Prostate cancer has the highest incidence in men over 60 years of age. In the world, almost 400 million men are diagnosed each year and in Latin America it is the first in incidence and the third in mortality. In Mexico, it represents the leading cause of death from tumors in men, which is why it is “a real public health problem,” explains Dr. Héctor Manuel Sánchez López, urologist oncologist, currently head of the Nephro-urology and Transplantation Service of the Hospital. Bajío Regional High Specialty (HRAEB), in León, Guanajuato.
In this context, research on the subject and detection must be comprehensive and timely, since prostate cancer is not homogeneous either, it depends a lot on the stage of the disease and the time the cancer is found in order to have better results.
“If this cancer is in an early stage, when it is barely localized only in the prostate, the treatment options even have a curative intention, if the patients are in a metastatic stage, that is, it has gone elsewhere. of the body -such as bones, lymph nodes, liver or lungs-, the treatment actions are to control and alleviate ”.
Treatments for this second stage of cancer are diverse, but at this time a clinical study offers promising results. The phase 3 TITAN study has shown that the combined treatment of apalutamide with standard hormonal therapy significantly improves overall survival in patients with advanced prostate cancer.
From the outset, it reduced the risk of death by 35% in patients with castration-sensitive metastatic prostate cancer, a group for which the treatment is aimed. With almost four years of follow-up, the final results showed that this treatment provided a statistically significant improvement in overall survival, regardless of the extent of the disease, as well as other encouraging data that benefit the quality of life of patients. About two out of three patients are still alive after 44 months of follow-up within the clinical study.
The specialist explains in an interview that unlike other treatments from decades ago, this new indication means that it improves the survival of patients with quality of life, now these drugs allow survival to be prolonged and considerably improved, since they act at a more precisely within the malignant cell, they cut and interrupt the progression.
In Mexico, almost 75% of patients are in an advanced stage of the disease and almost 40% at diagnosis have metastases, hence the importance of having innovative drugs for these stages.
Sánchez López explains that for many years the recommendation was to give an androgen blockade, that is, through an injection or an orchiectomy (total or partial surgical removal of one or both testicles) testosterone production is suppressed, because of colloquially, “it is what cancer eats to maintain itself.” However, with this alternative alone, in some patients this was insufficient.
In recent years, chemotherapy and abiraterone, an inhibitor of androgen biosynthesis, have also been incorporated, now apalutamide is incorporated, which is an oral drug. “It is a very well tolerated drug that meets the criteria that urologists want from innovative drugs. That it is not complex to administer, that it has an oncological benefit (impact on survival) and quality of life ”.
How to detect prostate cancer as early as possible?
The specialist explains that in Mexico there is no screening system for prostate cancer, that is, a test that is done on all patients when they reach a certain age, however, in patients who have a history or symptoms, the early detection through a blood prostate antigen or digital rectal examination, to identify nodules.
For this reason, actions such as those of the Thousand Struggles Against Prostate Cancer campaign, in which it is intended to learn more about the disease, the types of treatment, coverage in public and private systems, associations, support groups and emotional support, all to Through the story of a fighter who, when he removes his mask, returns to be Abelardo and fight against the disease, they become a valuable tool that can be the difference for many people.
Sánchez López says that many actions aimed at men’s health are lacking to reduce this 75% of advanced disease to perhaps 7% as we see it in Europe, even so the author of the Uro-onco Manual is optimistic, as he assures that cancer Prostate is one of the most advanced in research and that more molecules are being incorporated for the benefit of patients.
The Apalutamide study can be consulted in the following link: https://clinicaltrials.gov/ct2/show/study/NCT02489318
To learn more about the Thousand Fight Against Prostate Cancer campaign: https://www.milluchascontracancerdeprostata.mx/