Improved diagnostics and new treatments for prostate cancer mean
Once you turn 50, your risk for prostate cancer begins to increase—more than 80 per cent of men diagnosed are over 65, with northern Europe and North America leading the trend.Even a few years ago, prostate cancer patients had limited options, essentially choosing between mere surveillance and intervention that involved removing or destroying the entire prostate gland.
The former risked letting cancer progress too far while the latter brought prolonged side effects that left men miserable—incontinence, erectile dysfunction, loss of libido. And while less invasive treatments did exist, many clinicians were skeptical about their effectiveness.
“It’s been pretty stark,” says Dr Mark Emberton, professor of interventional oncology at University College Hospital, London (UCHL). “We either don’t treat you or we treat you maximally.”
But now some experts are reconsidering this view. With the latest technologies, once experimental methods may prove advantageous in some cases. New drugs have been approved, and studies have found that some novel drug combinations expand lifespan in patients whose tumour is aggressive. Some trials have had success in treating prostate cancer with immune vaccines.
These options offer more hope and less suffering, but they also present patients with more choices than ever. Even being screened for prostate cancer is now a choice—and a very debated one. And even if you are diagnosed, it doesn’t mean you need to be treated because many prostate cancers are so slow growing that men would succumb to other causes first. “You’re very unlikely to die from a low-risk prostate cancer within ten years of the diagnosis,” says Dr Henk van der Poel, a urologist at the Netherlands Cancer Institute.
While the debates continue, here’s what patients should know.
THE SCREENING CONUNDRUM
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