By Dr Harold Gunatillake - Health Writer
More than 36,000 men are diagnosed with prostate cancer each year in the UK and of them more than 10,000 die. In Sri Lanka the numbers are increasing though figures are not available. The Sri Lankan cancer registry data show a low rate of CaP, but the actual incidence of CaP in Sri Lanka is probably higher than reported, as seen in the densely populated districts and the high rate of incidental diagnosis of CaP in TURP (Transurethral Resection) specimens.
"That is mind-boggling," said the lead author, Dr Scott E. Eggener, a Universityhttp://cdncache-a.akamaihd.net/items/it/img/arrow-10x10.png of Chicago urologist. "What we were hoping was that young, healthy men who were most likely to benefit would be screened at higher rates and that screening would tail off in older men." The American Cancer Society and the American Urological Society discourage screening for men whose life expectancy is 10 years or less.
But although 80-year-olds are much more likely than 50-year-olds to have chronic illnesses and a limited life expectancy, age should not be the deciding factor, Dr Eggener said. Healthhttp://cdncache-a.akamaihd.net/items/it/img/arrow-10x10.png condition and life expectancy are far more important," he said. "There are 50-year-olds that shouldn't be screened and 70-year-olds that may benefit from it." (Screening Prostates by Gina Kolata published April 11, 2011)
Study leader Dr Hayley Whitaker, from Cancer Research UK charity's Cambridge Research Institute, said: "We looked in tissue and urine from over 350 men with and without prostate cancerhttp://cdncache-a.akamaihd.net/items/it/img/arrow-10x10.png to detect the link. "We then looked to see who had the genetic change. It was really exciting to find out that the genetic change and the amount of protein were linked. "The protein is easy to detect because it is found in urine and would potentially be a very simple test to carry out on men to identify those most at risk of developing the disease." Dr Kate Holmes, research manager at The Prostate Cancer Charity, described the test as "potentially… a powerful way to predict how likely a man is to develop prostate cancer".
Scientists at the University of Surrey have discovered that prostate cancers secrete a chemical called EN2 that can be found in a urine test.
Professor Hardev Pandha University of Surrey one of the researchers, said the new EN2 test was more reliable and accurate. "In this study we showed that the new test was twice as good at finding prostate cancer as the standard PSA test," he said. "Only rarely did we find EN2 in the urine of men who were cancer free, so if we find EN2, we can be reasonably sure that a man has prostate cancer." Larger-scale trials are now being planned in the UK and the United States. The researchers envisage the EN2 urine check would be used alongside the PSA blood test. A group of new drugs reveal promising results to prolong the lives and also relieve the symptoms of prostatic cancer. All the following new drugs are approved by the FDA.
The drug was first discovered at the Institute of Cancer Research in London, and its chief executive Professor Peter Rigby said he was "very proud" that men with advanced prostate cancer had this new treatment option. (BBC News 11 Oct.2010) These drugs are considered only for those whose growth has spread to beyond the prostate gland and with no response to check with hormone therapy. They are the last resorts.Life expectancy can be prolonged by two years, approximately. Presently, they are very expensive.
The standard treatment if the cancer is caught before spread beyond the gland can be cured by surgery and radiation therapy.
"Scientifically, the Cell-Search facility will enable us to capture prostate cancer cells and investigate them at a molecular level," said Professor Nelson. "It will be used in clinical trials of prostate cancer treatments and to monitor the treatment of cancer in individual patients from around Australia."
They note that prostate cancer is a common cancer, found in most men's prostates on autopsy, although often the men had no idea they had it. The cancer can be lethal, but it usually grows so slowly that men die with it, not because of it. For most men, screening only has harms because it leads to biopsies and treatments with unpleasant side effects. And, they say, it might not help cure many deadly prostate cancers because those cancers may have already spread outside the prostate, microscopically seeding other organs, long before a P.S.A. test indicates a possible problem
One reason treatment is the most common choice is that it is hard to know if a cancer is lethal. Pathologists can distinguish between cancers that look particularly aggressive and those that do not, but there is a real possibility that even if tissue obtained at a biopsy has only less aggressive tumour cells, more aggressive cells might still be lurking in the prostate.
"It is the hardest thing in the world not to look for a cancer and not to treat it," Dr Andriole says. And doctors, he added, have many inducements to screen. They often are afraid they could be sued if they do not screen and a man is found to have a lethal cancer. And there are financial incentives.
Dr Brooks of the cancer society says he travels the country and talks to primary care doctors about screening, and has learned that many have misconceptions about the test's benefits.
"They often don't appreciate the downside of screening," Dr Brooks said, "and they don't appreciate the delay in benefit." In addition, Dr Brooks said, primary care doctors often "overestimate the likelihood that early detection of prostate cancer will lead to survival benefits."
Added to that, Dr Brooks said, is the length of time it takes to discuss the pros and cons of screening with patients. Often it is easier to just order the test. Dr Bruce Roth, a professor of medicine at the University of Washington, said that ideally, a doctor should take a man's overall health into account and not just go by age in ordering P.S.A. tests. But if a man has been screened year after year, it can be hard to suggest he stop because he may not live much longer. (Screening Prostates at any age by Gina Kolata)
Whatever, the above discussion reveal, all men must have their PSA checked annually, during the productive years of one's life.
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