Almost 4 in 10 Prostate Cancer Diagnoses in UK are Late

The BBC has recently featured a report by the UK charity Orchid, which found a “worrying trend” of 37% of prostate cancer cases diagnosed late, at stages three or four. The comparable figure in the US is only 8%.
According to the BBC report, Orchid chief executive Rebecca Porta said: “With prostate cancer due to be the most prevalent cancer in the UK within the next 12 years, we are facing a potential crisis in terms of diagnostics, treatment and patient care. Urgent action needs to be taken now.”

The Orchid report, entitled “Prostate Cancer – Britain’s Growing Problem” also found that 23% of cases are diagnosed in hospital Accident & Emergency Departments, the majority of these cases being already at an advanced stage at the time of diagnosis. In addition, the analysis found that 42% of prostate cancer patients had seen their GP about their symptoms twice or more before they were referred (with 6% seen 5 or more times before referral). The report includes a comprehensive analysis of current and future aspects of patient care in the UK:
“Experts in the report point out deficiencies in the current approach to prostate cancer diagnostics. With the debate over the effectiveness of PSA tests still continuing there is a call for a unified, efficient and effective testing programme for those at high risk and those with worrying symptoms. “There is an urgent need for better tests to define how aggressive a prostate cancer is from the outset, building on diagnostic tests like MRI scans and new biopsy techniques which help to more accurately define the extent of the prostate cancer. This would enable us to counsel patients with more certainty whether the prostate cancer identified is suitable for active surveillance or requires urgent surgery and treatment” says Greg Shaw, Consultant Urological Surgeon at University College London Hospitals.”

The foreword of the report, by Rebecca Porta, Chief Executive of Orchid, concludes: “Prostate cancer cases are set to rise dramatically over the next decade. With added support, a refocus on patient needs and a willingness to accept that prostate cancer will become the UK’s most prevalent cancer, together we can make sure we are skilled and ready to tackle this growing cancer, save lives and deliver better outcomes for men.”
The report also contains Orchid’s recommendations for urgent action by policymakers to address the growing Prostate Cancer problem in the UK.

Original report (PDF):

PCa on the Beeb

On March 6th the BBC Radio 4’s ‘Inside Health’ carried a half-hour programme on Prostate Cancer with some of the UK’s leading clinicians and researchers such as Freddie Hamdy and Mark Emberton featured and many issues explained for the lay listener.

Download MP3 and listen back on this link:

PSA Testing Does Not Save Lives, Major UK Study Concludes

Death rates from Prostate Cancer over 10 years among symptomless men who underwent once-off screening were identical to those who did not. This indicates that PSA levels are a poor indicator of the presence or severity of Prostate Cancer, and underlines fears that positive screening results cause unnecessary anxiety and overtreatment that alters quality of life, without improving outcomes.


Original study:

See also JAMA editorial:

What? Where? – What Men Don’t Know…

location prostateIt seems that 9 out of 10 British men do not know what the prostate gland does. More than half of British men don’t know where their prostate is located. Almost 1 in 5 British men did not know they had a prostate. These results are from a survey by Prostate Cancer UK.  Would the results be much different for men in any other European country? Yet, prostate cancer is now the leading cause of cancer in British men. Figures released last month showed that it is now responsible for more deaths annually in men than breast cancer is in women.


Full survey results:

FDA Approves Apalutamide for Non-Metastatic Castration-Resistant Prostate Cancer (nmCRPC)

The US Food and Drugs Administration has approved Apalutamide (Erleada) for the treatment of patients with non-metastatic castration-resistant prostate cancer (nmCRPC). The drug is now the first FDA-approved treatment in this setting.

Non-Metastatic Castrate-Resistant Prostate Cancer is where men on Androgen Deprivation Treatment experience a rising PSA but where scans do not reveal the location of a new tumour.  This new drug appears to delay the actual onset of metastases or spread for about 2 years.

The approval is based on the phase III SPARTAN trial in which apalutamide reduced the risk of metastasis or death by 72% in patients with non-metastatic CRPC. The median metastasis-free survival (MFS) was 40.5 months in the apalutamide arm versus 16.2 months in the placebo arm.

“The FDA evaluates a variety of methods that measure a drug’s effect, called endpoints, in the approval of oncology drugs. This approval is the first to use the endpoint of metastasis-free survival, measuring the length of time that tumors did not spread to other parts of the body or that death occurred after starting treatment,” Richard Pazdur, MD, director of the FDA’s Oncology Center of Excellence and acting director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research, said in a statement. “In the trial supporting approval, Erleada had a robust effect on this endpoint. This demonstrates the agency’s commitment to using novel endpoints to expedite important therapies to the American public.”

