1. Prostate Cancer Coalition of NC A statewide collaborative effort by concerned organizations and individuals to support awareness, early detection, and “best practices” care for men who are, or will someday be, prostate cancer survivors. www.pccnc.org

2. Learning Objectives 1. Risk benefit discussion 2. Screening and prostate health 3. Early detection to support clinical treatment guidelines for patients that opt to screen 4. Tools to support informed pre-treatment consult for your patients

3. Risk Benefit Discussion Risk Assessment Physical Exam & Baseline PSA Careful review of personal health and family history A Thorough Understanding of the Diagnostic and Decision Making Process

4. Risks Screening can help identify, but is not specific to, prostate cancer. 65% of elevated PSA is caused by: other prostate health conditions activity known to artificially elevate PSA Screening can be normal even when a man has prostate cancer. Abnormal screening is NOT a cancer diagnosis. Every man diagnosed with prostate cancer should know to consider personal health, priorities, and how aggressive his cancer is prior to evaluating treatment options.

5. Benefits Can help identify several non-cancerous conditions. can become uncomfortable if left untreated Only known method of detecting prostate cancer during its early stages. Better options, and often more time to research and consider those options.

6. Evidence Based Healthcare Best Research Evidence Patient Values Clinical Expertise Johns Hopkins/ Cochrane Collaboration course, "Understanding evidence-based healthcare: A foundation for action."

7. PCP Clinical Practice Guidelines Reflect NCCN guidelines applicable in a primary care setting A convenient, evidence- based reference for evaluating screening results Reviewed and supported by NC’s 3 National Cancer Institute (NCI)-designated Cancer Centers (Duke, UNC, and Wake Forest)

8. Referral Discussion Guide Reflects American Urological Association “best practices” guidelines for follow up Facilitates patient’s ongoing education and shared decision making

9. Newly Diagnosed Tutorial Helps patient understand prognostic factors at diagnosis Supports patient involvement and a multidisciplinary analysis of treatment options

10. Localized Pilot Program Patient Radiation Oncology Medical Oncology Urology Multi-disciplinary consultation encouraged and supported Forms to support multi-institutional collaboration

11. Collaborate to Provide Leading Edge Research and the Best Possible Care for those Affected by this Disease Patient Radiation Oncology Medical Oncology Urology Difficult cases discussed at local GU tumor board When necessary, engage with academic centers

12. Moving Forward: Goals Reduce the prostate cancer death rate Continue to address gaps in patient education Support personalized care Facilitate informed / shared decision making

13. Conclusion: practical strategy Avoid under-detection of aggressive/ potentially fatal cancers Manage over-detection with the guidance of modern clinical treatment guidelines Empower patients to be actively involved in treatment choice Primary care physicians, urologists and oncologists work together