N.S. seeing rise in prostate cancer cases
Study suggests the number will double by 2040
A new study says the annual number of prostate cancer cases worldwide will double by 2040.
The study, done by the Lancet Commission, suggests cases will rise from 1.4 million in 2020 to 2.9 million in 2040.
Dr. Ricardo Rendon, a urologist at the QEII Health Sciences Centre in Halifax and president of the Canadian Urology Association, said Nova Scotia has already been seeing an increase in the number of prostate cancer cases – both low-grade and advanced cases.
“What we have seen lately, over the last few years, is that we're seeing more advanced prostate cancers, so the lethal prostate cancers,” Rendon said in an interview.
In 2023, there were 790 diagnoses new prostate cancer in Nova Scotia. There were also 170 deaths attributed to prostate cancer in Nova Scotia last year.
Rendon explained that a recommendation released a few years ago by the U.S. and Canadian task forces on preventive health care resulted in less screening of prostate cancer.
However, a follow-up study in Europe revealed that screening makes a difference – a 21 per cent improvement in survival.
“You only need to screen about 500 patients to save one life, which compared with other screening methods is an amazing number,” Rendon said.
PREPARING FOR SURGE IN CASES
The study stresses the surge in cases cannot be prevented by lifestyle changes or public health interventions alone.
“So, we have to prepare adequately for that,” Rendon said.
“We need to start to be smarter about screening patients but also smarter about treating patients.”
Rendon said many patients who require treatment still require surgery and/or radiation, but there have been advances in those treatment methods.
“Patients are able to treat their cancer with less sessions, significantly decreased number of sessions, and that's really good because it decreases the need for resources and contact with the cancer centres, particularly in a region like ours where patients have to travel,” he said.
He said Nova Scotia has also moved away from open surgery to robotic surgery, which allows for more precision and a faster recovery for patients.
Rendon said there have also been advancements in treatment for advanced cancer.
“Before when a patient had advanced prostate cancer, the treatment was by taking away their testosterone, their male hormone, because that's sort of the food for prostate cancer, and then the prostate cancer shrunk but eventually started to grow again,” he explained.
Rendon said now there are multiple treatments available and more targeted therapies, such as theragnostics, a combination of therapy and diagnostics that “uses both imaging technology and targeted therapies to identify and treat diseases such as cancer as well monitor response to treatment.”
But Rendon said Nova Scotia's resources are limited. He pointed to the shortage of primary care physicians across the province.
He explained once patients are treated, they can and should go back to their primary care physician for follow-up.
“But we cannot discharge these patients because they don't have anyone to follow up,” he said.
“Some of these systems that have been created, they're really not for day-to-day management of heart issues or previous cancers, so it's clogging our system dramatically because we cannot discharge our patients.”
Rendon said patients remaining under the care of specialists at hospitals is more expensive and decreases their ability to treat other people.
He acknowledged Canada has a good amount of resources in comparison to other countries, but they need to be optimized.
“We're going to have to make some significant changes because we're already in the presence of an expensive health-care system and now, with the aging population, with the increase in cancers, we're going to have to adjust and prepare for that because we're already underresourced, so there's going to have to be significant changes at all levels,” he said.