But for sure there are big hurdles. It seems to be getting clear now that urologists not getting up to speed is the problem and the company urgently needs to solve that. And that may be hard. There are for sure lots of doctors who are just going to do what they are used to doing--i.e. only referring men for screening after they have pain, because that was OK to do in the days of just Taxotere. Or giving men Zytiga off label so that the patient will be happy to see psa drops, without even considering Provenge. Not screening for mets to determine Provenge eligibility asap. These are all tough nuts to crack, perhaps, and show we were all naive to expect docs would all quickly know the facts and behave accordingly.
And how many times have I said that to negate doctor apathy, we need to do DTP marketing. Educated patients will demand Provenge and find a doc willing to assist. This forces lazy docs to get with it.