Scanning headlines: King Charles undergoing BPH treatment next week--Can a cuppa fix a royal pain? And American Cancer Society reports PCa rates up again.
By Howard Wolinsky
The American Cancer Society (ACS) has just announced its new estimates for prostate cancer for 2024—and they’re not good.
ACS estimates 299,010 new cases of prostate cancer will be diagnosed in 2024, with 32,250 deaths. The incidence is up 11,000 cases with 2,500 more deaths compared with 2023. Many advanced cancers are being diagnosed late.
Roughly half of these patients will have Gleason 3+3=6 (Grade Group 1) or favorable Gleason 3+4 =7 (Grade Group 2), making them eligible for active surveillance.
Last year’s increase was huge, and ACS has called for action, especially for Black patients. Many experts blame declining PSA screening for the rise as the U.S.Preventive Services Task Force gave a D to PSA screening in 2012 and a C in 2018 if men made a shred decision with their urologists.
Rick Davis, a prostate cancer patient and founder of AnCan Foundation, said: “Overall for PCa, not as sensational as the increase shown last year - a projected increase of 11,000 in 2024 vs 20,000 in 2023. That said, I think we are at record levels for PCa although I have not graphed all the years.”
ACS lumped prostate cases in with a rise in other major cancers: “Although the cancer death rate has been on the decline, rising diagnoses of 6 of the most common cancers (breast, prostate, endometrial, pancreatic, kidney, and melanoma) threaten that longstanding downward trend. Put simply, that’s because when more people are diagnosed with cancer, more people are likely to die because of cancer.”
Ali Manson, VP, of Government Relations and Advocacy for Zero Prostate Cancer. “For yet another year, the data shows increasing prostate cancer incidence rates as well as mortality rates, whereas other types of cancer are decreasing.”
Davis said he thinks ACS has understated its figures because its stats lag two to four years: “Deaths not up nearly enough, but they use a lag that will result in a big increase before long.”
More news and views on Defense Secretary Austin and his secret surgery and hospitalization. My take in MedPage Today: https://www.medpagetoday.com/special-reports/apatientsjourney/108309?trw=no
The ACS estimates for 2024 are reported inits flagship publication CA: A Cancer Journal for Clinicians.
Last year, ACS announced a new action plan, "Improving Mortality from Prostate Cancer Together" — or IMPACT — to address the rise, especially in Black men, and to curb the increasing rate of advanced, difficult-to-treat cases.
William Dahut, MD, PhD, chief scientific officer for the ACS, said in 2023: "We must address these shifts in prostate cancer, especially in the Black community, since the incidence of prostate cancer in Black men is 70% higher than in White men and prostate cancer mortality rates in Black men are approximately two to four times higher than those in every other racial and ethnic group.” (A study published last year challenged that claim, finding that, after controlling for socioeconomic factors, race does not appear to be a significant predictor of mortality for prostate cancer.)
I contacted ACS’s press office to find out what IMPACT accomplished in the past year. I’ll let you know. I’m still waiting for a response.
King Charles III schedules BPH surgery next week, encourages public to be aware of BPH
By Howard Wolinsky/Royal Correspondent
King Charles III may be a new British king, but he is a relatively old man, having recently turned 75.
To paraphrase Bard William Shakespeare’s “Hamlet,” the flesh of king and commoner alike is heir to the plague of BPH (benign prostatic hyperplasia), or an enlarged prostate.
Buckingham Palace said the King's condition is benign but he will undergo a "corrective procedure."
The BBC reported that Charles had been due to meet foreign dignitaries and cabinet members in Scotland this week, but those meetings have been canceled on medical grounds.
The Beeb also said it also thought the King was keen to share his diagnosis with the public to encourage other men who may be experiencing symptoms to get checked. If that’s the case, good on him.
High-profile public figures can educate and reassure the public at large about these medical issues. British celebs, including Elton John, Rod Stewart, Colin McFarlane, Stephen Fry, and many more have been very open about their treatments for prostate cancer.
High-profile Americans should take a page from them.
"In common with thousands of men each year, the King has sought treatment for an enlarged prostate," the Palace said.
BPH, which is common in men 50 and above, is considered benign because it is noncancerous, according to the UK National Health Service website.
Still, it can be a royal pain in the butt, causing men to wake up to pee multiple times a night.
NHS says: “If the prostate becomes enlarged, it can place pressure on the bladder and the urethra, which is the tube that urine passes through.
“This can affect how you pee and may cause:
difficulty starting to pee
a frequent need to pee
difficulty fully emptying your bladder.”
Many men worry that having an enlarged prostate means they have an increased risk of developing prostate cancer. This is not the case.
The risk of prostate cancer is no greater for men with an enlarged prostate than it is for men without an enlarged prostate. However, some men have both BPH and prostate cancer.
BPH treatments can yield prostate pieces called “prostate chips”—not to be confused with fish and chips, BTW—which are biopsied. If cancer is found, it typically is low-risk Gleason 6.
Hopefully, things won’t go tits up for Charles.
One of my brothers, who is considering being treated for BPH asked me what “corrective” procedure Charles will undergo, adding it’s not likely the standard offered by NHS
Who knows? There are many options. No doubt bookmakers are making odds in London and Vegas.
I suggest Charles consider water vapor therapy, which I wrote about for Medscape Medical News. I think it may be a perfect fit for his highness.
The technology, known as Rezūm, involves a single-use scope with a 1-cm retractable needle pocked by an array of steam-emitting holes. Clinicians thread the scope up the urethra and release the 103° C vapor, just barely boiling to destroy tissue.
For the prostate, "it's just like having a cup of hot tea," said Canadian researcher Dean Elterman.
British guidelines approve of the procedure for men with prostates 30 centimeters and above.
We’ll see if this procedure is Charles’ urologist’s preference.
So best of luck to His Royal Highness as he “attends hospital.” Nothing like a cuppa to soothe what ails you.
Don’t miss an ASPI program on genetics and prostate cancer
Active Surveillance Patients International is holding a webinar on genomics at 12-1:30 p.m. January 27.
Christina Nakamoto, Medical Science Liaison for Urology at Myriad Genetics, will discuss the benefits of medical-grade, genetic tests and how testing can provide personalized information about a patient's prostate cancer in facilitating an informed shared decision-making process between the patient and his medical team on Active Surveillance and/or other treatment options. Michael Glode, MD, who serves on ASPI's Medical Advisory Committee, will join the discussion and field questions during a Q &A session. Send your questions in advance to contactus@aspatients.org.
While we’re at it: Join the ZERO support group on AS in March—I need your support
By Howard Wolinsky
For the past three years, I have run a special Active Surveillance support group for ZERO. Last year, our virtual support meeting drew 60 patients to talk about AS. It was by far the biggest session of any at the annual ZERO Summit.
So sign up now and join us at 11 a.m. Eastern on March 12, 2024.
Register in advance for this meeting:
https://us02web.zoom.us/meeting/register/tZUsfuqgrjIoG9AWf7voMhzT_UjdqbQQbQPA