Dr Peter Saul (Associate Dean for General Practice in Wrexham – N Wales) commenting on an article by Dr Simon Chowdhury (Oncologist) and Professor Roger Kirby (Urologist) at The Prostate Centre, Department of Medical Oncology, Guys Hospital, in The Practitioner magazine (published for doctors across the world) covers many subjects and is issued on a monthly basis. One recent article is on
“Advances in the treatment of metastatic prostate cancer 25 Apr 2013
Prostate cancer is the most common cancer in men in the UK. It accounts for nearly a quarter of all male cancer diagnoses and is the second most common cause of male cancer death. Most patients present with localised disease, but there are still many who present with metastatic disease. Medical castration using LHRH analogues has become the gold standard in managing both locally advanced prostate cancer, in combination with radiotherapy, and metastatic disease. Eventually most men with advanced prostate cancer become resistant to ADT. This is now called castrate refractory prostate cancer (CRPC), and is associated with a poor prognosis. There is now hope for patients who progress after chemotherapy with the emergence of several new agents that have been shown to benefit patients.”
The article goes on to summarise:
“The best outcomes for prostatic cancer are in dedicated centres treating large numbers of patients and where data on treatment outcomes are more readily available. For advanced prostate cancer access to the latest clinical trials and therapies is vital as evidenced by the progress seen with such drugs as abiretone and enzalutamide. The drugs extend life and have significant palliative benefits and until recently, were only available in clinical trials. GPs have a vital role in helping to direct their patients to such centres.”
Science Magasine on 22nd April reports 22ns April on “Why is cancer so common?”:
The text below refers to “The future of cancer research”:
“The field of cancer research is moving away from defining a cancer by where it is in the body, as one type of breast cancer can have more in common with an ovarian cancer than another cancer in the breast.
Instead scientists are looking deeper at what is going wrong inside cancerous cells – a tumour can have 100,000 genetic mutations and these alter over time.
By pinpointing the mutations that can cause certain cancers, doctors hope to personalise treatment – choosing the drug most likely to work on a particular type of tumour.
Scientists are creating targeted cancer therapies using their latest insights into cancer at a molecular level. These treatments block the growth of cancer by interfering with molecules specifically involved in tumour growth and progression.
Clinical trials using gene therapy are also underway. This experimental treatment involves adding genetic material into a person’s cells to fight or prevent disease.”
and then, ironically for people in Wales, For more information and advice, visit NHS Choices
The ability to choose (either by patient or GP) means access to reliable information in order to make the choice. Not much hope for patients in Wales then…. where choice restriction is used as a method of rationing.
We all need the ability to choose specialist treatment centres, not only for prostate, but also for bowel, lung, melanoma skin cancers etc if we are to have a shot at getting the best outcomes.