Dr. M. Scott Lucia talks about why a man with repeated high PSA tests might have a negative biopsy for prostate cancer.
Per-Anders Abrahamsson is the Chair of the Department of Urology at Skåne University Hospital at Lund University in Sweden and the Secretary General of the European Association of Urology (EAU).
Prostatepedia spoke with him about European urology and lessons learned from the randomized European screening trial.
How does the European approach to prostate cancer differ from approaches in other parts of the world? Or is there even a specifically European approach?
Dr. Abrahamsson: Yes, absolutely. In Europe in the 1990s, we were very conservative, with few exceptions. We didn’t really introduce early detection or screening programs whatsoever. In 1991, when I was working in the United States, the American Congress, American Cancer Society, and American Urologic Association all launched screening programs for prostate cancer.
At that time, Bob Dole was a Republican in Congress. He underwent surgery for prostate cancer. All of a sudden, you found advertisements in all the American airports for early detection (screening) of prostate cancer.
That was totally different from what we experienced in Europe at that time. We were a little bit more strict and conservative.
On the other hand, we knew for sure that we had a very high mortality rate for prostate cancer, especially in Scandinavia and Sweden, where I come from. In fact, we had the highest mortality rate in the world at that time.
Of course, we started to wonder what could we do about it.
That is why Sweden and Finland joined the European Randomized Screening Trial in the early 1990s.
How important are international collaborations for prostate cancer research?
Dr. Abrahamsson: Extremely important. I realized that when I was doing my PhD thesis in the 1980s, but even more so when I ended up in Rochester. As I said earlier, in Rochester, I had the opportunity to recruit good researchers from all over the world and to interact and collaborate with a number of leading centers in the United States and Canada. That sort of international collaboration was critical and crucial—and is even more important now in 2017.
You cannot do it alone. Collaboration is the key, especially if you look at patient-oriented research, what we call clinical research. You need increasing numbers of patient cohorts to study and follow over time in order to find out whether or not, for instance, screening can make a difference in terms of reducing mortality. Also to evaluate new treatment options, not only in surgery or radiation, but also for drugs and gene therapy coming out of vaccines, etc.
Collaboration is critical and crucial.