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A cancer coming in from the cold

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.