IS THIS A CASE OF BIAS AGAINST MEN?

New fig­ures show prostate is now a big­ger killer than breast can­cer ... which gets TWICE the fund­ing

Daily Mail - - Front Page - By Ben Spencer Med­i­cal Cor­re­spon­dent

PROSTATE can­cer has be­come a big­ger killer than breast can­cer for the first time, of­fi­cial sta­tis­tics re­veal to­day.

More than 11,800 men a year are now killed by the dis­ease in Bri­tain, com­pared with about 11,400 women dy­ing of breast can­cer. It means prostate can­cer has over­taken breast can­cer as the third big­gest can­cer killer in the UK, be­hind only lung and bowel.

De­spite this, it re­ceives less than half the re­search fund­ing of breast can­cer – while ex­perts warn that treat­ments for the dis­ease are trail­ing at least a decade be­hind.

The Daily Mail has been cam­paign­ing for

nearly 20 years to raise the pro­file of prostate can­cer. But while care has leapt for­ward since the Mail’s ‘Dy­ing of Em­bar­rass­ment’ cam­paign be­gan in 1999, it has been slow com­pared with the im­pres­sive ad­vances made on breast can­cer.

Last night, char­i­ties called for ac­tion to im­prove sur­vival chances for prostate suf­fer­ers. They said that with an im­prove­ment in fund­ing, deaths could be ‘dra­mat­i­cally’ re­duced over the next decade.

The an­nual num­ber of breast can­cer deaths fell by 1,500 be­tween 1999 and 2015, the Of­fice for Na­tional Sta­tis­tics fig­ures show. This re­flects ex­tra­or­di­nary strides made in re­search, screen­ing and treat­ment to tackle a dis­ease that af­fects 55,000 women a year.

How­ever, over the same pe­riod, the yearly death toll for prostate can­cer – the most com­mon male can­cer, with 47,000 Bri­tish men di­ag­nosed each year – rose by 2,400.

In 1999, some 9,460 men died from prostate can­cer, com­pared with 12,947 deaths from breast can­cer. Breast can­cer is very rare among men, with 80 deaths in the UK in 2015.

The ONS fig­ures show that by 2015 – the most re­cent year with avail­able data – male prostate deaths had risen to 11,819, sur­pass­ing the breast can­cer deaths, which had dropped to 11,442.

The age­ing pop­u­la­tion is the main rea­son for the in­crease in prostate can­cer deaths – with older men more likely to get an ag­gres­sive form. And men are far more likely to ig­nore symp­toms than women.

But last night ex­perts said the gulf in re­search fund­ing is also driv­ing the dis­par­ity.

Pro­fes­sor Nick James, a lead­ing prostate can­cer re­searcher from Birm­ing­ham Univer­sity, said: ‘ We are ten if not 20 years be­hind breast can­cer in terms of re­search. We are play­ing a late game of catch-up.’

An­other fac­tor is that while screen­ing for breast can­cer is rou­tine – with mid­dle-aged women in­vited for scans ev­ery three years – tests for prostate can­cer are no­to­ri­ously in­ac­cu­rate and there is no na­tional screen­ing pro­gramme. An­gela Cul­hane, of Prostate Can­cer UK, which re­leased the fig­ures, said: ‘With half the in­vest­ment and half the re­search it’s not sur­pris­ing progress in prostate can­cer is lag­ging be­hind … the good news is many of th­ese de­vel­op­ments could be ap­plied to prostate can­cer and we’re con­fi­dent, with the right fund­ing, we can dra­mat­i­cally re­duce deaths within the next decade.’

Men with prostate can­cer wait four times longer for di­ag­no­sis than women with breast can­cer – and a quar­ter of men wait 126 days.

Prostate can­cer has had £227mil­lion of govern­ment and char­ity funds since 2002, less than half the £529mil­lion in­vested in breast can­cer. The re­sults can be seen in the re­search out­put – with 9,300 prostate re­search pa­pers pub­lished glob­ally last year, com­pared with 21,000 breast can­cer pa­pers.

And the im­pact can be seen in the vast dis­par­ity in care. Breast can­cer has seen rapid strides in treat­ments in re­cent years – with rev­o­lu­tion­ary pre­ci­sion and im­munother­apy drugs such as Kad­cyla and Her­ceptin trans­form­ing the way women are treated.

