Prostate cancer, the most common cancer among men and the second most common cause of cancer-related deaths among American men, hits African-American men particularly hard. Our men are more likely to get prostate cancer and twice as likely to die from the disease.
This form of cancer is frequently very slow growing, often causing no symptoms until it is in an advanced stage. At that point, symptoms may include difficulty starting urination, weak or interrupted flow of urine, and frequent urination, especially at night. It is so slow growing that most men with prostate cancer die of other causes; many never know they have the disease. But once prostate cancer begins to grow quickly or spreads outside the prostate, it becomes dangerous. While the disease is rare before age 50, experts believe most elderly men have traces of it.
New approaches to prostate cancer treatment, regulated by the Food and Drug Administration, are constantly being considered.
In 2004, the FDA approved docetaxel, the first chemotherapy for metastatic prostate cancer that showed a survival benefit.
“When prostate cancer metastasizes to another location in the body, it is in most cases incurable and the goal of treatment is to improve a patient’s symptoms or function, or to extend the length of the patient’s life, ” said Daniel Suzman, M.D., a medical officer in FDA’s Office of Hematology and Oncology Products in the Center for Drug Evaluation and Research. Since docetaxel’s approval, the agency has approved five additional therapies, all of which have shown improvements in survival.
And two major trials have shown adding docetaxel to hormonal therapy for men with metastatic disease that had not previously been treated improved their survival.
That’s become a standard of care for men who have a high burden of disease (such as cancer that has spread to the soft tissues or to many spots in the bone) and are a good candidate for chemotherapy, according to Dr. Suzman.
One promising area of research is related to preventing over treatment of patients with prostate cancer that is still localized to the prostate and who have a low risk of becoming symptomatic or dying from the condition. Carefully selecting men who are low risk is crucial. There is increasing evidence that close surveillance and repeated biopsies may safely allow these patients to delay surgery or radiation. “There is a need to reduce the burden to patients of over treatment if the prostate cancer is slow growing,” Dr. Suzman said.