Other Players

The oldest existing prostate cancer group is the Prostate Cancer Education Council (www.pcaw.com), founded in 1988. It originated

''Like, I totally agree! This 'political correctness' has gone waaay too far!''

Prostate Cancer Awareness Week and has worked hard to make men aware of the necessity of having regular PSA tests and rectal exams. It too has corporate sponsorships.

Other cancer organizations serve individuals with all types of cancer, not just prostate cancer. The largest and oldest is the American Cancer Society (www.cancer.org), which began in 1913. It has both state and local offices and raises both public awareness and funds for research and prevention. The National Coalition for Cancer Survivorship (www.canceradvocacy.org), founded in 1986, is the oldest cancer organization led by cancer survivors themselves. It works closely with the media to promote education about cancer. Both of these organizations accept donations.

Finally, there are the pharmaceutical and radiation-related industries, which stand to gain financially from the widespread use of hormone and radiation therapies. These companies sponsor prostate cancer awareness events and cancer screening programs. In late 2004 the Theragenics Corporation, manufacturer of the seeds most com monly used for radiation seed therapy, persuaded Congress to pass a resolution ''encouraging doctors to inform prostate cancer patients of all the proven treatment options available, including brachy-therapy.''7 Congress thereby put itself into the medical information business.

The pharmaceutical industry, however, does not have an especially distinguished record in the prostate cancer field. For example, TAP Pharmaceutics has paid over $1 billion since 2001 to settle a series of civil claims and criminal charges. Jointly owned by Abbott Laboratories and Takeda Chemical Industries, TAP is the manufacturer of leuprolide (Lupron), one of the two major LHRH blockers widely used in hormone therapy. The company was accused of bribing urologists to switch their patients from Zoladex (goserelin) to Lupron. One scheme was to give doctors free Lupron samples and then encourage them to bill Medicare or other third-party payers. In another scheme, ''the company gave the federal government an inflated wholesale price for Lupron and then sold the drug to hundreds of doctors at a far lower price. On billing Medicare, the doctors could expect to get $100 or more in illicit profits on every shot.''8 It is alleged that hundreds of urologists cooperated with the company, some netting $30,000 or more.

Has advocacy been effective in raising awareness of prostate cancer and increasing funds for research? It unquestionably has been on both counts. Research funds have increased more than tenfold since 1993. Funds for prostate cancer research, however, still are only approximately half those devoted to breast cancer on a per patient affected or per death basis. Prostate cancer is disadvantaged in its advocacy efforts in that most of those affected are older men, and it is difficult to organize them to march on Congress. Over the last decade prostate cancer, often abbreviated PC, has become somewhat more politically correct, but it still has a long way to go.

CHAPTER

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