Prostate cancer, Favo: “The treatment must be multidisciplinary”
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In recent decades, cases of prostate cancer have increased. The reason? Mainly because the tools capable of leading to an early diagnosis have been increasingly refined. And this is reflected in the decrease in mortality, demonstrating that an early diagnosis, in addition to leading to a possible cure, favors an easier and more correct management of the disease. Unlike other tumors, in fact, for prostate cancer there are multiple treatment alternatives, to be established on a case-by-case basis. This is why – reaffirms the Italian Federation of Volunteer Associations in Oncology (Favo) – multidisciplinarity and structural collaboration between different specialists must be encouraged. “For prostate cancer – explains Maria Laura De Cristofaro, president of Europa Uomo Italia – we ask that national and local institutions mobilize alongside patient associations, as happens for breast cancer, to promote and support early diagnosis and multidisciplinary approach, crucial for the efficacy of treatments and for improving the quality of life of patients and their families”.
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The numbers in Italy
According to Aiom data “The numbers of cancer 2022”, in Italy prostate cancer corresponds to 19.8% of all male cancers and is the most common among men, with a prevalence of 564,000 patients, an incidence of 40,500 new cases each year and 7,200 deaths each year. The 5-year survival after diagnosis reached 91% of the 5-year survival.
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The quality of life of patients
For the first time, the quality of life of those suffering from prostate cancer was investigated by two surveys – EUPROMS 1 and 2 – carried out by the patients themselves, with scientific criteria, organized by Europa Uomo Europa on behalf of all 27 national associations, to have even clearer the needs of patients to be indicated to the governmental world, they highlighted three main key messages: active surveillance must be taken into consideration as the first treatment to ensure the best quality of life (if within the medical safety limits for the specific case ); early diagnosis is essential; cancer centers with multidisciplinary teams are needed.
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Radiation therapy: an underutilized treatment
Among the various possible options for the treatment of prostate cancer, radiotherapy is underused in Italy, denounces the 15th Report on the Welfare Condition of Cancer Patients, presented in the context of the XVIII National Cancer Day promoted by FAVO. In fact, it is calculated that only one patient out of four receives this type of treatment which can cure, or even make the neoplasm chronic. The scarce use of therapy may be due to some logistical difficulties such as very long waiting times or excessive distance from the hospital. Or precisely from the lack of a multidisciplinary approach to the patient affected by the most widespread and frequent male tumor in our country. “High-precision radiotherapy offers the patient safe, fast and effective treatments and with a very favorable cost-benefit ratio – adds Prof. Barbara Jereczek, Director of the Radiotherapy Division at the IEO in Milan -. In recent years we have seen a great technological development that has significantly improved the toxicity profile. It undoubtedly represents a premise for the continuous improvement of care in the treatment of prostate cancer. It is also indicated in all stages of the disease and can be used alone or associated with other therapeutic modalities. Precisely its frequent use in combination with other therapies makes multidisciplinarity necessary, which allows for a better selection of therapies and also favors dialogue with the patient”.
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Towards precision medicine and theragnostics
“Prostate cancer is a very complex disease and for this reason it requires the collaboration of several specialists – says prof. Massimo Di Maio, National Secretary of the Italian Association of Medical Oncology/AIOM -. As far as pharmacological therapies are concerned, even if more slowly than for other tumors, we are seeing progress in the direction of precision medicine. We are moving towards a greater characterization of the molecular alterations present in tumor cells. In this way we will be able to predict which drugs can work and which cannot, which unfortunately we do not know how to do optimally today”. More recently, an interesting result should be noted in the field of innovative treatments for advanced disease: theragnostics (“therapy + diagnostics”), which represents the integration of a diagnostic method with a specific therapeutic intervention, based on the use of a ligand radioactive agent that selectively targets cancer cells. The path of a patient with prostate cancer – concludes Di Maio – even if in an advanced stage, can last years, and it is not possible to ignore the attention to his quality of life.
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