1. Management of Senior Adults with Prostate Cancer Patients’ Perspectives Louis Denis - Europa Uomo Milan, 27.03.08

2. Cancer Facts for the Senior Adult Male The scare is there: BPH symptoms labeled as PCa Patient Scaring Antigen Peak incidence PCa 70 & death 76 y. Co-morbidity is a fact of life: CVD, lung, diabetes + 50% Milan, 27.03.08

3. Cancer Diagnosis Is still seen as a death sentence by patient and doctor alike. The doctor wants to cure by optimal, medical treatment. The patients wants cure but also holistic care with quality of life. Milan, 27.03.08

4. The PCa Conundrum The PCa trinity: –1/3 latent, indolent no treatment (overdetection – overtreatment) –1/3 long medical history of 15 years –1/3 a lethal disease (underdetection – undertreatment) Milan, 27.03.08

5. The lost patient Tsunami information (Professionals, media, friends ) The medical labyrinth EBM Guidelines Nomograms Loss of personality Outcome results Statistics PANIC Milan, 27.03.08

6. Treatment Senior Adult Men Few if any clear guidelines mainly for curative attempt. Age is taken as a cut-off for treatment rather than health status. Cancer control is acceptable for survival and quality of life. Milan, 27.03.08

7. Europa Uomo stands for 1.Develop individualized prostate cancer treatment based on optimal medical treatment and personalized cancer care. 2.Help reduce overtreatment in indolent cancer. 3.Help reduce undertreatment in lethal disease. Milan, 27.03.08

8. Solving the Problem in the Senior Adult Males 1.Clear distinction into low risk and high risk prostate cancer. 2.Treatment selection on health status and life expectancy. 3.Effective, palliative chemotherapy is not the end but the beginning where hope is key to the balance of treatment vs. care. Milan, 27.03.08