Disease States

Prostate cancer screening and the latest pioneering treatment

Prostate cancer is the most common type of cancer in men, affecting mainly those aged over the age of fifty (1).  In the UK, approximately 34,000 men are diagnosed with prostate cancer each year (1) and there are in the region of 250,000 men currently living with the disease (2).  Prostate cancer cells can potentially spread to further areas of the body where they may undergo division and form a new secondary tumour (1).  The most common place for secondary tumour development is bone such as the spine, pelvis, thigh bone and ribs (1).  Thus, prostate cancer requires early diagnosis and rapid treatment to help prevent or delay it from spreading outside the prostate gland.

Randox currently offer two PSA tests, free PSA or complexed PSA.  Prostate Specific Antigen (PSA) is a protein produced by cells of the prostate gland and PSA is detectable in the serum of almost all men and levels tend to increase with age and size of the prostate.  Free PSA is used in combination with Total PSA as a screening method for early detection of prostatic cancer.  Total PSA levels greater than 10 ng/ml may indicate the presence of prostate cancer (3).

In a recent study by Professor Hans Lilja, it was shown that a single PSA level test at the age of 60 strongly predicts a man’s lifetime risk of diagnosis and death from prostate cancer (4).  They found that 90% of deaths due to prostate cancer occurred in men with highest PSA levels at age 60. In comparison, there were negligible rates of prostate cancer or death by the age of 85 in men with average or low PSA levels (4).  The results also suggest that ≥50% of men aged 60 and older might be exempted from further prostate cancer screening, which would lead to a reduction in both over-diagnosis and over-treatment (4).  Chandana Reddy M.S., senior biostatistician at the Cleveland Clinic, states that “routine screening not only improves the patient’s quality of life by stopping metastatic disease but it also decreases the burden of care…this demonstrates that the PSA test is extremely valuable in catching the disease earlier and allowing men to live more productive lives after treatment” (5).

A new treatment for prostate cancer has been pioneered by scientists at Queen’s University Belfast with the aim of saving the lives of thousands of individuals diagnosed every year (6).  This novel treatment will benefit males suffering from advanced and aggressive forms of prostatic cancer, which has spread to the bone (6).  This research combines chemotherapy with two treatments of radioactive chemical that targets diseased bone (6).  It is hoped this combination will lead to increased survival rates.  Dr Joe O’Sullivan, consultant and senior lecturer in clinical oncology at the Centre for Cancer Research and Cell Biology at Queens, proposes that “the combination of Chemotherapy with the radioactive Rhenium-186 HEDP has the potential to improve outcomes, including survival, for men with this form of cancer” (6).

In Conclusion, early identification of prostate cancer coupled with novel therapies may lead to enhanced survival rates, improved quality of life and decreased burden on NHS.  “Approaches such as these will hopefully make the next 20 years of PSA based screening better than the first 20” states Gerald Andriole, Chief of Urologic Surgery at Washington University School of Medicine (3).

References

  1. http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Prostate/Prostatecancer.aspx
  2. http://www.prostate-cancer.org.uk/
  3. http://www.labtestsonline.org.uk/understanding/analytes/psa/test.html
  4. Science NewsNo Support for Routine Prostate Screening, but One-Off Test at 60 May Be Beneficial ScienceDaily (Sep. 14, 2010) — Existing evidence from randomised controlled trials does not support routine population screening for prostate cancer, concludes a study published online in the British Medical Journal.
  5. Science News Prostate Cancer Screening Improves Quality of Life by Catching Disease Before It Spreads, Study Finds ScienceDaily (Oct. 25, 2010) — Men treated for prostate cancer who were diagnosed after the start of routine screening had a significantly reduced risk of the disease spreading to other parts of the body (metastases) within 10 years of treatment, compared to men who were treated prior to the use of routine screening, according to the first study of its kind to be presented Nov. 1, 2010, at the 52nd Annual Meeting of the American Society for Radiation Oncology (ASTRO).
  6. http://www.u.tv/News/New-treatment-for-prostate-cancer/8320b788-7c1b-45d8-894b-5e15d21e7126

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