Meeting Report: Elaborating the Essential Requirements for Quality Cancer Care: Prostate Cancer

11 June 2020

What are the core elements of quality cancer care when it comes to treating and caring for prostate cancer patients? What might improved EU policy be able to achieve in this respect?

To such questions attention was directed during the virtual launch event for the landmark new publication, the Essential Requirements for Quality Cancer Care: Prostate Cancer.

Co-Chairs of the project, Prof Maurizio Brausi and Dr Peter Hoskin, introduced participants to the new consensus expression developed by representatives from 19 European & international societies, including healthcare professional and patient associations.

Outlined during their presentation were the agreed needs to be met for prostate cancer care including such matters as:

  • Multidisciplinary team working among core and extended groups of professionals
  • Minimum case volumes
  • Performance measurement of outcomes and care
  • Professional education needs
  • Meeting research needs in daily practice
  • Delivery of quality information to patients

Full details are provided in the Essential Requirements for Quality Cancer Care: Prostate Cancer.

The virtual meeting then heard from a range of patient perspectives about pressing needs to be met to improve prostate cancer care.

Ken Mastris, Europa Uomo, reiterated the need for health systems to treat the patient, not only the disease. In this respect, an important part of prostate cancer care that must be addressed is the role of primary care physicians after a patient has received treatment. The role of primary care is emphasised in both The Essential Requirements for Quality Cancer Care: Prostate Cancer as well as articulated more fully in a distinct Essential Requirements for Quality Cancer Care: Primary Care published in 2019.

Ken Mastris and Dr Peter Hoskin also discussed the management of treatment side effects, and the crucial role of multidisciplinary team working in this respect, with different professions playing leading roles in respect of differing side effects to treatment that may arise.

Robert Greene, European Cancer Patient Coalition, raised the possibility of patient advocates being a part of a multidisciplinary team in future. The potential for this suggestion was recognised by presenters, with discussion taking place on need to support such advocates in gaining specialised knowledge and understanding.

Dr Matti Aapro, President of the European Cancer Organisation, highlighted emerging practice in the USA and elsewhere, of cancer nurses acting as the formalised ‘case manager’ in helping to achieve a better navigation for the patient during their treatment and follow up journey. Ken Mastris welcomed this trend, highlighting that in his experience, patients found nurses to be highly accessible and relatable members of the healthcare team, with whom they had confidence in speaking openly with about their preferences and concerns.

Eleonora Varntoumian, European Oncology Nursing Society (EONS), praised the strong focus of the ERQCC Prostate Cancer on the role of cancer nurses, and emphasised the need to support this with the provision of solid opportunities for specialised education.

Discussion gave attention to screening and prevention needs in respect of prostate cancer, with some particular attention to addressing the heightened risk associated with men of African and Caribbean ethnic heritage. Dr Matti Aapro, President of the European Cancer Organisation and Member of the EU Cancer Mission General Assembly, indicated that significant research projects on these matters could be predicted within the Mission, due to commence in 2021.

Prof Heinz-Peter Schlemmer, Head of the Department of Radiology at the German Cancer Research Center (DKFZ), emphasised the key need for image quality in ensuring best decision-making in prostate cancer care. Imaging quality across Europe, and even within countries, varies enormously. Technologies like Fusion Biopsy Systems allow much improved targeting of treatments and should be more readily available. Nuclear medicine physicians must also have access to the right radiotracer.

Christoph Bardin, European Society of Oncology Pharmacy (ESOP), sought the opinions of presenters on how a future of greater oral medication in prostate cancer might change the overall picture of how treatment and care is provided. Prof Hein Van Poppel, European Association of Urology (EAU), certainly envisaged some advantages in terms of patient convenience, but also cautioned studies and research remain to be completed.

Concluding the meeting, Prof Hein Van Poppel, Adjunct Secretary General at the European Association of Urology (EAU), brought the attention of participants in the meeting to the potential of Europe’s Beating Cancer Plan to advance progress in tackling pressing issues in prostate cancer care, such as in respect to:

  • achieving earlier detection through screening;
  • decreasing mortality; and,
  • improving the quality of life of prostate cancer patients.

A new recently published EAU White Paper on Prostate Cancer highlights such problems as evidenced rises in prostate cancer mortality, which has been linked with reduced testing.

Professor Van Poppel progressed to present additional policy points, including the need for:

  • Consistent approaches to Health Technology Assessment across Europe
  • The need to achieve better access for prostate cancer patients to innovative forms of treatment at an affordable price
  • Embedding survivorship care planning into normal practice to a much greater degree
  • Ending all forms of unfair discrimination received by cancer patients, including in respect to accessing financial services

Key research needs for prostate cancer that might be addressed at a European level including via funding mechanisms such as the EU Cancer Mission include:

  • personalised medicine opportunities;
  • co-morbidity matters;
  • the leverage of Big Data; and
  • other prospective opportunities for improvement from new technologies such as Artificial Intelligence and robotics.

The need to overcome persistent GDPR barriers to research should also be addressed in the near future.

It was recommended that the forthcoming EU4Health Funding Programme include a strong element to achieve greater public awareness about prostate cancer, and discussion also indicated the desirability to commence education about cancers earlier, including potentially at school age level. This was well supported by Dr Matti Aapro, President of the European Cancer Organisation, who emphasised the cascading benefit of educating young people, who spread messages to their parents and others.

    • Downloaed the presentation slides here and here.
    • View the recording from the virtual event here.

 The next virtual meeting of the European Cancer Organisation will be held on Thursday 25th June, 14:00-15:30 CEST on the topic of ‘Advancing Requirements for Quality Breast Cancer Care’.