The company, Janssen, which obtained the FDA approval has also made an application to the European Medicines Agency for marketing authorisation for the same drug.

Read more on the following link.

Richard Pazdur, MD

Gold Cystoscope Award for Shahrokh Shariat

Shahrokh ShariatThe American Urological Association (AUA) has honoured Shahrokh Shariat, Head of MedUni Vienna’s Department of Urology, by awarding him its prestigious Gold Cystoscope Award.

In so doing, the prize jury was recognising Shariat’s contribution to urologic oncology in the areas of epigenetics, oncology biomarkers and predictive nomograms.

Shariat is the first person from outside the USA to win the prize. “It is a particular honour for me and is testament to the growing international importance of the work of our team here at the Medical University’s Department of Urology,” says Shariat, delighted at the award. “It is great that our contribution to urologic oncology is so highly valued throughout the world.”
The prize will be presented at the AUA’s annual conference in Boston (USA) on 16 May 2017.

Since 1977, the American Urological Association (AUA) has awarded the annual Gold Cystoscope Award to urologists for outstanding achievements in their field. Founded in 1902, the AUA’s mission is to ensure the highest standards in education, research and healthcare policy. It has a membership of approximately 19,000 and publishes the “Journal of Urology”.

About Shahrokh Shariat
Shahrokh Shariat came to Vienna from Teheran (Iran) as a child, completed his secondary education here and studied chemistry and mathematics at the Swiss Federal Polytechnic in Lausanne before switching to a medical course at MedUni Vienna.  After gaining his doctorate, Shariat went to the USA, where he completed a Research Fellowship at Baylor College of Medicine in Houston, Texas, and did his specialist training in urology at the University of Texas in Dallas. Shariat specialised in urologic oncology at the Memorial Sloan-Kettering Center in New York,.

From 2010 to 2013 he headed up the bladder cancer unit at Weill Medical College of Cornell University in New York.

Since June 2013 he has run the Department of Urology of MedUni Vienna at Vienna General Hospital.
Shariat has written a total of 900 peer-reviewed publications and holds four patents, which were generated from his research work in the field of prostate and bladder cancer. His Scopus h-index (Hirsch factor) is 76, his Google h-index 100. In 2012 he was voted best urologic oncologist in New York. He was twice selected as one of the leading urologists in the USA. He is the only person to have been awarded both the top prizes for urology: 2014 EAU Crystal Matula Award and now the AUA Gold Cystoscope Award 2017.

Vienna, 17 January 2017

Immunotherapy – what is it and what can it do?

In the past decade the science of genetics had expanded greatly and with the mapping of the human genome scientists have been able to understand mechanisms that tumour cells use to confuse the body’s defences and allow tumours to grow.  Clinicians have now been able to develop ways to “unmask” the cancer cells and to allow the body’s natural defences to recognise the tumour cells as foreign and shrink or eliminate the tumour.  Update will reference a series of articles about immunotherapy.  A great deal of research is taking place in the field of prostate cancer using immunotherapy techniques and there is great hope that this will prove a boon in the treatment of the disease. The following article in Cure Today may act as an introduction to the topic. 

How Ken Mastris survived prostate cancer

ken mastris prostate cancer storyAfter more than 40 years working as a credit controller with a leading British telecommunications company, Ken Mastris was greatly looking forward to retirement. With a hefty stockpile of vacation days, he decided to take some time off to travel abroad and enjoy a well-deserved holiday. While on the month-long trip, Ken started to notice some physical changes. He was not passing urine as frequently as he normally would, but chalked it up to nothing more than his body’s reaction to the hot August weather and possibly dehydration.

Read the full story (pdf)

Recommendations to lower the risk and mortality rate of the most frequent cancer in men

Prostate cancer is the most commonly diagnosed cancer in men with more than 417,000 new cases and 92,000 deaths in Europe recorded each year.

Currently, 1 in 7 men in Europe will develop detectable PCa before the age of 85. More than two million men in Europe are living with this disease.

PCa is a malignant tumour in the prostate. Most of the tumours develop slowly and do not cause any symptoms. The risk of getting PCa increases with age. PCa is in early stage generally asymptomatic, which means that there are no clear symptoms to indicate its presence. In most cases, symptoms such as trouble urinating are caused by an infection or by benign prostatic enlargement (BPE), a non-cancerous growth of the prostate. If PCa does cause symptoms it is usually a sign that the disease is at an advanced stage. The symptoms of advanced PCa include: rapid onset of local symptoms or pain in the hips, back, chest, or legs from cancer that has spread to the bones and blood in the semen.

Read full article (download PDF).

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