Prostate cancer is the most widespread among the male population in Italy and constitutes 20% of all cancer cases diagnosed aged 50 and over.
Survival 5 and 10 years after diagnosis is very high and today survival improves even for the most serious cases, such as hormone-sensitive metastatic ones.
For this reason, the Italian Association of Medical Oncology (Aiom) and the Aiom Foundation are launching a new information campaign to raise awareness among oncologists but also patients, caregivers, institutions and the population on the new therapeutic availability for this neoplasm.
In 2023, prostate cancer affected 41,100 men in our country and there has been an increase in new cases of 14% per year in the last three years.
More than 60% of patients manage to definitively defeat carcinoma, even those affected by the most serious forms of the tumor.
"The introduction of targeted therapies - explains Saverio Cinieri, president of the Aiom Foundation, in an online press conference - has changed the history of the fight against this carcinoma. Until a decade ago the therapeutic options for certain clinical situations were very limited. Today instead new drugs and a sequence of multiple lines of treatment are available."
The Aiom project involves the dissemination of a newsletter for specialists, video interviews with leading Italian experts, webinars for patients and caregivers and strong activity on social media.
Successes, underlines Marcello Tucci, director of Oncology at the Cardinal Massaia Hospital in Asti, "have also emerged in an earlier setting of hormone-sensitive metastatic disease. In this subgroup of patients only 30% survive five years from diagnosis. In the majority In some cases, the disease evolves and becomes resistant to castration. In other words, hormone therapy does not cause sufficient benefits and other, more effective treatments are absolutely necessary. A strategy that has further improved the control of hormone-sensitive metastatic disease has been that of using a new generation oral androgen receptor inhibitor, such as Darolutamide, which, for example, has been shown to reduce the risk of death by 32% if administered together with hormonal therapy and chemotherapy".
In Italy alone, adds Orazio Caffo, director of the Medical Oncology Operational Unit of the Santa Chiara Hospital, Trento, "over 564 thousand men live with a diagnosis, and their number has more than doubled compared to 10 years ago. 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".
Age is one of these, "along with obesity, diet and smoking, and then there are hormonal and genetic factors", continues Cinieri.
According to the latest data, worldwide annual diagnoses of prostate cancer amount to 1.4 million.
"In general, in the early stages the disease is asymptomatic - specifies Tucci -. Only when it progresses do some non-specific symptoms appear such as the decrease in the power of the urinary stream, hematuria, dysuria and perineal pain. In the more advanced stages however the skeleton it is often the first site where metastases appear. The characteristic bone pain thus develops, mainly localized mainly at the spinal level".
If the cancer is confined to the prostate it can be treated with surgery or radiation therapy, experts explain.
However, when the disease presents metastasis in the hormone-sensitive phase, it is essential to enhance androgen deprivation therapy with new generation hormone therapy or chemotherapy.
A further step forward in blocking the development of the tumor comes from the Darolutamide molecule, which represents a new and important therapeutic option when 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", concludes Caffo.
THE ACTIVE SURVEILLANCE APPROACH
It is a strategy that "is becoming increasingly popular - explains Caffo - but these are selected cases: in fact it concerns low-risk patients with limited disease, and there are precise protocols to identify such patients to whom active surveillance can be applied, which must also be accompanied by adequate psychological support".
Naturally, the oncologist specifies, "the active surveillance approach does not mean doing nothing, but rather means carefully monitoring to detect any mutation of the disease and intervening promptly when and if this becomes necessary, that is, only when it is really needed" .
This approach, continues Caffo, "therefore avoids unnecessary treatments, with benefits for patients".
Furthermore, today "there are clear data that highlight how the use of active surveillance is greater where multidisciplinary teams are operational to take charge of the patient. This demonstrates the crucial importance of multidisciplinary management, i.e. with the presence of various specialists in the team, including patients with this type of neoplasm".
Reproduction reserved © Copyright ANSA