Prostate cancer funding – pause or paralysis ?

Prostate cancer – the widow and orphan maker

Incredible but true:-  In Britain one man an hour dies from prostate cancer

Cancer_AOne of America’s oldest and respected men’s and fathers’ rights organisation (NCFM) [1] has this week released a critique of the American government’s policy in the funding (or the lack of it) of cancers that affect men, namely, prostate cancer.

Expenditure numbers are always big in the USA so it should not surprise us that the Center for Disease Control (CDC) latest budget request is for $11.86 Billion dollars, which is an $ 87 Million dollar increase.

What was shocking – but sadly not a surprise given our identical experience in the UK – was that of the existing $13.7 Million earmarked for prostate cancer programme no increase in funds was requested by the CDC explained in the budget narrative as; “. . . . the evidence on prostate cancer screening remains unclear.”

This immediately put us in mind of our attempts in 1998 – 99 to get funding (at any level) earmarked for prostate cancer in the UK. The situation then was that while the Gov’t contributed millions of pounds every year to cancer (see first table), it was all directed towards the politically sensitive and PC topic of breast cancer. Prostate cancer never got a mention – yet it killed as many men as breast cancer killed women. The figures of the period show the discrepancy in thinking.

Cancer_CAlmost £24 million was being spent by government on female related cancers and only £2m on male specific cancers (£1m of which came from the Daily Mail). Only when the Daily Mail lost once of its best reporters to prostate cancer at a very early age did it and the public blackmail’ government to match its one million pounds research donation (in March 2000).

In Britain and Ireland there are 40,000 diagnoses of prostate cancer each year. Prostate Specific Antigen (PSA) is a protein produced by both normal and cancerous prostate cells and this sis the method adopted for testing. The situation in 2015 was that there were 330,000 men diagnosed with prostate cancer (ref. ‘Prostate Cancer UK’, Oct 2015), and 10,500 were dying from it each year. One in eight men in the UK will, on average, be diagnosed with prostate cancer and for black men the likelihood is 1 in 4 (the reason for this is still not understood).

In a letter to Robert Whiston, from Baroness Hayman at the Dept. of Health, dated 29/6/1999 concerning cancer screening for men, she confirmed there were two beast screening programmes (BSP) for women, and that since 1988 (when the BSPs were introduced into the UK) the death rate for breast cancer had fallen faster than the European average.

Cancer_BHowever, she declared that after her Dept. had commissioned two reviews into prostate cancer testing, i.e. the PSA test, (from the University of Bristol and the Institute of Cancer Research and both 1997) she had been recommended that because of the high risk of false positive rates that:

  • “. . . . with the current evidence and the present technology a screening programme could not be supported and there was no case to be made for a national screening programme. . . .. There is currently no evidence to support the assertion that a screening programme for prostate cancer could save lives.”

It was later learnt that ‘guidance’ had then been issued to all Health Authorities that patients should not be offered routine prostate cancer screening – despite all existing cancer screening programmes producing at varying degrees the same ‘false positives’.

Less than two years later, in March 2000, New Labour announced the launch of a £20m pilot project, lasting 10 years, “to see if a national screening programme for women suffering from ovarian cancer should be established” – again, nothing about prostate cancer or prostate cancer funding.

  • “ . . . . The plan is for 100,000 women to be screen every year for 6 years with 50,000 undergoing a blood test and the rest an ultrasound test (at a cost of £100 per woman). The Medical Research Council will contribute £5.7m, the Dept. of Health £12m, the Cancer Research Campaign £1m and Imperial Cancer Research Fund a further £1m. Yvette Cooper, minister for public health said in welcoming that the study would provide “…. valuable new evidence of the best ways to treat and monitor the disease”.

The cost of a prostate cancer PSA test for men was £25 at the time.

