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Prostate News

Time for Decisive Action on Prostate Cancer

Categories: Medical

QUESTIONS TO ASK CANDIDATES FOR ELECTION TO PARLIAMENT 2017

Introduction

Every three years we have the opportunity to ask those standing for Parliament questions, but also to inform them about issues that concern us.

The Foundation Board suggests that you read this document and then convert it into letters, or emails to Parliamentary candidates to ask them for their opinions, or arrange to meet them to discuss the issues outlined below.  You can also seek their support for change, but also inform them about issues that concern you.

 

  1. Women have had access to free mammograms to check for breast cancer for 29 years, and that is wonderful. What will you and your party do to ensure that men have access to free prostate cancer testing?

The background to that question is as follows:

  • “BreastScreen Aotearoa was established nationally in December 1998 to provide free mammograms and follow-up for asymptomatic women,” according to https://www.nsu.govt.nz/health-professionals/breastscreen-aotearoa. Some men have difficulties getting prostate cancer checks done, and men have to pay for any checks that are done.
  • False positives and false negatives with prostate cancer and breast cancer tests are similar, yet many in the medical profession oppose prostate cancer testing while supporting breast cancer testing.

 

  1. It is great that resources have been provided to ensure the roll out of a National Bowel Screening Programme (for men and women) from July 2017, but what will you and your party do to ensure that the Prostate Cancer Awareness and Quality Improvement Programme to improve outcomes for men with prostate cancer is implemented?

Background to that question:

  • “The National Bowel Screening Programme will be rolled out progressively throughout New Zealand, starting with Hutt Valley and Wairarapa District Health Boards (DHBs) in July 2017. Other DHBs will follow in stages.”

Source: https://www.nsu.govt.nz/national-bowel-screening-programme/about-national-bowel-screening-programme

  • The Prostate Cancer Awareness and Quality Improvement Programme to improve outcomes for men with prostate cancer commenced in mid-2013, was supposed to be completed in 4 years, but has still not yet achieved its goals.
  1. Prostate Cancer Management and Referral Guidance was issued by the Ministry of Health in September 2015, but many doctors are unaware of the Guidance. What will you and your party do to ensure that this problem is addressed?

Background to that question:

  • The Guidance was very poorly publicised by the Ministry of Health.
  • The Guidance has not been promoted by the Ministry of Health.
  • DHB’s & PHO’s appear to have done little to ensure that GPs are trained about the Guidance.
  • No-one will accept accountability for the poor awareness of the Guidance.
  1. Māori, Pacific Island and those in lower socio-economic groups, and those living in more remote and smaller communities are disadvantaged in getting access to prostate cancer tests and treatment. What will you and your party do to ensure that this problem is addressed?

Background to that question:

  • Eight years ago, the 2009 Parliamentary Health Select Committee Report into prostate cancer noted that “Inequities and unfair differences are avoidable” – when will something effective be done about this?
  • Māori, Pacific Island and those in lower socio-economic groups and those living in more remote and smaller communities lack ready access to medical advice and expertise.
  • Those living in more remote and smaller communities do not have easy access to treatment and post-operative care.

See The Midlands Prostate Cancer Study: Understanding the Pathways of Care for Men with Localised Prostate Cancer in New Zealand (Health Research Council Reference, 11/082, February 2014), and Final Report for the Management of Metastatic Prostate Cancer Study (Lawrenson R, Brown C, Lao C, Obertova Z (2014), Uniservices Auckland, Waikato Clinical Campus, Hamilton).

  1. What will you and your party do to ensure that men and their families receive better support after prostate cancer treatment?

Background to that question:

  • A 2016 Australian study (Financial toxicity: a potential side effect of prostate cancer treatment among Australian men, Gordon, Walker, Mervin, Lowe, Hyde, Smith, Gardiner, and Chambers, Men’s Health-Seeking in the first year after diagnosis of localised prostate cancer, European Journal of Cancer Care, 2016) reported: “82% of men reported unmet supportive care needs” (sexuality, 58%; prostate-specific, 57%; psychological, 47%; physical and daily living, 41%; and health system and information) – the position in New Zealand must be similar.
  • Even with government-funded treatment, the financial costs of and losses following prostate cancer treatment are significant according to a 2016 Australian study (Hyde, Newton, Galvao, Gardiner, Occhipinti, Lowe, Wittert, and Chambers, Men’s Health-Seeking in the first year after diagnosis of localised prostate cancer, European Journal of Cancer Care, 2016) – the position in New Zealand must be similar.
  1. Men have problems accessing prostate cancer testing and treatment. What will you and your party do to ensure that this problem is addressed?

Background to that question:

  • According to a 2015 New Zealand Health and Disabilities Commissioner Report (The Health and Disability Commissioner, 2015, Delayed Diagnosis of Cancer in Primary Care: Complaints to the Health and Disability Commissioner: 2004-2013, at pages 14-15, see http://www.hdc.org.nz/media/283775/delayed%20diagnosis%20of%20cancer%20in%20primary%20care_april%202015.pdf):
    • Prostate cancer cases had the longest average treatment delays (13 months) followed by cases of colorectal cancer (9 months), lung cancer (8 months), lymphomas (6 months), breast and skin cancer (5 months each).
    • Delayed diagnosis and treatment can be fatal (highlighted by recent problems in Dunedin Hospital).

 

  1. The are major problems in providing men with metastatic prostate cancer with better palliative care. What will you and your party do to ensure that men with metastatic prostate cancer can access better palliative care?

Background to that question:

  • Midlands’ 2014 New Zealand Report into Management of Metastatic Prostate Cancer (referred to above) identified major deficiencies in palliative care.
  • The Prostate Cancer Awareness and Quality Improvement Programme recognises that “Providing appropriate and effective palliative care is important for the quality of life of men with metastatic prostate cancer.”
  • The Ministry of Health is supposedly leading a Review of Adult Palliative Care Services – see (page last updated 26 August 2015) http://www.health.govt.nz/our-work/life-stages/palliative-care/review-adult-palliative-care-services.

 

General background information about prostate cancer in New Zealand:

  • 2011: Parliamentary Health Select Committee commenced inquiry into the early detection and treatment of prostate cancer
  • 2013: Prostate Cancer Taskforce Report and Recommendations
  • 2013: 4-year Prostate Cancer Awareness and Quality Improvement Programme launched – not yet completed
  • 2015: Ministry of Health Prostate Cancer Management and Referral Guidance issued 30 September 2015 – not being properly implemented

Source: http://www.health.govt.nz/our-work/diseases-and-conditions/cancer-programme/prostate-cancer-programme