Cases of prostate cancer have increased by 14% in the last three years, but the good news is that more than 60% of patients manage to definitively defeat the carcinoma. The combined reading of these data is a warning not to let our guard down, especially since today, thanks to scientific innovations, we can also face this tumor and get out of it. And it is precisely for this reason that the Italian Association of Medical Oncology (Aiom) and the Aiom Foundation are today launching a new online information campaign with information and training activities dedicated to clinicians but also to patients and caregivers, institutions and citizens.
The most common cancer among men
In 2020, there were 36 thousand cases of prostate cancer in Italy. Three years later, unfortunately, there has been an increase of 14% with 41,100 men affected in 2023. “It is by far the most widespread cancer among the male population resident in our country – he explains Saverio Cinieri, president of the Aiom Foundation. This is due to the ever-increasing incidence but also to the constant increase in survival and recovery rates. As has happened with other oncological diseases, the introduction of targeted therapies has changed the history of the fight against carcinoma. Until a decade ago, therapeutic options for certain clinical situations were very limited. Today, however, new drugs and a sequence of multiple lines of treatment are available.”
More accurate diagnoses and an aging population
But what causes the increase in diagnoses? “In the last decade, prostate cancer has become the most frequent oncological pathology in the male population in all Western countries,” he replies Orazio Caffo, director of the Medical Oncology Operational Unit of the Santa Chiara Hospital, Trento. In Italy alone, over 564 thousand men live with a diagnosis and their number has more than doubled compared to 10 years ago. At the basis of these epidemiological data there is also the greater probability of identifying the disease through tests such as the Psa dosage or digital rectal examination. Furthermore, we are witnessing a general aging of the population and the ever-increasing presence of risk factors.”
by Tina Simoniello
Familiarity and lifestyle among the risk factors
In addition to age, hormonal and genetic factors come into play: “It is estimated – underlines Cinieri – that the risk is at least doubled in the case of a first-degree relative affected by the neoplasm. However, only in a small subgroup of patients does prostate cancer develop as a hereditary disease. Finally, lifestyles also play a fundamental role in this case. Obesity, a diet that involves excessive caloric intake and cigarette smoking have an influence.”
by Dario Rubino
One of the factors that can contribute to delaying diagnosis is the fact that the disease is asymptomatic in the early stages. “Only when it progresses – claims Tucci – some non-specific symptoms appear such as decreased urinary output power, hematuria, dysuria and perineal pain. In the more advanced stages, however, the skeleton is often the first site of the appearance of metastases. This is how the characteristic bone pain develops, mainly localized mainly at the spinal level.”
60% of patients overcome the disease
Even for prostate cancer, however, innovation has managed to guarantee effective treatments for all patients, even those affected by the most serious forms of the tumor. And today – according to Aiom data – more than 60% of patients manage to definitively overcome carcinoma. “If the cancer is confined to the prostate – explains Caffo – it can be treated with surgery or radiotherapy. However, when the disease presents metastases in the hormone-sensitive phase, it is essential to enhance androgen deprivation therapy with new generation hormone therapy or chemotherapy”.
The treatment strategy in patients with castration-resistant disease
In prostate cancer, in recent years there have been positive results for patients with castration-resistant disease. “More recently – he underlines Marcello Tucci, director of Oncology at the Cardinal Massaia Hospital in Asti – successes have also emerged in an earlier setting of hormone-sensitive metastatic disease. In this subgroup of patients only 30% survive five years after diagnosis. In the majority of cases the pathology evolves and becomes resistant to castration.”
Increasingly effective therapies
In other words, hormone therapy does not cause sufficient benefits and other, more effective treatments are absolutely necessary. “A strategy that further improved the control of hormone-sensitive metastatic disease – continues Tucci – was to use a new generation oral androgen receptor inhibitor, such as Darolutamide, which, for example, has been shown to reduce by 32 % risk of death if administered together with hormone therapy and chemotherapy”. Caffo also confirms this: “Darolutamide, which represents a new and important therapeutic option, when it is added to androgen deprivation therapy and chemotherapy. The drug obtained approval from the European Commission a year ago, and we expect that it will soon also be available for Italian doctors and patients”.
Inform, train and raise awareness
The campaign by Aiom and the Aiom Foundation, created with the non-conditioning contribution of Bayer, aims to raise awareness primarily among oncologists but also patients, caregivers, institutions and the population in general about the new therapeutic availability for this neoplasm. The Aiom project involves the dissemination of a newsletter for specialists, video interviews with leading Italian experts, webinars for patients and caregivers and activities on social media.