Researchers at Kaiser Permanente Southern California recently demonstrated that a comprehensive population based prostate cancer program can provide positive patient outcomes. The study is published in the journal Urology Practice.
“While prostate cancer is the second-leading cause of cancer death among men, providing high quality care for men living with prostate cancer presents a challenge,” said study lead author Ronald K. Loo, MD, regional chief of urology, Southern California Permanente Medical Group. “Increased survival rates have made prostate cancer similar to other chronic conditions, which means we need ongoing management strategies that span the natural history and clinical course of the disease.”
Kaiser Permanente Southern California is an integrated health care system that provides complete clinical care for 3.7 million members. The program started in 2003 with the aim of improving care for men with prostate cancer. The program includes screening, shared decision for treatment after cancer diagnosis, and care for men with advanced disease. Results from the study titled “The Continuum of Prostate Cancer Care: An Integrated Population Based Model of Health Care Delivery” revealed that screening men with prostate cancer aged above 75 years decreased during the study period from 50% to 30% in 2009 and to 15% in 2012. With this program, the researchers were able to identify approximately 1,200 men with prostate cancer who were not clinically followed from 2006 to 2010.
The program identified a total of 9,381 men with elevated serum prostate-specific antigen (PSA) who were not evaluated by a urologist within 12 weeks of receiving results. Of these, a total of 3,377 men received a biopsy and one-third had a prostate cancer diagnosis.
Results also showed that men who underwent a robot-assisted procedure to aid surgeons during prostatectomy versus traditional surgery had lower rates of blood loss and were more likely to report return of sexual function. Hormonal therapy was altered to a dosing approach based on circulating testosterone levels, preventing some of the side effects of this therapy. Coupled with a systems approach to osteoporosis prevention, this treatment resulted in lower rates of bone fractures.
“This comprehensive, regional care management program has proven to deliver reliable improvement in the way a health care organization approaches prostate cancer care,” said Dr. Loo. “We believe that other health care providers and organizations may wish to adopt aspects of this program, as clinicians treating men with prostate cancer aim to provide the highest quality, affordable care.”