circulation Online supplement - > 100M Broad spectrum content Audience diversification consumers/patients advocates professionals researchers international
Slide 28 - Media Syndication Mass impressions Minimal cost Increase reach
Slide 29 - PodCasting for Health Reinforce the print message Portability for consumers Viability for diverse situations: personal public health clinical research
Slide 30 - Cell Casting for Health Enhanced consumer interactivity Opt-in network 1.877.2CHECKNOW Customized content Applications for: clinicians researchers public health
Slide 31 - Going to the Barbershop: Empowering Communities Through Risk Communication
Slide 32 - Barbershop based Health Awareness Initiative Project BHAI (Brother): 48 shops in Jharkhand and Orissa Provinces - India cancer prevention and tobacco control enhance knowledge enhance healthy behavior create a sustainable environment build on existing networks and partnerships expand to co-morbid disease
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Slide 34 - Research Partnerships
Slide 35 - Creating a New Network The Prostate Net Core Distribution: 80,000+ Website visits/month 1,200 Patient Support Group Leaders 1,000+ Public Health Workers ~ 6,000 Medical Oncologists > 4,000 Urological Specialists > 2,000 Cancer Researchers Sponsors National Ass’n. of Barber Boards of America ~ 200,000 Barbers Participating Medical/Research Centers > 300 American/National Medical Ass’ns. > 5,000 Doctors Community
Slide 36 - Create Heroes Meet James He came to a Health Fair On HIS BIRTHDAY!! To give himself The Gift of Life!! Warren brought his son to a Pca screening To educate him about being responsible for his health
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Slide 38 - Why is all this needed?! To Eliminate the Suffering and Death from Cancer “If You’re Not the Lead Dog, the View Never Changes” - Mike Ditka
Slide 39 - Thank You! WWW.THEPROSTATENET.ORG 1.888.477.6763