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Prostate Cancer Crisis: Imaging is the Solution

Prostate Cancer Crisis: Imaging is the Solution. Faina Shtern, MD President, AdMeTech Foundation. Prostate Cancer Crisis: Imaging is the Solution. AdMeTech Foundation’s Mission:

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Prostate Cancer Crisis: Imaging is the Solution

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  1. Prostate Cancer Crisis:Imaging is the Solution Faina Shtern, MD President, AdMeTech Foundation

  2. Prostate Cancer Crisis:Imaging is the Solution • AdMeTech Foundation’s Mission: To End the Era of Blind Prostate Cancer Care: To Create a Future of Image-Guided, Minimally-Invasive Diagnosis & Treatment

  3. Courtesy of: Thomas M. Wheeler, MD, Baylor College of Medicine

  4. Prostate Cancer Crisis • Prostate Cancer Epidemic • “Blind” Diagnosis & Treatment • Patient Care Crisis • Socioeconomic Problem

  5. Prostate Cancer Epidemic • Most common major cancer: • 1 in 6 men is diagnosed • A new case – every 2.5 minutes • A man dies of prostate cancer every 18 minutes • In 2007: • 30,000 men died • 70,000 had treatment failures • 230,000 new cases • 1.5 million men had biopses

  6. Prostate Cancer Epidemic & African American Men • Greater risk (by 60%) • Younger Men • More Virulent & Lethal Disease • Higher Mortality (>100%)

  7. Imaging Technologies & Transformation of Prostate Cancer Care • “If prostate cancer is caught at a time when it is confined to the prostate, generally it can be cured by radiotherapy and surgery” Professor Alan Horwich Royal Marsden Hospital, UK

  8. Unnecessary Biopsies:Patient Care Crisis & Socioeconomic Impact • 230,000 new cases • 1.5 Million men have biopsies • 1 Million men per year have unnecessary biopsies with related fears, trauma and costs • Costs for Healthcare: • Over $2 Billion per year

  9. Unnecessary Biopsies:Patient Care Crisis & Socioeconomic Impact • 20 million men who had biopsy • 2 Million men live with prostate cancer • 18 million men had unnecessary biopsies: • Cost to Healthcare: $36 billion

  10. Potential Cost Savings with Imaging Per Year • Cost of Unnecessary Biopsies: • $2.00 billion • Potential Cost of Imaging for Additional Screening and Diagnostic Procedures: • $600 million • Savings with Improved Imaging: • $1.4 billion (assuming cancer yield of only 25%)

  11. Current Diagnosis and Treatment is Blind There are no accurate, affordable and accessible imaging and other diagnostic tools to guide: Early Detection Biopsy Treatment

  12. Experimental MRI Shows Large 2 cm Mass Missed with Biopsies

  13. Experimental MRI-Guided Biopsy Large 2 cm Tumor: Aggressive, virulent prostate cancer (Gleason Score: 8 & 9)

  14. CT Imaging Shows Multiple Metastases

  15. Case Study:53 Year Old Man with Negative Standard Biopsies for 5 years • Rising PSA • Multiple negative biopsies • Experimental MRI - demonstrated tumor • Image-guided Biopsy showed virulent cancer • Metastases to lymph nodes • Treated with chemotherapy & radiation

  16. Blind Prostate Cancer Treatment: Complications • 50 – 80% of impotence • 50-60% of incontinence

  17. Mitchell Schnall, MD, PHDUniversity of PennsylvaniaPioneer of Prostate-Dedicated MRI • “What was the most devastating experience for my father… and what kept him embarrassed, ashamed and isolated from our family was his inability to control his bowels”

  18. Treatment Failures:Prostate Cancer Crisis Efforts to Reduce Treatment Failures should be a clinical and public health priority

  19. Barry Bostwick:Leading Man of Prostate Cancer • Barry’s Diagnosis – at the age of 52 • Barry Selected Radical Surgery • Diapers for Quite a While • Challenges with Intimacy • Shots and Viagra

  20. Barry Bostwick:Leading Man of Prostate Cancer • Barry’s Father - Diagnosis at the age of 81 • Barry’s Father Selected Active Surveillance • No related problems or surgical complications

  21. Barry Bostwick:Leading Man of Prostate Cancer • “Was surgery really necessary?”

  22. Prostate Cancer Care:Fundamental Dilemma • To Treat or Not to Treat?

  23. Socioeconomic Impact • 2 million men live with prostate cancer • 18 million have had unnecessary biopsies: • ( $36 billion) • Treatment costs $8 billion per year • at least $2 billion is unnecessary • Lost Lives • Lost Quality of Life

  24. Framing the Need for Prostate Imaging:Patrick Walsh, MD, Johns HopkinsPioneer of Radical Surgery • “The most critical pieces of information…are the precise location and extent of cancer within the prostate. • I can’t think of anything more important. • Right now, there is no proven method… we need that desparately. ”

  25. Prostate Cancer Crisis:The Solution is Imaging • Potential Annual Reduction of Health Care Costs with Imaging: • $1.4 billion (unnecessary biopsies) • $1.6 billion (unnecessary treatment) • $2 billion (minimally-invasive treatment) • Total Reduction: $5 billion

  26. “ ” “…but you have to demand it to get it."

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