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Prostate cancer is a condition in which the prostate (a male reproductive gland that creates seminal fluid) develops malignant cells. Adenocarcinomas (cancer that develops from the gland cells) is the predominant form of prostate cancer and unfortunately, early symptoms are rarely detected. Men in advanced stages may exhibit symptoms such as blood in their urine, bone pain, weight loss, or erectile dysfunction.
Among men today, prostate cancer is the most common non-skin cancer, which is also the second-highest cause of cancer death, after lung cancer. However, in the late 19th century, it was considered rare due to a lack of education and awareness. It was in the 20th century that researchers and healthcare specialists began to learn more about the disease, increasing surgical interventions and the use of radiological treatments for patients. Also, the National Prostatic Cancer Project confirmed the effectiveness of chemotherapy later in the 1970s after three years of clinical study. Luckily, we now have a wide range of therapy choices when treating prostate cancer, depending on the diagnosis, stage of cancer, and the patient’s general health.
Recent diagnostic and therapeutic breakthroughs, such as tech-enabled radiation therapy, active surveillance, and health literacy, are revolutionizing cancer treatment and increasing survival rates around the globe. Here are some of the more common forms of treatment:
Some recent and more advanced therapies focus on delivering radiation particles intravenously directly to the cancer cell itself. Upon completion of one such experimental therapy, researchers noted a roughly 40% decrease in mortality among the men who took it during the course of the study. The medication, lutetium-177-PSMA-617, or LuPSMA, targets the PSMA protein found in cancer cells as well as the radioactive particle that causes the cells to die. The FDA approved this treatment for advanced prostate cancer in March 2022.
Researchers are attempting to discover a middle ground between not treating cancer at all and aggressive therapies because as men wait longer between treatments, they become more concerned about their condition. They took the “enzalutamide” named drug into consideration to see if it could slow the progression of cancer in men under active surveillance, and they discovered that compared to individuals who remained on active surveillance alone, it took the treated men (with enzalutamide) six months longer for their PSA levels to rise. However, there is still much to be studied to authenticate the efficacy of this drug.
20%–40% of the men who opt for radical prostatectomy (surgical treatment for prostate cancer) experience a rise in prostate-specific antigen (PSA) levels within ten years of the surgery. To treat it, doctors administer pelvic bed radiation therapy (PBRT), which reduces PSA levels to zero. However, new research indicates that PBRT is more effective when paired with other therapies. Upon experimenting with this new therapy, it was discovered that the outcomes of the more intensive therapies were better, but they also had more immediate adverse effects, although more studies and follow-ups are still needed to validate its efficacy.
Aside from these advancements, significant and extensive research has also been carried out on other therapies, such as cryotherapy, which freezes prostate tissues to kill cancer cells, and hormone therapy, which prevents the male hormone testosterone from being produced or from accessing prostate cancer cells, thereby finding ways to reducing side effects of these therapies and enhance patient outcomes.
Due to a lack of health literacy, most prostate cancer patients, particularly those at low to intermediate risk, struggle to choose the best possible treatment. Oftentimes, they are unable to comprehend the outcomes and implications, leaving them with a difficult decision: should they seek immediate treatment, be monitored with active surveillance, or undergo surgery?
According to one study of 12,149 men, it was concluded that the chances of getting a PSA test were 59% lower in those with low health literacy and 30% lower in those with moderate health literacy. Of these men, 5% reported having low health literacy, 54% moderate, and 41% high health literacy. This finding further amplifies the importance of the link between low health knowledge and the likelihood of high PSA findings.
To overcome this barrier, physicians must step up and use educational tools to educate their patients about the treatment processes available to them, as well as the side effects, to ensure that they make the best decision for the future of their health.
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