Prostate cancer is the second most commonly diagnosed malignancy in men worldwide. In 2018, an estimated 1.2 million men were diagnosed with prostate cancer, and about 358,000 died from the disease worldwide. Prostate cancer is the fifth leading cause of death from cancer in men.1 The number of prostate cancer diagnoses is increasing, probably as a result of the overall increase in life expectancy.
About The Prostate Gland
The causes of prostate cancer are unknown. There may be a hereditary disposition, for the risk is greater when one's father or brother has had a tumor. The risk of contracting the disease also increases with age. Men hardly ever develop prostate cancer before the age of fifty.
Detecting Prostate Cancer
Early prostate cancer usually does not cause symptoms, but more advanced cancers are sometimes detected because of symptoms they cause. Issues, and especially pain, during urination or ejaculation should be taken seriously. The same applies to a frequent urge to urinate, an inability to empty the bladder completely and finding blood in the semen or urine. That said, many of these symptoms are by no means a sure indication of cancer. They can also be caused by infections or by a benign enlargement of the prostate, which is very frequent. A urologist can give a precise diagnosis.
Most prostate cancers are diagnosed as a result of a screening blood test for prostate-specific antigen (PSA) or a digital rectal exam. An elevated concentration of PSA can be the first sign of malignant disease in the prostate. Some guidelines recommend first undergoing a prostate MRI and, depending on the scoring of the MRI images, possibly a follow-up biopsy. Further tests, including other medical imaging, might be needed to support the exact diagnosis, staging and monitoring for patients with malignancy.
Treating Prostate Cancer
There are more therapeutic options available to treat prostate cancer that has been diagnosed early. These treatments range from surgery to radiation treatment to therapy using hormone-receptor antagonists, i.e. substances that stop the formation of testosterone or prevent its effect at the target location. These treatments can help stop or slow the growth of prostate carcinomas.
Sometimes, the above-mentioned therapies are combined.
Advice for patients
If the tumor has already reached an advanced stage, there is no definitive cure. This disease state is known as castration-resistant prostate cancer (CRPC). This advanced form of prostate cancer is characterized by persistent, high-level androgen receptor (AR) function and resistance to conventional anti-androgens. The field of treatment options for castration-resistant patients is evolving rapidly. There is no standard treatment for CRPC patients who have rising Prostate-Specific Antigen (PSA) levels during androgen-deprivation therapy and no detectable metastases. In men with progressive non-metastatic CRPC, a short PSA doubling time has been consistently associated with reduced time to first metastasis and death.
A majority of men with CRPC have symptomatic bone metastases resulting in pain, skeletal events such as fractures or spinal cord compression, and/or reduced survival. In fact, bone metastases lead to an increased risk of morbidity and death in patients with CRPC.
Bayer Treatments for CRPC
Bayer has developed an alpha-particle emitting radioactive therapeutic agent which is approved in more than 50 countries worldwide for the treatment of CRPC and symptomatic bone metastases.
Bayer is growing its prostate cancer portfolio with an androgen receptor inhibitor (ARi) for the treatment of non-metastatic castration-resistant prostate cancer (nmCRPC). Despite recent advances in nmCRPC treatments, there remains a unmet need for new therapeutic options that not only delay the time to metastases, but also have a favorable safety profile, which is important for these patients as they are generally asymptomatic.
Bayer’s Diagnostic Options for Prostate Cancer
Every treatment starts with the right diagnosis. Imaging tests such as magnetic resonance imaging (MRI), positron emission tomography (PET), ultrasound and contrast-enhanced computed tomography (CT) are used to create pictures of the inside of your body. One or more such tests might be used to look for cancer in the prostate, to help the doctor see the prostate better during certain procedures (such as a prostate biopsy or certain types of prostate cancer treatment), or to see if prostate cancer has spread to other parts of the body. Which tests you might need will depend on the situation. Bayer’s radiology portfolio ranges from contrast media to devices that support radiologists in their mission to provide early diagnosis and targeted treatment.
1 GLOBOCAN 2018: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2018. Prostate Cancer. https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21492. Accessed July 2019.