EAU White Paper: More funding and PCa awareness needed EAU’s PCa recommendations to EU policymakers By Joel Vega More funding for research that leads to better diagnosis and treatment, and implementing effective public awareness programmes are among the key elements to keep prostate cancer high in the healthcare agenda, according to the recently launched EAU White Paper on prostate cancer. “We need the help of the European Union (EU) to make people aware of prostate cancer and its risks. As one of the cancers with significant mortality rates in Europe, there is a need to focus on specific awareness programmes,” said EAU Adjunct Secretary General for Education Prof. Hein Van Poppel (BE). “Moreover, there is a lot to be done in research that directly leads to improved diagnosis and treatment.”
The EAU White Paper was presented in Brussels on January 24 during the seventh Prostate Cancer Europe Roundtable organised by the International Centre for Parliamentary Studies (ICPS), a UK-based group which promotes effective policy making and good governance. Hosted by roundtable chair and former MEP John Bowis OBE, the meeting gathered patient advocates, medical, research and healthcare professionals to discuss proposals, strategies and issues affecting the diagnosis and treatment of prostate cancer patients. “Prostate cancer awareness still requires more effort from all concerned to keep it high on the agenda. What we aim is to closely look into patients’ needs and the views of various experts, and from there present a set of recommendations to government and members of the parliament,” said Bowis. Bowis was joined in the roundtable discussion by Marilys Corbex of the World Health Organisation (WHO) Regional Health Office for Europe, Prof. Hein Van Poppel and Jan-Willem Van de Loo representing the European Commission. Around 35 participants attended the day-long meeting which covered topics such as challenges in treatment and research, breakthroughs and new technologies, and public awareness programmes, among others. In the 22-page White Paper, the main issues in prostate cancer care were examined including risk factors, prevention, diagnosis, treatment, survivorship plans, the role of the EAU, and current EU activities in cancer control. And although there is limited, conflicting or low-level evidence to directly link PCa to obesity, poor diet and lack of exercise, the White Paper still recommends the importance of early detection.
The EAU White Paper and corporate brochure (foreground) during the launch in Brussels
Equitable healthcare access and actively promoting cancer awareness are among the proposals that topped the EAU recommendations. During the roundtable Van Poppel also emphasized the work done by professional medical groups such as the EAU
creating evidence-based guidelines for urologists and supporting patient advocates through EAU Patient Information Initiative. With help of the national societies of urologists, the EAU Patient Information has been translated to over 20 languages, while the EAU guidelines have been endorsed by all 28 member states and have been translated into 30 languages. He also mentioned the active Around 35 participants gather in Brussels for the 7th ICPS roundtable on prostate cancer collaboration with other medical disciplines such as oncology and radiology through joint research and scientific meetings. Aside from stressing equitable healthcare, the EAU recommendations also anticipates that the future “European authorities and Member States need to would include risk-adapted treatment programmes ensure that PCa patients receive high-quality that require contemporary imaging and diagnostic standardised and integrated care with a focus on a tools. The other EAU recommendations were: patient-centred multidisciplinary approach,” said Van Poppel, citing one of the EAU’s recommendations. • Access to innovative treatments and personalised medicines should be made fast and equitable for all PCa patients; • Prompt and consistent Health Technology Assessment (HTA) should be performed on all new screening diagnostic, therapeutic and rehabilitation technologies to provide the base for effective, efficient and targeted allocation of resources; • Sustaining awareness campaigns, both at European and national levels, and to help achieve the main goals set out in the paper, and • The EU and Member States should promote the implementation of survivorship plans including plans for PCa patients to facilitate Prof. H. Van Poppel presents the EAU White Paper on the return to a normal life for all European prostate cancer PCa patients.
• What is the biggest problem in Europe’s healthcare system? One challenge is the sustainability of health systems related to key factors such as changing demography and the rise in chronic non-communicable diseases. Another is growing costs related to health technologies which contribute to lower mortality rates. The challenge is how to reconcile these opposing trends and keep budgets under control. • As a public health campaigner what is the most significant lesson you have gained? One has to work with teams and we need to involve a broad range of professionals which includes both clinicians and NGOs such as patient advocacy groups. The interests vary and one must do skilful coordination. • As a bridge between government and the health sector, what makes communication among these groups more difficult? Governments think that doctors are only interested in expanding the services. On the other hand, clinical researchers are innovators and research has a price. There are also external pressures within governments. With areas of potential conflicts, communication is disrupted. • What areas in healthcare you think need more attention? Disease prevention is a priority and in the EU it accounts for only less than 3% of total expenditure. We need novel means of communication. Ensuring good access to quality care is another challenge. Third is independent research and in cancer this is a very vital issue. • If you look back in your career what would have you done differently? I would sooner get more involved in inter-disciplinary work. The advantages I’ve seen from international projects are really great. When you have the energy of people from different professions and countries, you get more power in intellectual debate and finding new ideas. • What important advice can you give to a young doctor just starting his career? I sympathize with young doctors today because they are flooded with knowledge and research. They have to know their main objective or focus, and just stick to it and go forward. But they shouldn’t forget the big picture and the patient is the key element of this big picture. • What do you do to avoid burnout? I travel and I like to go to the sea, the coast. • What’s the last wonderful book you have read? The last remarkable book I’ve read was “The Wind-up Bird Chronicle” by Murakami, an excellent book I got as a present from a dear friend. • What’s your favourite hour in a day and why? If I am home that would be the afternoon hours when I can enjoy the outdoors, go walking and cycling. I am very productive at night. Mornings are definitely not my type.
TEN QUESTIONS Interview by Joel Vega Photography by Denis Abbonato-Bei
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European Urology Today
Age: 55 Specialty: Public Health & Social Medicine City: Ljubljana Current Posts: Associate Professor and Head of the Centre for Health Care, National Institute of Public Health, Ljubljana, Slovenia; Project Coordinator, Cancer Control (CanCon) Joint Action, European Commission
• What is your biggest fear? The loss of a loved one…And receiving, for instance, news of the sudden death of someone in an accident because it’s uncontrollable and unchangeable.
Tit Albreht January/February 2017