Prostate Cancer Fact Sheet
Looking for the facts about Prostate Cancer and the rapidly growing Prostate Cancer market? The following information comes from our Prostate Cancer Market Info™ report, which is now available for purchase and download on our website, Drug Market Info.
What is Prostate Cancer?
Prostate cancer (PC) is a common cancer in men and the second leading cancer-related killer behind lung cancer. It is a malignant adenocarcinoma that grows as small tumors throughout a man’s prostate gland. Some tumors are indolent and require no treatment, but others are aggressive and life-threatening. Currently, there is no way to tell tumor aggressiveness and no clear guidelines about how to manage the disease, despite the launch of several new treatment options.
Most of the time (80%+) prostate cancer is discovered before it has spread beyond the prostate gland. For this reason, five-year survival is nearly 100% and 10-year survival is 91%. If metastasis has occurred, survival is considerably lower (29% at five years). For those patients with recurrences and/or advanced disease, metastasis is usually to the bone, a development that compromises quality of life, increases treatment costs and negatively affects overall survival.
Prostate Cancer: Diagnosis
Prostate Cancer generally causes no symptoms. Since the 1990s, prostate specific antigen (PSA) screening has been used to determine if a man has PC. PSA is a protein produced by cancer cells – a rising PSA level is suggestive of cancer, although there are other causes for a rising PSA. Testing is once a year for all men over age 50 (this recommendation is being challenged and is likely to affect future screening). Biopsies, along with digital rectal exams and imaging, are used to confirm if a man with an elevated PSA has prostate cancer.
If biopsies are positive for cancer, aggressiveness is rated using a scale between 2 and 10 that assesses differentiation: well-differentiated cancer is usually not aggressive and gets a low score; poorly differentiated cancers are aggressive and get high scores. These numbers are known as the Gleason Score, and it is the best available measure of cancer aggressiveness. Treatment decisions are often based to a large extent on a patient’s Gleason Score.
Prostate Cancer: US Epidemiology
Prostate Cancer (PC) is the most common non-skin related cancer in men:
- 1 of every 6 men will develop it in their lifetime
- Over 2 million in the U.S. currently have PC
- Nearly a quarter of a million men will be newly diagnosed in 2012
- 34,000 men die annually of PC – 2nd leading cause of cancer-related deaths, after lung cancer
There are 3 known risk factors for PC:
- Advancing age: PC is rare in men under age 50; common over age 80
- Race: Black men have the highest incidence in the world; Asians the lowest
- Family history: 1st degree relative doubles risk; 2+ relatives = nine-fold increase in risk
Mortality from PC has declined about 30% since 1992:
- “A man is more likely to die with prostate cancer than from it.”
- 80 is the median age of death from PC (close to average life expectancy)
- 12% percent of men die of PC after diagnosis
Prostate Cancer: Treatment
There is no universally recommended treatment for PC at any stage and many choices exist. Whether treatment should be delayed or begin immediately is controversial, especially in the earlier disease stages.
Treatment decisions depend on likelihood of disease progression and are predicated on the Gleason Score, metastasis, co-morbidities, a man’s overall health, and cancer stage at diagnosis, among other factors. If the disease is still confined to the prostate gland itself, common treatment options are:
- Radical prostatectomy
- Radiation therapy
- Active surveillance (no treatment, but frequent ongoing monitoring with PSA levels and biopsies)
There is no clear proven benefit for any approach at this time, but regardless of option chosen, nearly 100% of patients are alive 5 years out. Men are monitored for a recurrence with PSA levels every 3-6 months.
For men in whom PC has spread or those with a recurrence, androgen depletion therapy with LHRH analogs is the standard approach. This works by depleting testosterone, which is necessary for prostate cancer growth. Over time, some men have tumors that become resistant to this approach (castrate-resistant), and require the addition of other therapies, which may include anti-androgens, immunotherapy like Provenge® (sipuleucel-T) or chemotherapy like Taxotere® (docetaxel). Many of these men do not have symptoms and have no evidence of metastasis. The length of time a man is in this castrate-resistant stage is highly variable, but once metastasis is seen (usually on a bone scan), symptoms appear. At this point, options include chemotherapy, radiation and bone-targeted therapies (which reduce bone pain and prevent fractures). Men at the later disease stages have recently begun to have more options with the approval of three new drugs: Zytiga®, Jevtana® and Xtandi®.
Some Interesting Facts about Prostate Cancer
- Radical prostatectomy is the most frequently chosen option as initial curative therapy for PC.
- Active surveillance (monitoring disease progression without concurrent treatment) is always an option for less aggressive cancers. Currently, fewer than 10% of men opt for this approach.
- Most men are NOT symptomatic until the last 6 mos. of their lives, which drives demand for drugs with minimal impact on quality of life.
- Unlike many other cancers, there is no interval (such as 5 years) beyond which the risk of PC recurrence is negligible, and thus, ongoing surveillance is required.
Prostate Cancer: Research
The intracellular and extracellular pathways involved with prostate tumor growth, metastasis and treatment resistance will probably require use of multiple drugs or drugs with multiple sites of activity. Since the discovery of Taxotere®, the first chemotherapy to show activity and improve overall survival against advanced prostate cancer, research in the disease has significantly expanded. Clinical trials for prostate cancer increased 30% in just two years – over 2,000 clinical trials are now in various stages with 350+ in Phase 3 and over 900 in Phase 2.
What do Patients say about Prostate Cancer?
Here are some comments from patients:
“The secret with PC is to keep it in the prostate. You may wait and see for 3 years and now it’s outside the prostate and there is less you can do, but you could have done something 3 years back.”
“When I first started on the shots (of LHRH) I got a little tired, got hot flashes and found out what menopause is like!”
“You have to find ways to get through it. I’m 75 years old, not 30. I have aches and pains, I’m not as strong as I used to be, I have to take naps in the afternoon. How much of this cancer-related? How much medication related? How much just age-related? I think you can attribute a lot to age.”
To learn more about the ‘Patients’ Perspective,’ Drug Market Info will gladly put you in touch with patients and clinicians who can share their experiences.
Every Prostate Cancer Market Info report you purchase generates a donation to ZERO — The Project to End Prostate Cancer.
ZERO — The Project to End Prostate Cancer is committed to creating Generation Zero: the first generation of men free from prostate cancer. Zero prostate cancer deaths. Zero prostate cancer cases. Zero tolerance for prostate cancer. To accomplish their goal, ZERO provides comprehensive treatment information to patients, education to those at risk and conducts free prostate cancer screening throughout the country.
Posted on April 3, 2012, in Prostate Cancer and tagged Drug Market Info, Prostate Cancer, Prostate Cancer Market Info, Prostate Cancer pipeline, Prostate Cancer: US Epidemiology, ZERO — The Project to End Prostate Cancer. Bookmark the permalink. 5 Comments.