Yesterday’s New York Times article about health care reform and the overly inflated cost of the American health care system should ring large and loud alarm bells in the prostate cancer community. This article, along with the recent increasing pressure to halt prostate cancer screening, should put a major scare into the community. Unfortunately, the Times article specifically focused only on prostate cancer and has managed to throw additional fuel on the debate over whether men with early-stage prostate cancer benefit more from active and expensive treatment or from “watchful waiting.

In all honesty, the article did raise a number of legitimate concerns. Should treatments, which are used to combat prostate cancer, considering that there is no demonstrated survival advantage of one treatment over the other, be limited solely on the economic costs? This is a good question, especially when you consider the cost of proton beam radiation is often four times more expensive than surgery. However, when temporally linked with the PSA debate this can only signal devastating results for the prostate cancer community.

What about men with advanced prostate cancer, where does this debate leave them? I can assure you that they too are going to suffer. Those of us with advanced disease no longer can talk about cures and most of us are no longer as focused on side effects, but are instead intensely battling for our lives, trying to extend our survival time. However, we too will get lost in this debate. Fortunately, I have yet to hear the argument that men with advanced prostate cancer should not be treated, but only time will tell if this also changes. My concern remains that men with advanced disease do not get the research dollars or the insurance consideration but instead will lose their identity with the masses with the possible result hastening their demise.

Don’t believe me, yesterday. the stock market raised this very same question. Should men with advanced prostate cancer not be treated? The market spoke and raised this same question. Dendreon, the potential manufacture of Provenge (search this blog for a complete description and discussion about Provenge) had a significant drop in stock price purely as a response to this New York Times article and the recent general attack on treatments and screening for prostate cancer. The investment world is clearly thinking that along with the increasing resistance to prostate cancer screenings there will also be a growing resistance to spending money for the treatment for men with advanced prostate cancer.

Joel T Nowak MA, MSW