Patients with prostate cancer (all stages) live on average 7 years longer than 10 years ago.
Prostate cancer is the most common cancer in men. It occurs in about one in nine men. Current treatment offers a better quality of life and a chance to be completely cured. Nowadays more tumors are diagnosed than before and moreover at a stage where the cancer is curable. Targeted hormone therapy can slow the progression of the disease and affects the patient's life only very little.
In most cases, prostate cancer is a slowly growing tumor that can be developing for years without notice because it does not cause any symptoms. Symptoms are not noticeable until the advanced stage of the disease. (Late) symptoms include: the urge to urinate, frequent urination, the need to strain to empty the bladder, interrupted or weak urine flow, which often leads to a wrong diagnosis of benign prostatic hyperplasia (simple prostate enlargement). A very late and rather rare symptom is blood in the urine (a sign that the tumor has spread to the surrounding tissues). The prostate-specific antigen (PSA) test was a breakthrough in diagnostics in the 1990s. Its positive result indicates prostate cancer.
Modern methods are able to detect the incidence of a tumor before it spreads. Compared to the past, the disease is more often diagnosed at a stage where prostate cancer is still curable. „Targeted hormone therapy can help slow down the development of cancer and affects the patient's lives only very little. Thus, patients spend less time in the hospital and can live a full life,“ says Mgr. Jakub Dvořáček, MHA, executive director of the Association of Innovative Pharmaceutical Industry (AIFP).
Nowadays, prostate surgery can be performed laparoscopically (mini-invasive method) or with the use of robotic systems, which reduces the risk of complications and allows for faster recovery. Thanks to innovative medicine, there is a wide range of therapeutic alternatives allowing for gentle, individualized treatment. "Despite the limited possibilities of hormonal treatment with antiandrogens, their application in the case of non-metastatic forms of prostate cancer is beneficial for the patient," says Vilím Šimánek from the patient organization PROSTAK o.p.s. The treatment of prostate cancer, which improves the patient's prognosis, also includes modern immunological therapy. There has been great progress in the field of radiotherapy; e.g. brachytherapy allows to place a radioactive source directly into the tumor, thus sparing the surrounding tissues. However, there are many more methods.
Prevention and innovative medicine significantly, and in the long-term, extend the life expectancy of patients with prostate cancer. The five-year survival rate has significantly risen since 1990, reaching nearly 100% in the first, second and third stages of the disease, approaching 50% in the fourth stage. “Overall, we can see a significant increase in life expectancy over the last 10 years. Between 2006 and 2016, the life expectancy of 70-year-old patients increased by 25.1%, 60-year-old patients by 32.9% and 50-year-old patients by 44.6%,” says Jakub Dvořáček.
Early diagnosis of the disease helps to reduce mortality and hospitalization. Most hospitalizations are currently less than 1 week. Hospitalizations of less than or equal to one week increased by 17.4 percentage points when comparing 2007-2010 and 2015–2018. “Disability pensions have also decreased. Savings in this area amount to at least 112 million Czech Crowns between 2013 and 2017 alone,” concludes Mr. Dvořáček.
The purpose of therapy after surgical removal of the prostate is to prevent the metastasis of cancer cells from local sites to other body tissues. Treatment with antiandrogens significantly prolongs the patient's survival time without metastasis to various organs or bone tissue. However, hormonal therapy does not stop the mutation of cancer cells of the prostate, the cell loses the androgen receptor and the treatment becomes ineffective. Despite the limited possibilities of hormonal treatment with antiandrogens, their application in the case of non-metastatic forms of prostate cancer is beneficial for the patient. This kind of medication also has side effects, but they are outweighed by a significant slowdown in disease progression and by delaying chemotherapy treatment. For patients with advanced prostate cancer, second-generation antiandrogens represent great progress. Although they will not cure the disease, they prolong and improve the patient’s life. Unfortunately, this treatment is currently rather expensive.
prof. MUDr. Vilím Šimánek, DrSc.
PROSTAK o.p.s.
Materiály z tiskové konference Asociace inovativního farmaceutického průmyslu na téma "Nejčastější nádorová onemocnění žen a mužů: pokroky v léčbě rakoviny prsu a prostaty" konané 09.03.2020.