But men with prostate can­cer still rely on hor­mone treat­ments and chemo­ther­apy which have in essence hardly changed in years.

Pro­fes­sor James said: ‘Hor­mone treat­ments have been the treat­ment main­stay for prostate can­cer since the 1940s.’

He stressed that bet­ter hor­mone treat­ments have emerged, such as Abi­raterone, but prostate can­cer is yet to ben­e­fit from break­throughs in pre­ci­sion medicine.

‘Th­ese tri­als were done in breast can­cer ten or 20 years ago,’ he said. ‘We are fol­low­ing the same path­way as breast can­cer but we have to wait ten years for an­swers.’

The other key draw­back is screen­ing. Men over 50 are el­i­gi­ble for a ‘PSA’ blood test which gives only a rough idea of whether they are at risk, and then sent for biop­sies, which are also in­ac­cu­rate.

Pro­fes­sor Mark Em­ber­ton of Univer­sity Col­lege Lon­don said: ‘The great tragedy here is we have spent a lot of money on tri­als that have failed … the an­swer is MRI.’ But many hos­pi­tals do not have the right equip­ment for the scans. Prostate Can­cer UK es­ti­mates it needs to fund £120mil­lion worth of re­search over the next eight years to achieve its ten-year goal to halve the num­ber of ex­pected prostate can­cer deaths by 2026.

Ms Cul­hane added: ‘Plans to cre­ate an ac­cu­rate test, fit for use as part of a na­tion­wide prostate can­cer screen­ing pro­gramme, as well as de­vel­op­ing new treat­ments for ad­vanced prostate can­cer, are al­ready well underway … to achieve th­ese aims we need to in­crease our in­vest­ment in re­search.’ There is a big dif­fer­ence in pub­lic­ity for pros-

tate and breast can­cer. The lat­ter has been the sub­ject of ma­jor cam­paigns since the early 1990s, with the pink rib­bon and race for Life rais­ing fund­ing and aware­ness. It was not un­til 2007 that Movem­ber, the an­nual men’s can­cer cam­paign, came to Bri­tain.

Baroness De­lyth Mor­gan of Breast Can­cer Now said: ‘Com­par­ing sur­vival fig­ures in this way must not hide the very real con­cerns that progress on breast can­cer in the UK is now stalling. We ur­gently need to in­vest in re­search to stop more pa­tients dy­ing from breast, prostate and many other can­cers.’ A Depart­ment of Health spokesman said: ‘Can­cer sur­vival rates are at a record high and are im­prov­ing year- onyear … But we want to be even bet­ter. That’s why our re­search arm is cur­rently do­ing a £4mil­lion cut­ting- edge re­search project into prostate can­cer at The royal Mars­den [Hos­pi­tal], amongst other re­search on prostate can­cer. We have al­ready com­mit­ted £200mil­lion over the next two years to im­prove early di­ag­no­sis and care.’

FOR­GIVE the dark irony, but it’s a bla­tant case of dis­crim­i­na­tion against men. New fig­ures pub­lished to­day show prostate can­cer has be­come a big­ger killer than breast can­cer for the first time. There is one very sim­ple rea­son – more than twice as much is spent on breast can­cer re­search. In ad­di­tion, a well pub­li­cised mass screen­ing pro­gramme has seen women’s sur­vival rates soar. True, many men are em­bar­rassed and re­luc­tant to have their prostate checked, but even those who do see a doc­tor wait four times longer for a di­ag­no­sis than women with breast can­cer.

For nearly 20 years, the Mail has cam­paigned to raise aware­ness of prostate can­cer, but it re­mains woe­fully low on the list of NHS pri­or­i­ties. There is no screen­ing, PSA blood tests re­main no­to­ri­ously un­re­li­able and ther­a­pies have barely moved on in decades. Men are ef­fec­tively dy­ing of com­pla­cency and in­dif­fer­ence.

So yes, we welcome the fall in breast can­cer deaths which is rightly a source of pride for the NHS. But the fact that prostate can­cer deaths are at a record high is a source of shame.

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