Earlier this year, US Defense Secretary Lloyd Austin testifies that he disclosed his prostate cancer … [+]
Here’s the state of prostate cancer, according to a new Lancet Commission on Prostate Cancer report published just on April 4 The Lancet. It is already the most common cancer among men in 112 different countries, accounting for about 15% of all cancers in men worldwide. And it will continue to become much more “common”. The report estimated that the number of new cases of prostate cancer would increase from 1.4 million in 2020 to 2.9 million by 2040. This would equate to more than doubling in just two decades.
If you wanted to put a finger on this prostate condition and what causes this surge, you could point to a number of factors. Prostate cancer rates were already trending up before 2020, so some of this projected increase is an extension of what’s happening. Plus, as the population continues to grow, you’ve got males — more and more males in the future. Furthermore, as life expectancy increases, more and more men will live well (or not well) at the ages when prostate cancer becomes more likely.
The Commission warned that much more needs to be done to address this continued rise and that “Without urgent action, these trends will cause a rapid increase in global deaths from prostate cancer”. In 2020, prostate cancer is responsible for approximately 375,000 deaths worldwide, a number that could also grow unless things change. Although prostate cancer can be cured if diagnosed early enough, survival is less likely with either more aggressive cases or those diagnosed at later stages.
This is why prostate cancer surveillance is so important. You can’t see your prostate in the mirror or selfies unless something has gone terribly wrong. And prostate cancer tends not to cause symptoms until it’s more advanced. So you should rely on regular screening of your prostate-specific antigen (PSA) blood levels when you’re 50 and older — earlier if you’re at higher risk, such as a family history of prostate cancer at younger ages. Not everyone does such checks. In fact, many lower-income people may not even have access to such tests. Too many people around the world are still diagnosed too late in the course of their disease.
The Lancet Commission therefore highlighted the need to ensure that everyone in high-, middle- and low-income countries is tested when needed. It is not enough to make tests available either. There needs to be enough communication to the entire public and the consequent information about the importance of prostate cancer screening and the consequences of the disease.
Another issue is that PSA is not perfect. Elevated levels do not always mean prostate cancer. Normal levels do not necessarily rule out prostate cancer. Shawn Dason, MD, Assistant Professor of Urology at The Ohio State University College of Medicine, called the PSA “a broadly useful number. There is an increased risk of prostate cancer associated with increased prices.” While a biopsy may eventually be needed to determine if someone has prostate cancer, you can’t just tell everyone who has a prostate to get a regular biopsy, since getting such a procedure probably isn’t on many people’s list of fun things to do. they do. Furthermore, an excessive number of prostate biopsies could be quite expensive for society. The Lancet Commission therefore called for the development of more testing options, such as new types of blood tests and imaging approaches that can increase the accuracy of prostate cancer screening.
Then there is the treatment of prostate cancer. While there are more and better treatment options available today compared to several decades ago, these options are still far from perfect. Treatments may not be able to get rid of all the cancer. And each of the currently available options has its drawbacks and side effects. For example, Dason described two very common effects of surgical removal of the prostate: “One is urinary incontinence. For most men this will work itself out eventually. The other is erectile dysfunction. Over time, men can regain function, but it depends on how much of the nerves that affect erections can be preserved during surgery.” So it’s no surprise that the Lancet Commission called for more research to develop and create more and even better treatment options.
Finally, much of the research to date has focused on certain specific demographics rather than everyone around the world. Can you guess which demographics have gotten the most attention? Well, one is males, which makes sense since they’re usually the ones with prostates. The other is those of European heritage. In other words, many research studies have not included those of other heritages, such as African, even though the incidence of prostate cancer in men of African heritage is about twice that of men of European heritage. The Lancet Commission recommended that this disparity be properly addressed and that research, surveillance and treatment efforts for prostate cancer reach a wider, more diverse range of people.
Fulfilling all the recommendations of the Lancet Commission will require that little thing called money and other accompanying resources. This is where political and business leaders come into play, as they control many of the resources. The big question is whether such leaders will heed the need for urgent action. After all, many such leaders don’t exactly have the best track record of paying enough attention to such calls until it’s too late. Instead, they often don’t engage with something until it’s right in front of their faces. And your prostate—if you have one—is usually not in front of anyone’s face. Instead, it should sit just below your bladder and in front of your rectum, around your urethra. But just because something can’t be seen or heard doesn’t mean it shouldn’t be taken very seriously.
