Prof. Eamonn Rogers
Patient Office Chair, EAU
Smart early detection programmes mark a paradigm shift in prostate cancer, placing the patient’s wellbeing front and centre.
Prostate cancer is the most common male cancer in Europe, with about 450,000 Europeans diagnosed every year, but it can often go unnoticed. Earlier stages of prostate cancer can be asymptomatic for a long time or remain without symptoms. Some cases may not require treatment beyond active surveillance.
However, delaying diagnosis for aggressive forms allows the cancer to spread through the body and become more deadly. Regular check-ups, akin to breast and colorectal cancer screening, are crucial for early detection — even without symptoms.
Prostate cancer’s controversial past with early detection
Some past prostate cancer screening programmes have faced criticism for overdiagnosis, resulting in overtreatment without considering the patient’s quality of life. These programmes prioritised diagnosing the presence of cancer rather than the risk it posed to the patients.
When patients are confronted with a cancer diagnosis, many demand immediate action, regardless of whether treatment is necessary. Sometimes, treatments do more harm than good. Even successful prostate cancer treatment can negatively impact a patient’s quality of life — affecting the patient’s urinary, bowel and sexual functioning, plus the emotional burden of a cancer diagnosis.
Newer programmes not only have the potential
to redefine how clinicians diagnose and treat
prostate cancer but also how patients
experience living with cancer.
Smart early detection is shaping prostate cancer care
Modern prostate cancer screening now incorporates risk-based strategies. These algorithms assess the patient’s cancer risk to tailor treatment decisions effectively. Newer programmes not only have the potential to redefine how clinicians diagnose and treat prostate cancer but also how patients experience living with cancer. Not every diagnosis is terminal; understanding that is important to the patient’s participation in their own care.
Patient-centric prostate cancer detection
These methods are not theoretical; they are already being applied. Sweden has been trialling an early detection programme. The ‘Organised Prostate Cancer Testing Programme (OPT), first concentrated on rural areas and, following that success, is expanding across Sweden. A European Union co-funded project, PRAISE-U, expands on these successful screening trials with five pilot sites across Europe. It aims to assess the feasibility of the risk-based approach, including psychosocial effects.
Smart early detection programmes are a shift in prostate cancer care and part of a growing movement towards more patient-centric care.
