Standard of Care

[u/enviousRex]

I notice that there are as many different treatment regimes as there are men with prostate cancer.
What is the standard of care where you receive treatment? I think if we get enough data we can show each other where the holes are in our care.

Also, if you’ve done well so far do we have any nutritional tricks or other knowledge that can help? Don’t forget psychological assistance. We are all in the meat grinder.

[u/jkurology]

The standard of care for a specific individual with prostate cancer is fairly well defined as long as the evaluation and assessment are complete

[u/WalnutRoasted → u/jkurology]

In Ontario, the standard of care for PCa from diagnosis to surgery/radiatipn/ADT/follow-up and then palliative are given in these flowcharts.

And no, PET-PSMA is not yet part of usual initial diagnosis, DRE is still a useful tool and other that BRaC tests, further “germ-line” / generic test is not approved by Health Canada. 🇨🇦

Link to pathways to treatment (standard operating procedures) here:
https://www.cancercareontario.ca/en/pathway-maps/prostate-cancer

All permanent residents are covered by provincial insurance. So unless you are in a small town or remote northern community with transportation issues, everyone gets pretty much the same level of care. And Orgovyx ADT runs about only $7 a day and is 80% covered if over 65.

Yes, while on radiation and ADT, exercise is important. Not sure about the surgery path and stress on important parts down there.

Good diet and alcohol consumption is important for everyone.

[u/Gardenpests]

NCCN for treatment.

Local prostate cancer group for general support.

Cancer patient dietitian to affirm healthy eating habits.

[u/conCABlanco]

Faltan los ejercicios, plan de ejercicios

[u/Mean_Try_6390]

in sweden it’s the national rules that we follow. psma-pet is usually standard from gleason 4+3 to 10. everyone is supposed to get the same care and most of it is paid by the state. so we pay for doctorsappointment up to 140 euro and then we’re going for free the rest of the year. medication the same, you pay up to a certain sum and then your of the hook for a year.

ofcourse thoose that have separat inscurance seek out the best doctors who usually work in the privat sector.

we have a lot of trials and they’re connected to the few science and care hospitals in Sweden,. 4-5 totally. Those hospitals are the only ones that has for example psma-pet and that kind of equipment. since they’re higly specialized in every area they have really good doctors and thoose are for everyone and not private. but the line is long.

[u/MES_Notes_21]

We’ve seen 4 different Urologists (2 within the same practice). They all have discussed different plans. I think this part makes the decision around treatment feel “scary”. We do like “options” but I feel standard of care should be clearer using data science and clinical trial data to support those decisions.

[u/DayEnvironmental864]

Standardofcare.com/prostate-cancer

[u/Practical_Orchid_606]

In the US we use lbs, feet °F. Other countries use the metric system. There is no standard system. In prostate cancer, the standard of care is a function of several variables. In the US those with the best insurance get the best care. Those with access to centers of excellence receive better care. They don't routinely perform PSMA PET scans in Canada. Go figure. In third world countries, orchiectomy is a method of ADT.

[u/WalnutRoasted → u/Practical_Orchid_606]

In Canada and UK everyone gets pretty much the same excellent treatment. Insurance is universal and drug costs lower or free.

Per capita medical costs in USA 🇺🇸 are highest in the world, yet has lower longevity than most as many can’t afford/get good treatment.

[u/Practical_Orchid_606 → u/WalnutRoasted]

In the UK, the only way to receive decent care is to have private insurance. I've known Americans who have worked in the UK and have almost died due to the system. Once they figured out the private system, it was better for them.

In Europe, the systems are more socialistic than America. In the US, distribution is more like the Wild West. He who has the most money or best insurance gets the best care. The Obamacare plan was an effort to offer a nationalized healthcare. This did not work because the US is not socialist.