Thursday, September 23, 2004

Research and treatment of prostate cancer — the second-leading cancer killer of American men — has been shortchanged, a new report by the Prostate Cancer Foundation suggests.

“The future is optimistic for prostate cancer. But right now, we have only one chemical agent that benefits patients whose cancer has spread to the bones. Meanwhile, there are five or six different drugs for patients with advanced breast cancer, and three or four drugs for those with [advanced] colon cancer,” said Dr. Michael A. Carducci, an oncologist for the Johns Hopkins Kimmel Cancer Center and an author of the foundation’s report.

Progress made on prostate cancer in the past five to seven years has been the first such progress in more than 60 years, Dr. Carducci said in a telephone interview.

The report warns that the prevalence of this deadly form of cancer will rise sharply in the next few years as more baby-boomer males turn 50, the beginning of the primary risk age for the disease. Because of this, the study cites an “urgent” need for new therapies and better coordination of treatment.

The Report to the Nation on Prostate Cancer, written by 24 leading prostate cancer specialists, estimates that this year, 230,000 American men will be diagnosed with the disease, which kills 30,000 men annually.

With so many men entering the age group at greatest risk for prostate cancer, says Leslie Michelson, foundation vice-chairman and CEO: “The number of new prostate cancer cases in the U.S. is anticipated to increase by 50 percent to more than 300,000 new cases per year by 2012.”

One in six American men will develop prostate cancer in their lifetimes, making it the most commonly diagnosed non-skin cancer in the United States. It is more common than breast cancer, which afflicts 1 in 8 American women in their lifetimes. Yet treatment and research for prostate cancer has lagged behind breast cancer.

“A lot of that has been due to women’s activism. For men, prostate [cancer] has been a silent killer. If surgery or radiation doesn’t cure it, there are not many options,” Dr. Carducci said.

American Cancer Society data show prostate cancer is second only to lung cancer as the nation’s top cancer killer of men. “The two highest-risk populations are African-American men and men with a family history of prostate cancer,” the Johns Hopkins physician said.

Already, 48,000 men annually progress to advanced prostate cancer. “For those men, few, if any options remain,” the foundation says, adding that victims “are left to progress to painful” bone cancer.

“If it spreads to the bones, they have less than two years to live,” Dr. Carducci said. If prostate cancer recurs, he said, “median survival is 13 to 15 years,” which means victims still will die early.

The report says it is “crucial” to the well-being of prostate cancer patients and management of the disease to coordinate care among urologists, radiation oncologists and medical oncologists.

“Many patients are not made aware of a multidisciplinary team approach until their cancer has progressed to a late stage,” it says.

The study further recommends that better ways be found to distinguish between aggressive, fast-growing prostate cancers and those that are less aggressive and slow-growing. It also recommends the development of new therapies for advanced prostate cancer.

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