High Intensity Focused Ultrasound is one of the experimental treatments taken by men with a diagnosis of prostate cancer. The problem for patients and clinicians is the small number of randomised control trials for the procedure and also the relative lack of long-term follow up of patients. The recent study published in the Journal of Urology shows that patients and their physicians who are trying to find an alternative to radical treatments such as a prostatectomy or radiotherapy are often attracted to HIFU because it offers men with relatively low risk disease a treatment which appears to avoid the risks of incontinence and sexual difficulties which come with radical treatments. HIFU is also seen as a option for men with low risk disease who do not wish to follow an active surveillance regime.

While the study reported is interesting and supportive of the efficacy of HIFU it only has a two year follow-up. For prostate cancer treatment comparisons this is usually considered wholly inadequate.

See Report in Renal & Urology News 

At the ESMO virtual congress last week there was an update on last year’s report what may be a new treatment model for men with mCRPC and BRCA1, BRCA2 or ATM mutation.

Last year’s ESMO congress was very impressed by the initial findings of the PROfound Trial. The positive progression-free survival (PFS) data reported last year in the PROfound trial continues, with final overall survival (OS) data presented last week at ESMO Virtual Congress 2020 (Abstract 610O) showing significant benefits with the PARP inhibitor Olaparib in men with metastatic castration-resistant prostate cancer (mCRPC) and BRCA1, BRCA2 or ATM mutations.

The final overall survival data together with positive progression-free survival are said to be very likely to alter the treatment models for patients with mCRPC who may otherwise have been treated with enzalutamide or abiraterone. The recent FDA approval is anticipated to be followed by EMA approval.

Read more from the ESMO Virtual Congress on this report and find the abstract here.

This is a very detailed study showing the variations in PCa incidence and mortality; in 44 countries for incidence and 76 countries for mortality. The Objective of the study team, led by MaryBeth Culp, of the America Cancer Association, is to assess recent worldwide prostate cancer incidence, mortality rates, and trends using up-to-date incidence and mortality data.

The authors examined recent trends in prostate cancer incidence and mortality rates in 44 and 76 countries respectively, and concluded that prostate cancer incidence and mortality rates have been on the decline or have stabilized recently in many countries, with decreases more pronounced in high-income countries. These trends may reflect a decline in prostate-specific antigen testing (incidence) and improvements in treatment (mortality).

Read more here

Trying to keep up with the recent developments in the management of non-metastatic castration-resistant prostate cancer (nmCRPC) has not been easy. Direct comparative data are not available to inform treatment decisions and/or guideline recommendations. In a study published this month the authors reviewed all the available articles published up to June 2020 which met their criteria. Researchers did what is called is called a meta-analysis to indirectly compare the efficacy and safety of currently available treatments. It should be borne in mind that not all these treatments are reimbursable or available in all European countries. From the three papers which covered 4117 patients they compared metastates free survival as well as PSA-Progression Free Survival and compared the incidence of adverse events for the three treatments. The authors suggest their findings may facilitate individualised treatment strategies and inform future direct comparative trials.

See abstract here

Since the presentation by André Deschamps to the General Assembly last June considerable additional information on EUPROMS – our Quality of Life Survey – has been processed and is now available.

An opportunity to hear the additional information will be made available by way of a Zoom presentation led by our Chairman, André Deschamps on Thursday 1st October at 11 am CET.

This invitation is available to all members and their partners of all Europa Uomo affiliated organisations. As long as there are open places, several people per member group may register and log in.

For organisational reasons please indicate your participation by email to the Secretariat (europauomo@skynet.be) by Monday 28th September at the latest. The secretariat will provide you with log in details.

One of the topics that male cancer patients appear to have a problem discussing with their oncologist is the impact of their cancer on their sexuality.  This leaflet from the ECL is only available at the moment in English, but they hope to have it translated into other languages in due course.   It provides suggestions as to how a patient should proceed with raising the topic. The key take-away points are:

* Sexuality means different things to different people, and people express their sexuality in their own unique ways.

* Sexuality needs do not disappear when a person is diagnosed with cancer, but it can have different meanings throughout the pathway and may require adjustment during the different phases (diagnosis/ treatment/ after cancer) of your journey. Even in the last (palliative) phase people continue to be sexual beings and may need intimate or sexual contact.

* The illness and its treatment can cause disturbances and changes to your sexual health. Some of them can be temporary but others can last long-term.

* Taking care of your intimacy is very important. Masturbation as well as talking, listening, touching, holding and caressing others can improve your mental health and facilitate your sexual activity.

* It might be a good idea to invite your partner(s) to the medical consultations and sessions where you plan to talk about your sexual health and problems.

* Friends, family and other survivors can be helpful to partially alleviate your emotional challenges.

* Your sexual health matters and taking care of your sexual health is important. It is OK to request information on sexuality issues and to receive practical advice and emotional support from HCPs.

‘New approaches in patient-focused cancer drug development’

The European Medicines Agency is hosting a symposium to explore themes such as the natural evolution of patients’ role from interested stakeholders to advisors and decision makers, evidence-based methods of patient preference data collection. In addition, topics, such as collaborative research networks and registries for real-world data generation, also in difficult areas, including rare cancers and palliative care, will be discussed.

The Agency shares the European Commission priorities of improving cancer prevention and care, and fully appreciates the opportunities brought by the rapid scientific and technological advances but also the challenges that these will bring.

Coupled with the digital transformation that features in many Commission policy areas, such as big data and digital platforms, there is a real opportunity to develop the impactful actions in the area of health data to speed up development and optimisation of cancer treatments while at the same time augmenting data generation to satisfy the evidentiary standards of patients, clinicians, regulators and payers.

Please click on the agenda for more details.

No registration is required to participate in this event. A link to the live broadcast will be available here during the event.