Europa Uomo, the European Prostate Cancer Coalition, has consulted with leading experts in Europe to develop recommendations, aimed at improving the lives of men with prostate cancer in Europe.

Overall goal: Improve high quality care for all men with prostate cancer in Europe in order to reduce the death rate and growing burden of prostate cancer on individuals and society

To achieve this, we need to:

• Provide access to free, appropriate early detection for prostate cancer, coupled with supporting information

• Improve prompt and accurate diagnosis of prostate cancer at all stages of disease

• Provide equal access to effective treatments and technology

• Improve the identification, assessment and treatment of those at risk of dying from prostate cancer

• Offer a range of management approaches, including active surveillance, to those whose prostate cancer is unlikely to progress

• Empower men and their families so they can be involved in decisions about their personalised care plans, whilst providing ongoing information and support

Specific recommendations for improving patient care

Risk assessment and PSA testing for prostate cancer should be available ‘free of charge’ if requested by men or their healthcare team

• Provide appropriate counselling and information beforehand

• PSA analysis should be standardised across the EU and quality-assured

• Clearer guidance and consensus on PSA testing and biopsies should be provided to healthcare professionals to ensure appropriate use

• New diagnostic tools for early disease, such as biomarkers and MRI, should be urgently evaluated and adopted if proved effective to reduce the need for unnecessary, invasive biopsies

Improved education and information about risks factors and symptoms of prostate cancer should be provided to the public and healthcare professionals

• Information should emphasise the importance of early detection and referral in improving outcomes for men with prostate cancer, including advanced and metastatic disease

• The public and healthcare professionals should be made aware of signs and symptoms to look out for, including those suggestive of relapse

• Education materials should be tailored to men and developed in partnership with healthcare professionals and patient organisations

Prostate cancer care should be coordinated and managed by a multiprofessional team within a certified centre or network of excellence

• Diagnosis and care should be managed by a team of healthcare professionals experienced in treating high volumes of prostate cancer patients

• Access to appropriate technology and testing techniques should be available to improve classification of prostate cancer and the effectiveness of treatment decisions

• Centres in which care is delivered should be certified as meeting an agreed set of quality indicators and European standards. (This approach is recommended by ESO and EAU and follows similar models in the UK, Belgium, The Netherlands and Germany)

• Where necessary to prevent or manage metastatic complications and improve palliative care, allied healthcare professionals should be integrated into the multiprofessional team to offer coordinated, holistic care

• A key worker, e.g. a specialist nurse, should be made the main, consistent point of contact for patients’ queries and follow up

• Centres or networks of excellence should include appropriate collaborations with patient organisations

Care plans should be comprehensive and tailored to the individual patient

• A personalised care plan for each patient should be decided by the multi-professional team based on prognostic, risk and quality of life factors, and involving the man and his family
• Access to a broad spectrum of effective licensed therapies or observational strategies, including active surveillance, should be guaranteed so that a management strategy is designed around individual circumstances
• Men should be counseled and their needs assessed before deciding on personalised management options. Follow up information and support should be offered throughout the treatment journey to address concerns and help men manage side effects
• Psychological and practical support, including psychosocial care, should be available and tailored to individual needs and the stage of disease to help men cope with diagnosis to end of life care
• Referral to patient peer support should be offered, if available
• Complications and concerns, such as incontinence, impotence and bowel problems, should be addressed with specialist support
• Information and support for end of life care should be provided at an appropriate time, allowing men and their families to plan ahead

Prostate cancer research should be adequately funded to improve optimal care

•Improved and coordinated investment from governments across Europe would enable more academic-led research to identify the most effective treatments
• Research should focus not only on treatment but also on prevention, early detection and diagnostics, better ways to distinguish aggressive or lethal disease versus latent, slow growing tumours, markers to evaluate treatment response and psychosocial/ survivorship
• Real-life data on routine treatment use and outcomes should be collected, reported and shared across Europe
• Information on clinical trials should be simplified for men and their families to support participation
• Clinical trials should be better designed to ensure study endpoints are of real benefit to patients and that effective treatments become available faster

• Patient organisations should be consulted to prioritise research options and provided with appropriate information

Source: Europa-Uomo