Prostate Cancer ? Updates on New Drugs and Investigations | The ...

• Continuing Series ? Previous Article: Dilemma Of Prostate Cancer

By Dr. Harold Gunatillake - FRCS-Health Writer

Prostate Cancer would be considered the worst cancer, (similar to breast cancer in women), any man can be afflicted with, and the most worrying disease any man can suffer from. More than 36,000 men are diagnosed with prostate cancer each year in the UK ? more than 10,000 die from the disease.

In Sri Lanka the numbers are increasing though figures are not available. ?The Sri Lankan cancer registry data showed a low rate of CaP, similar to other South Asian countries, but the actual incidence of CaP in Sri Lanka is probably higher than reported, as seen in the densely populated districts and the high rate of incidental diagnosis of CaP in TURP (transurethral resection) specimens.
PSA Test
Even, checking annually the most popular test Prostate Specific Antibody (PSA) may not indicate the presence of the disease in the body. On the contrary with PSA testing, most prostate cancers are now found before they cause symptoms. PSA is a protein produced by the gland. Even with a PSA within the normal range, one could brew up the disease within, unknowingly. Furthermore, you may not have any symptoms and signs for a long period whilst the disease is brewing up.
Likewise, high PSA may not reveal that you suffer from the disease quite definitely, because as one grows older the PSA also physiologically rises.? This is notoriously inaccurate and although ten to 15 percent of men will have high enough PSA levels to warrant carrying out a prostate biopsy, only two to three? percent will require any treatment.
The question keeps arising and has never been satisfactorily answered. Now it has come up again, in the context of a provocative new study on the popular P.S.A. test for prostate cancer. The paper, published in The Journal of Clinical Oncology, finds that men in their 70?s are being screened at nearly twice the rate of men in their 50?s ? and men aged 80 to 85 are being screened as often as those 30 years younger.
?That is mind-boggling,? said the lead author, a University of Chicago urologist, Dr. Scott E. Eggener. ?What we were hoping for was that young, healthy men who were most likely to benefit would be screened at higher rates and that screening would tail off in older men.?
The American Cancer Society and the American Urological Society discourage screening for men whose life expectancy is ten years or less. The cancer is so slow-growing that it can take that long for screening to show a benefit.
The United States Preventive Services Task Force recently concluded that screening should stop at 75. Scientific director for the group, Dr. Mary Barton said, ?it is more than just a lack of data? that led to that conclusion. ?What data we do have for this group suggests it is a net-harm situation,? she added.
But although 80-year-olds are much more likely than 50-year-olds to have chronic illnesses and a limited life expectancy, age should not be the deciding factor, Dr. Eggener said. ?Health condition and life expectancy are far more important,? he said. ?There are 50-year-olds that shouldn?t be screened and 70-year-olds that may benefit from it.?
(reference Screening Prostates by Gina Kolata published April 11, 2011)
In U.K. the researchers have discovered that a protein found in urine is affected by a genetic change linked to the cancer.
Study leader from Cancer Research UK charity?s Cambridge Research Institute, Dr. Hayley Whitaker, said: ?We looked in tissue and urine from over 350 men with and without prostate cancer to detect the link.
?We then looked to see who had the genetic change. It was really exciting to find out that the genetic change and the amount of protein were linked.
?The protein is easy to detect because it is found in urine and would potentially be a very simple test to carry out on men to identify those most at risk of developing the disease.?
Research manager at The Prostate Cancer Charity, Dr. Kate Holmes, described the test as ?potentially?a powerful way to predict how likely a man is to develop prostate cancer.?
Scientists at the University of Surrey have discovered that prostate cancers secrete a chemical called EN2 that can be found in a urine test.
Their findings from a study of 288 patients, published in the journal Clinical Cancer Research, suggest this is better than the PSA check at detecting cancers, with far fewer false positives.
One of the researchers, Professor Hardev Pandha University of Surrey said the new EN2 test was more reliable and accurate.
?In this study we showed that the new test was twice as good at finding prostate cancer as the standard PSA test,? he said.
?Only rarely did we find EN2 in the urine of men who were cancer free so, if we find EN2, we can be reasonably sure that a man has prostate cancer.?
Larger-scale trials are now being planned in the UK and the United States. The researchers envisage the EN2 urine check would be used alongside the PSA blood test.
A group of new drugs which reveal promising results to prolong? lives and also relieve the symptoms of prostatic cancer have been produced.
The following new drugs are approved by the FDA. Cabozantinib- (Exelixis) ? seems to eradicate bone metastasis in some patients.
Docetaxel (chemotherapy drug)
Dendreon?s Provenge ( works by training the body?s immune system to fight the cancer) Johnson & Johnson?s Zytiga (new form of chemotherapy- inhibits an enzyme called CYP17, clamps down on testosterone production)
Sanofi?s Jevtana (chemotherapy drug).
Alpharadin? (Norway Company)
Abiraterone (Janssen)
Abiraterone acetate interferes with the production of the hormone testosterone, which can fuel the growth of prostate cancer.
The trials involved more than 1,000 men with very advanced, aggressive cancers, whose prognosis was poor, with only months left to live.
The 797 patients given abiraterone plus a steroid lived for an average of 14.8 months, compared to 10.9 months for the remainder who simply got the steroid.
Another advantage of the drug was the relative lack of side effects compared with chemotherapy or radiotherapy, making it a far more attractive prospect for patients. The drug was first discovered at the Institute of Cancer Research in London, and its chief executive Professor Peter Rigby said he was ?very proud? that men with advanced prostate cancer had this new treatment option. (BBC News Oct.11, 2010)

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Source: http://www.thesundayleader.lk/2011/07/10/prostate-cancer-%E2%80%93-updates-on-new-drugs-and-investigations/

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