Monday 27 May 2002
Prostate cancer is set to become the most common cancer in men within the next three years say experts at The Institute of Cancer Research as they launch Everyman Male Cancer Awareness Month. New figures show that incidence has been rising steadily since 1971 and if trends continue it will overtake lung cancer before 2006.
However prostate cancer receives a fraction of the total spend on cancer research in the UK.
The escalating incidence is largely due to increased detection through the PSA (Prostate Specific Antigen) test, although not all men who test positive will go on to develop the life threatening form of the disease.
Dr David Dearnaley, male cancer expert at The Institute of Cancer Research comments:
"Prostate cancer is different to most other cancers because at least 70 per cent of it doesn't need treatment. The tragedy is that at the moment we have no way of telling which cases will become aggressive and therefore need treating and which will not. The side effects of treatment can be very severe in some men - impotence and incontinence - so we only want to treat those who will develop the life threatening form of the disease."
However he adds:
"What this means in reality is that many men could receive treatment who may not need it. On the other hand, if prostate cancer is not detected early by PSA testing, some men will have developed advanced, incurable disease."
Around 22,000 cases of prostate cancer are diagnosed in the UK each year.
New statistics show that since the early 1990s deaths from prostate cancer gradually began to decline, but mortality is still high - 9,500 men a year die from the disease in the UK.
Professor Colin Cooper, head of the UK's first dedicated male cancer research centre at The Institute of Cancer Research says:
"PSA is a blood test which only gives us limited information. What we need is a laboratory test that can tell us straight away whether or not a man's prostate cancer is going to be aggressive. Prostate cancer research is at least ten years behind research for other major cancers, and this is largely due to lack of funding.
"The National Cancer Research Institute has pledged more money, and The Institute is now managing NCRI's South of England Prostate Cancer Collaborative - a co-ordinated research programme, which is a good start. However, this cancer is in urgent need of greater funding support from all possible sources."
Various approaches are being explored to help determine which men require treatment and which do not.
A new 'Active Surveillance' trial for men with early prostate cancer has just started at The Institute of Cancer Research. Men are offered a PSA test at regular intervals, have rectal examinations at the same time, and a prostate cancer biopsy every two years. If during this time a man's PSA level rises rapidly, curative treatment will be given.
Tumour hypoxia (a deficiency in the amount of oxygen reaching the tissues) which may promote prostate cancer progression will also be studied in this trial.
The early results of a Canadian study of Active Surveillance showed that less than one quarter of the men required treatment.
New tools are also being developed in the laboratory to determine the molecular and genetic events that lead to aggressive disease. The results of the biopsies taken from the Active Surveillance programme will help in this research to determine which men will develop aggressive prostate cancer and in which cases the disease will follow a slow and indolent course.
Dr David Dearnaley says:
"There is some good news in that after increasing steadily for nearly twenty years, the mortality rate for prostate cancer is at last just starting to decline. This is likely to be due in part to the increased use of hormonal drugs which began in the early '90s - an approach pioneered in the UK at The Institute of Cancer Research."
Men who are interested in receiving further information on the Active Surveillance Trial should phone 020 7878 3810.
- ends -
For more information, please contact:
The Institute of Cancer Research
Tel: 0207 970 6030
email: [email protected]
Notes to editors
- As well as an increase in PSA testing, other reasons experts give for the increase in the number of prostate cancer cases are an ageing population (prostate cancer is most common in the over 60s) and possibly dietary and environmental factors.
- A report carried out by The Institute of Cancer Research on behalf of the Department of Health, published in the British Journal of Cancer 2001, shows that there is a rise in the number of men being referred for a PSA test by their GPs. The rate of PSA testing in 1999 was more than double the rate reported in 1994 (3.5 per cent of men aged over 45 years, compared to 1.4 per cent). PSA testing through other sources is likely to be much higher.
- The Department of Health's new initiative 'The PSA Informed Choice Project' launched in Autumn 2001 means that men over the age of 50 can now request a PSA test after they have received appropriate counselling. This new policy is likely to lead to more diagnosis.
- In North America use of the PSA test is widespread. It is estimated that 70 per cent of men over the age of 50 have had a PSA test.
- Statistics show that rates of prostate cancer are rising, and those which show a decrease in mortality, are both referred to in this report. They are based upon figures from The Office for National Statistics looking at men in England and Wales aged from birth - 84 years, from 1973 to 1998 and 1962 to 1998.
Please note:
Unfortunately the press office are unable to answer queries from the general public. For general cancer information please refer to The Institute's cancer information page.