ISLAMABAD, February 14 (Online): Prostate cancer might overtake lung cancer as the most common form of the disease among men within three years, specialists said yesterday.
Increased testing has been a key factor in identifying the disease in more patients, with the rate doubling in 25 years, but it poses a dilemma. Many men with prostate cancer should never need the radical treatments used against it, while failure to spot it early enough could lead to thousands continuing to die from the aggressive forms of the disease.
The increasing prevalence could also present the NHS with a huge extra bill for diagnoses and monitoring as more men live longer. An estimated 22,000 cases are diagnosed each year and 9,500 men die annually. Lung cancer cases in men, meanwhile, are tumbling as fewer smoke.
But the Institute of Cancer Research, London, yesterday said only a small fraction of the research funds devoted to other cancers was spent investigating that of the prostate.
The government has said that every man over 50 should be given the option of a screening test for the disease, known as the PSA test, which measures blood levels of a protein which tend to rise when the prostate gland enlarges. The levels also rise when men are suffering more benign conditions, however, and a biopsy is needed to confirm the disease.
David Dearnaley, male cancer expert at the institute, said: "Prostate cancer is different from most other cancers because at least 70% of it does not need treatment. The tragedy is that we have no way of telling which cases will be aggressive and therefore need treating and which will not.
"The side effects of treatment can be very severe on some men - impotence and incontinence - so we only want to treat those who will develop the life-threatening form of the disease. What this means is that many men could receive treatment who may not need it."
The institute, a charity which receives government funding, is to run an "active surveillance" trial of men whose prostate cancer has been identified early. These will be offered regular tests and examinations but no treatment. A similar project in Toronto, Canada, has indicated that fewer than one in four men on such a programme may need surgery or chemotherapy.
A publicity campaign to encourage men and their partners to be more forthcoming about prostate and testicular cancers is being launched next month.
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