Making Blue the New Pink: Reimagining Prostate Cancer Care for Veterans

When I was in junior high, I used to write letters to my cousin, Lonne, who served in Operation Desert Storm. He was just 18 when he left for duty, and it was the first time someone I was close to had gone to war. I wanted him to know he was on my mind every day. When he returned home, he graciously gave me the medal he earned overseas.

Perhaps that’s why I am so passionate about caring for veterans, many of whom live with health challenges they could not have anticipated when they enlisted—including a higher-than-normal risk of developing prostate cancer.

Today, 500,000 veterans are living with prostate cancer, and 16,000 veterans have been diagnosed with metastatic disease. Awareness and early detection are key to saving lives and protecting quality of life, yet many veterans are not aware that they face increased risk for developing this disease.

For urology practices, meeting the health needs of these men depends on new approaches for identifying veterans in need of prostate cancer checks or follow-ups and ensuring access to care.

Exploring Tech-Enabled Care Management

According to BlueIsTheNewPink.org—an organization dedicated to raising awareness of veterans’ risk for prostate cancer, denoted with a blue ribbon—15,000 US veterans will be diagnosed with prostate cancer in 2022. Another 489,000 veterans with prostate cancer are already in the Veterans Health Administration (VA) system, the largest integrated health care system in the United States, providing care to 9 million veterans each year.

But although 60% of US veterans are eligible to receive care through the VA, fewer than half of veterans rely on the VA for care, a RAND assessment found. That means it’s up to urology practices to know that men who are veterans face increased risk for prostate cancer and to proactively identify and monitor these men for signs of disease. For veterans who are diagnosed with prostate cancer, care navigation capabilities also could prove vital.

Following are 3 practical and tech-enabled approaches to prostate cancer identification and management that urology practices should consider for the veteran population.

#1 Leverage artificial intelligence (AI)-based tools to identify veterans who would benefit from prostate cancer screenings or follow-up.

Veterans who were exposed to herbicides, such as Agent Orange, are at heightened risk for prostate cancer, according to ZERO - The End of Prostate Cancer, a nonprofit group dedicated to ending prostate cancer.

Further, as men age, their risk for prostate cancer increases. Given that 36% of veterans are between the ages of 50 and 69 years, knowing which male patients are veterans is an important first step in risk identification. An analysis of members of this cohort who also have other risk factors for prostate cancer—such as a family history of prostate cancer, a single family member who has been diagnosed with advanced prostate cancer, men with African or Ashkenazi Jewish ancestry, or men who possess certain genetic risk factors for prostate cancer—will further pinpoint which patients should be seen in person and how often.

#2 Empower medical assistants to dig deeper with tech-enabled, condition-specific scripting.

Since nearly 1 of 4 patients with prostate cancer faced care delays, changes, or cancellations during the pandemic, conversations that help uncover the reasons for delayed screenings or treatment protocols, like hormone therapy injections following a diagnosis of cancer, are crucial. Yet physicians are already pressed for time, and nurses typically do not have the capacity to conduct these conversations, especially in practices facing workforce shortages.

Increasingly, urology practices are relying on AI-powered care coordination software to help medical assistants initiate these conversations. With each response, the software prompts medical associates to ask follow-up questions like, “I see that you cancelled your last follow-up appointment. Tell me more. Did you have trouble making it to the appointment?” or “I noticed you missed your last hormone therapy injection. Did you have any concerns about the side effects?” With this information in hand, medical assistants can propose solutions such as transportation assistance or a discussion with a urologist on an alternative treatment if side effects are to blame.

At one California urology practice, use of AI-powered software to guide conversations between medical assistants and patients helped clinicians detect prostate cancer progression 21% sooner. For high-risk populations like veterans, condition-specific conversations could make a dramatic impact on health.

#3 Use multiple modes of communication to reach patients.

A cadence of personalized communication—from letters to phone calls, emails, and texts—helps patients realize, “This care is important—and it’s not too late to make it a priority.” It also opens the door to conversations that can help break down barriers to care, such as facilitating access to care during times that are most convenient for patients or at locations that are closer to home. Additionally, these communications enable staff to address misconceptions regarding the importance of screenings or in-person follow-up, providing a vital opportunity for more informed decision-making.

In Conclusion

Sometimes it takes time to understand the long-term effects of military service on veterans’ health. For urologists, knowing the heightened risk veterans face for prostate cancer and developing a proactive response is one way to serve those who dedicated themselves to service. By taking a tech-enabled and highly compassionate approach to engaging veterans in prostate care, urology practices can reduce veterans’ risk for complications from this disease and save lives.