In many parts of the world, the month of November is colloquially known as ‘Movember,’ or Men’s Health Month. To celebrate Movember, both men and women are encouraged to engage in discussions, activities and campaigns to raise awareness and resources for men’s health issues. Primary among those issues is prostate cancer – around 80 percent of men will get prostate cancer by the time they are 80 years old; every year nearly 1 million new cases are diagnosed; and unfortunately, incidences of the disease appear to be increasing.
So far, fantastic events have been organized across the world in recognition of the month, and this Movember, men and their health care advocates might just have an even better reason to celebrate. Research presented earlier this month to the U.K. National Cancer Research Institute indicates that a genetic test will soon be available which could distinguish between aggressive and non-aggressive prostate cancer. Aggressive prostate cancer is a type which will enlarge and spread rapidly, affecting not only the prostate but nearby organs as well such as the bladder. If a tumor associated with aggressive prostate cancer is not removed, the patient is likely to experience medical complications and even death.
Developed by the English firm Myriad Genetics, the new prostate cancer test is said to be able to evaluate gene activity inside a sample of any prostate tumor. By looking at how active genes are inside the tumor, and how quickly cells divide, the test can indicate with some certainty whether the tumor is aggressive, or not.
So, why do doctors and researchers care about the aggressiveness of prostate cancer? The primary reason for so much concern about aggressive versus non-aggressive cancer is that each type of prostate cancer should be treated in a very different way. Non-aggressive prostate cancer should not be operated upon; if the prostate is removed from a patient with a very mild form of cancer, he risks harmful and unnecessary side effects. On the other hand, a man with aggressive prostate cancer should absolutely have his prostate removed, in order to avoid a potentially fatal incarnation of the disease.
If the Myriad Genetics test works as expected, doctors will have an important tool with which to treat prostate cancer patients: men with non-aggressive cancer can be offered less invasive treatment options, and men with aggressive cancer can opt to have cancerous tumors and the prostate removed as quickly as possible.
It is interesting that in the case of prostate cancer, too much medical care is actually a huge problem. Professor Dan Berney, one researcher who worked on developing the test, said that at the moment doctors are over-treating prostate cancer patients. If a doctor decides that her patient’s prostate cancer might be serious, she will recommend that the entire prostate gland is removed. However, surgically getting rid of the prostate can result in serious side effects: inability to control the bladder, and difficulty keeping an erection. One study from the American Cancer Society found that five years after prostate surgery, 29 percent of patients still wore pads due to bladder incontinence, and 15 percent had no control over bladder function whatsoever or experienced frequent urine leaks. Erectile function can remain abnormal for up to two years following prostate removal, and some men have reported orgasms post-surgery that are less intense, or have disappeared altogether.
Of course, for a patient with aggressive prostate cancer, these side effects from removing the gland are manageable, in comparison to the risk of allowing cancerous cells to spread. However, for a patient with non-aggressive cancer, it is far more healthy to leave the prostate intact. Non-aggressive prostate cancer is slow moving, may be asymptomatic, and is often diagnosed in older patients who live unburdened by the presence of a tumor, and die from natural causes or another ailment before ever having their lives affected by the prostate cancer. For these non-aggressive cancer patients, prostate removal would be less a treatment, and more a burden.
Helping doctors distinguish between aggressive and non-aggressive prostate cancer patients could mean life-saving care for those with a serious form of the disease, and better health and quality of life for those with the non-aggressive form. Myriad Genetic’s test should assist doctors in deciding which cases of prostate cancer should be operated on, and for men and men’s health care advocates everywhere, that’s very good Movember news.