Prof. Per-Anders Ambrahamsson, MD: What European Men Need to Know About Prostate Cancer

Prof. Per-Anders Abrahamsson, MD discusses the lack of standardized screening guidelines for prostate cancer in Europe and around the world. He also talks about how the advocate community can help spread the word and educate men and women about prostate cancer.

The Group Room at the 2011 European Multidisciplinary Cancer Conference was made possible, in part, by:

 

VIDEO TRANSCRIPT

Selma Schimmel, Founder & CEO, Vital Options International:

This is Selma Schimmel at the Multidisciplinary Cancer Congress 2011 in Stockholm. Professor Abrahamsson, in Europe what is the standard of care regarding the screening for prostate cancer?

Prof. Per-Anders Abrahamsson, MD, Dept. of Urology, Lund University, Sweden:

Well I met the number one screening expert outside here, Fritz Schröder, running the European randomized screening trials and the other one so far in the world with, I think, mature data coming out two years from now. But he presented already 2009 here in Stockholm the first outcome, and at the same time published in New England Journal of Medicine the benefits in terms of reducing mortality of prostate cancer by close to 30%. So when we have even more material data two years from now I think it’s going to be very hard for politicians, even us as clinicians to resist screening for prostate cancer. But until now there’s only one country in the world promoting screening for prostate cancer, and that is United States of America.

Selma Schimmel:

So do you have any guidelines in place in any of the European countries or not?

Prof. Per-Anders Abrahamsson:

Oh yes, we do because Sector Yellow of the European Association of Urology, I am responsible for all our European guidelines. They are used not only across Europe but also in Latin America; we are now translated into 42 languages so even in China and Brazil they use my friends and colleagues use the European guidelines including all the drugs we talked about earlier but also in terms of screening and so forth.

Selma Schimmel:

At what age is it recommended here to begin PSA testing?

Prof. Per-Anders Abrahamsson:

We don’t recommend the PSA testing in general, certainly not masquerading. I haven’t found any country in Europe actually doing that.

Selma Schimmel:

So is it digital rectal exam?

Prof. Per-Anders Abrahamsson:

It is. But on the other hand when you have a family history of prostate cancer, in other words your brother or father suffered this disease of course those men are there we recommend PSA testing to start up already at the age of 40. But in general when it comes to masquerading all males around Europe there’s no general recommendation.

But I am right now actually on a regular basis travelling to Brussels to European Parliament and talking to politicians because this main chat is for the future because this is the most common cancer in the western world. So of course they are concerned about what is going to happen ten years down the road because one third of the population, half a billion people in Europe are going to be diagnosed not with only prostate, but cancer in general. So it’s going to be made a challenge to health care providers and so forth.

Selma Schimmel:

Perhaps you could take a moment to speak to patients and the advocate community that will be benefiting from your work and this video that we’re doing with you – what can we do as patients, as advocates, to help you to facilitate the necessary change and awareness that must happen so we can diagnosis these cancers earlier?

Prof. Per-Anders Abrahamsson:

Well the organization I represent Sector Yellow since 2007 we have a very close relationship, in fact, collaboration with European Patient Organization in terms of prostate cancer. So we work together – we have a lobbyist in the UPM Parliament for instance, we are sending out patient leaflets, and we have a website together and so forth, and we have started that three or four years ago but we are taking off now, I think and increasing the awareness among the male but also female population about prostate cancer.

Selma Schimmel:

Since you do not do a routine screening in the same way that’s done in the US, I would imagine that if you were, who knows their family history – a brother, a father who’s had prostate cancer – they really need to be proactive. Is there a message at a teachable moment that you can give us right now for those viewers?

Prof. Per-Anders Abrahamsson:

I think, for instance in the Scandinavian countries there is increasing awareness but there is an increased risk of lifetime risk to be diagnosed with prostate cancer if you have a family history, so that is common knowledge actually in my part of the world. Maybe not the former eastern European countries but we are getting there, so I think that information is something we need to bring out to the general population. And that is actually on-going, and once again I think women are more aware of this rather than the male population, which should be the other way around actually. But when it comes to screening in general, I think we’re going to get there in a few years as we discussed earlier. But also we cannot already experience and hope that screening is going on. I mean more and more males are aware of that, the reason we call it prostate and prostate cancer so they think right now for sure that there is a rather simplistic blood test called PSA.

Selma Schimmel:

And this may seem like the next question. Simplistic to you but I think it’s important for the number of men who do not routinely go to the doctor. Are there symptoms that a man might present with, should be a warning sign that they really need to get to a urologist?

Prof. Per-Anders Abrahamsson:

Well that’s the problem, because if you are in the early phase of prostate cancer you don’t have any symptoms whatsoever. So it means that we have a task to really educate the main population across Europe. In addition to that I mean we can cure most of them if they come to the doctor in an early phase by surgery or by radiation, or by both. So I think in most centers in northern Europe and western Europe at least, we can cure now as a minimum 70% of the main population because various, as I said earlier also, screening is going on and increasing awareness as well.

Selma Schimmel:

It would seem to me imperative that men – just like women go for their routine exams to the gynecologist – that men should be incorporating their exams with a urologist.

Prof. Per-Anders Abrahamsson:

That’s what I address whenever I come to the European Union and Parliament in Brussels, but also here in Swedish Parliament, that all males above 50 at least should go to the doctor, test their blood pressure, have a PSA taken, and so forth. It’s so simple, and I think that’s going to happen, actually because the generation born in the 40s and 50s now, and they’re going to start up more on a regular basis to go to the doctor. So various and tremendous change at least in the western part of Europe and the Nordic part of Europe.

Selma Schimmel:

And in closing I just have to laugh as the physician was leaving as you were coming in to sit with us, you said to him ‘eventually you’re going to need an urologist’.

Prof. Per-Anders Abrahamsson:

That’s absolutely true because the life expectancy of a western community especially in Sweden, as we surpassed Japanese population recently we’re going to reach an age of 85 to 90 years of age and certainly in the long term run they’re going to need an urologist, absolutely.

Selma Schimmel:

Thank you Professor Abrahamsson, it’s a real pleasure speaking with you.

Prof. Per-Anders Abrahamsson:

Thank you so much.

END OF VIDEO

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