The VA provides the ideal setting for such trials. An estimated 12,000 veterans are diagnosed with prostate cancer each year, and it’s the most frequently diagnosed cancer among veterans.
“The average VA physician sees more prostate cancer than the average practitioner,” says Dr. Fojo. “Nearly 100% of their patients are male. And these days, many of our veterans from wars in the 40s, 50s, and 60s are reaching the age where prostate cancer becomes a problem for them.”
The VA also has a uniquely valuable asset: a database that includes the electronic medical records of thousands of veterans treated with standardized treatment protocols. This allows researchers to glean information about the effectiveness of various prostate cancer treatments among specific groups and demographics. It also makes it possible to compare standard treatments with emerging therapies.
“This is a really beautiful data system of the records, treatment outcomes, and laboratory results for thousands of men, which helps enable research and advances in care,” says Dr. Drake.
“It’s an amazing data set. I can tell you how 15,000 veterans did when treated with the standard of care,” Dr. Fojo says. “In the work that we’re doing, we now have amassed so much data that you can actually conduct a clinical trial in a small group of patients and benchmark it against the standard of care and get highly statistically significant results, if you’re dealing with something that’s effective.”
Over time, the data should be able to help researchers predict how successful a treatment will be in individuals, based on their age and other characteristics. “Eventually, we will be able to actually project how effective this is going to be for this 80-year-old Caucasian or this 80-year-old African American versus this 60-year-old Caucasian or this 60-year-old African American,” says Dr. Fojo. “Whether they’re getting it as the first treatment or as the second treatment, all of that data will be available to us.”
Dr. Fojo has a long history working with veterans — his first rotation as a medical student was at a VA hospital.
“Veterans hospitals are the best places in the world to work in as an oncologist,” says Dr. Fojo. “For the veterans, the experience at the VA is more than just the doctor’s visits. It’s a visit to a place where there are a bunch of people you know and who care about you. As a physician, to be part of that feels really good.”
“The most important thing for an oncologist is to give the very best care to their patients,” he continues, “so you can walk away at the end of the day and say, ‘I did the very best that we could have.’ I think any veteran can feel confident that their prostate cancer has been treated optimally and that this will continue and even get better.”