Sitting on a problem

Spouses around the world whose hubbies spend all their time with their butts parked on the sofa watching wretched football on the t.v. might try informing them that they are significantly increasing their risk of prostate cancer. Breast, lung and bowel cancers get much media coverage, rightly so as the three biggest cancer killers in the western world. But prostate is not far behind (it’s too serious for jokes) – it’s the fifth most common cancer overall – and world-wide it kills 258,000 men a year. Prostate cancer can be treated by surgery, radiation therapy or drugs, including ‘chemical castration’, a phrase guaranteed to send a frisson through any male – though it simply means administering oestrogen to oppose testosterone production. This is effective in many cases but advanced forms of the disease are resistant to chemotherapy and for these there is no real treatment. Thus the news that a new drug, (abiraterone, trade name Zytiga), will come into use next year has to be hailed as a step forward. Abiraterone has just negotiated a phase 3 clinical trial in which (administered with prednisone, the pro-drug of prednisolone) it extended the average survival time for men with advanced prostate cancer from 11 to 15 months and it was approved by the U.S. Food and Drug Administration in April 2011.

Four months doesn’t sound a lot but it is a 36% increase. What’s more, abiraterone works in a different way to chemical castration: instead of stopping testosterone activating its target cells it prevents its synthesis altogether by blocking the action of an enzyme. So this is a totally new targeting strategy.

It isn’t a cure for prostate cancer, so ladies you can still use the stats to get him to do the washing up rather than watching the degrading pantomine that is professional football. But it is a small step in the cancer war and may be the precursor to affecting a major cut in the number of men who die every day from prostate cancer in the UK (28) and in the 28,600 that it kills every year in the USA.

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