A cancer coming in from the cold

It’s a disease that affects men and many are reluctant to seek diagnosis, but awareness of prostate cancer is rising along with survival rates, writes Liz Bestic

Five years ago prostate cancer was barely on the map, but now there is a wider choice of therapies, promising drugs on the horizon and patients who are living ever longer with the disease.

A spotlight has been shone on what was a “Cinderella” cancer few people had heard of and very few men were willing to be tested for.

Now men all over the country are growing moustaches and running marathons to highlight a cancer which affects one in nine of them and kills almost as many men as women who die from breast cancer.

Currently the most common cancer in men, by 2030 prostate cancer is expected to be the most common cancer overall.

But campaigners and charities are achieving so much for men with this disease. Prostate Cancer UK recently led a successful campaign to make the breakthrough life-enhancing and life-extending drug, abiraterone, available on the NHS throughout the UK.

The charity has also developed a quality checklist to guide men through their treatment journey from the point of their diagnosis onwards.

“Prostate Cancer UK has tripled its investment in research to become the largest single funder of prostate cancer research in the country,” says chief executive Owen Sharp.

“The main focus of this record £25-million funding will be to find a more accurate diagnostic test, to establish a means of distinguishing aggressive from non-aggressive tumours, and to develop new and less invasive treatment options.”

The PSA (prostate-specific antigen) test has long been known to be limited as a diagnostic tool, but recent research has already revealed potential new biomarkers for improved prostate cancer diagnosis.

Men all over the country are growing moustaches and running marathons to highlight a cancer which affects one in nine of them

Clinical trials, such as PIVOT and PROMIS, are helping in this area by determining those men who need treatment and those who do not.

Research has pointed towards the possibility of a new urine test, for example, which could accurately identify some 66 per cent of men who have the disease and correctly rule it out in almost 90 per cent of those who do not.

Another potential new blood test acts like a barcode to read genetic changes in the blood. While these potential new tests remain years in the making, they offer hope for the future.

At London Cancer they are addressing the worries that many men have about the side effects caused by treatment. Cutting-edge techniques, such as robotic-arm technology, may be able to help specialist cancer surgeons to be more targeted in treating tumours, to minimise the risk of incontinence and impotence in as many patients as possible.

The landscape of prostate cancer is changing rapidly. Now patients with late-stage disease are increasingly being presented with real choices about treatment options and how to live out their lives.

Thanks largely to the work of Prostate Cancer UK and its partnership with Movember, the disease is rapidly rising up the political and healthcare agendas. Yet there is still concern that decisions about new drugs are made purely on the grounds of financial cost. A new UK-wide system, which prices drugs according to their value to the patient and society, is being considered and may replace the temporary, England-only Cancer Drugs Fund.

Nobody working in the field of prostate cancer is complacent, however. All healthcare professionals need to be better educated to ensure men are given the best possible advice to make the correct decisions about treatment options available to them.