1. Advanced Stage Prostate Cancer Origin and Progression Virgil Simons Founder & President The Prostate Net

2. “The Denial of Death”: The Barrier in Male Communications and Early Detection Everybody wants to go to Heaven, but nobody wants to die!

3. Health Care Utilization, Gender and Age No regular physician by age Age Men Women All 33% 19% 18-29 53% 33% 30-44 38% 22% 45-64 24% 13% 65+ 10% 6% - Source: Commonwealth Fund (2000) No regular physician by age Age Men Women All 33% 19% 18-29 53% 33% 30-44 38% 22% 45-64 24% 13% 65+ 10% 6% - Source: Commonwealth Fund (2000)

4. Definition of Advanced Disease  Prior therapy failures  Surgery  Radiation therapy  Hormonal therapy  Locally advanced on diagnosis

5. Exacerbating the Problem Increasing employee cost burden Regulations on employers => increasing costs => decreasing competitiveness Insurance compensation standards Medicare reimbursement changes Increasing employee cost burden Regulations on employers => increasing costs => decreasing competitiveness Insurance compensation standards Medicare reimbursement changes

6. Primary Care Impact Decline in doctors entering into Primary Care Medicine Resistance to greater use of nurse practitioners Continuing shortage of nurses Closing of ER’s Resistance to “Convenient Care” clinics Decline in doctors entering into Primary Care Medicine Resistance to greater use of nurse practitioners Continuing shortage of nurses Closing of ER’s Resistance to “Convenient Care” clinics

7. Men’s Lack of Participation in the Healthcare System  Men are less likely to utilize the health care system than women  American men are less likely to carry health insurance, less likely to have seen a physician in the previous year, and more likely to delay seeking healthcare than American women => factors that account in part for lower average life expectancy for men  Men are less likely to utilize the health care system than women  American men are less likely to carry health insurance, less likely to have seen a physician in the previous year, and more likely to delay seeking healthcare than American women => factors that account in part for lower average life expectancy for men

8. Defining Barriers to Men’s Participation in Healthcare  Attitudinal Barriers  Gender Role Stoicism  Work Role Stoicism  Distrust of the Health Care System  Fatalism: “you’ve got to die of something.”  Maladaptive Self-Reliance: “A ‘man’ takes care of his own problems.”  Attitudinal Barriers  Gender Role Stoicism  Work Role Stoicism  Distrust of the Health Care System  Fatalism: “you’ve got to die of something.”  Maladaptive Self-Reliance: “A ‘man’ takes care of his own problems.”

9. Moving the Bar Forward: Success Stories and Templates for Change Moving the Bar Forward: Success Stories and Templates for Change