Cancer_D

“Silent killer”

In as Telegraph article on Ovarian Cancer, dated March 22nd 2000, Prof. Ian Jacobs of Bartholomew’s Hospital London described Ovarian Cancer as the silent killer. Silent because its symptoms are not immediately apparent and a diagnosis is can be difficult:

  • “Because ovarian cancer involves a blood test, it is cost–effective”. However, there would be some cases where tests would show abnormalities, even though there was no cancer. The unnecessary surgery rate is thought to be between 0.1% and 0.5% of cases.

The PSA prostate cancer test also involves a blood test and would, on occasions, also show abnormalities, even though there was no cancer (ie false positives), yet prostate cancer is abandoned penniless and Ovarian has millions spent on it. But with all the funding and publicity the only ‘silent killer’ left today is prostate cancer.

Ovarian Cancer was once the 4th biggest cancer killer (just like prostate cancer) – usually in the post-menopausal 50 – 74 age group who account for 80% of all ovarian cancer cases. And among prostate cancer sufferers, probably 80% are also in the 50 – 74 age group (and in common with ovarian cancer it can also strike people in their 30s).

Is your life worth only £417 ?

Other than skin cancer, prostate cancer is the most common cancer for men in the US. Only lung cancer kills more men than prostate cancer. [2] Prostate cancer is the second most common cause of cancer deaths among white, black, Cancer_EAmerican Indian/Alaska Native, and Hispanic men; and the fourth cause of cancer deaths for Pacific Islander men. [3]

Two large Prostate-specific antigen (PSA) trials recently published conflicting results. A European trial found a clear and significant reduction in mortality, but a US trial found little benefit and even some harm. [4]

Left: Comedian Bill Bailey is fronting a new fund-raising campaign by Prostate Cancer UK in a series of adverts

The picture in Britain had not changed very much by 2013 – prostate cancer remained the most common form of the disease in men but is bottom of the league for research spending, Gov’t figures reveal. According to the Daily Mail, just £17 million was spent by government and charitable sources in 2011, which works out at £417 for each of the 40,841 men diagnosed with the disease that year.

Imagine, if a husband died aged 35 of prostate cancer, how much loss of wealth creation would  follow, lowered GDP due to 30,000 similar deaths, and how much cash money the government would have to pay out every month in benefits and allowances to a widow and her orphans and the subsidies needed for schooling and medical treatments etc.

In contrast, breast cancer still had the highest research funding of any cancer at £41.6million, with leukaemia receiving the most per patient (£3,903). Owen Sharp, chief executive of Prostate Cancer UK, said:

  • ‘Men in the UK have a problem and they don’t want to talk about it. Neither do the wives and partners who will end up supporting them, the doctors who will treat them, nor the politicians who will count on their vote. Prostate cancer is simply not on the radar. We need to follow the lead of the successful female movement against breast cancer and create a real change for men.’

The cure is simple. It is the ‘official mind’ that must change. As a “P Armstrong”, London, wrote 3 years ago:

  •  “Dr Julie Sharp of Cancer Research UK was quoted on the subject as follows: “We fund the best science we can to make the greatest impact – we don’t have quotas for specific types of cancer.” Right ! This is Cancer Research UK, which sends out letters addressed ‘To the Woman of the House‘ and bans men from participating in the ‘Race for Life’ annual run. Makes you wonder, eh ?”

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appendix 1

USA 1992 – ‘The death rate for cancer of the prostate is 24.1 per 100,000 The death rate for female cancer of the breast is 27.4 per 100,000. Cancer of the prostate killed about 32,000 men in 1992 and about 44,500 were killed by breast cancer. Breast cancer has $92 million on it by the US Gov’t. Cancer of the prostate has $14 million spent on it by Gov’t (ie 660% more funding for a 13.7% death rate difference). Projected funding in 1992 is $132m for breast cancer and $20m for prostate.’ – Cancer Facts and Figures, 1991. American Cancer Society.

appendix 2

Extracts taken from readers’ comments Daily Mail 2013-

“Kitty”, Milton Keynes, UK.  ‘Jayell – ‘doesn’t effect them personally’? I have just lost my adored husband, horribly, to PC. how much (sic) more ‘personal’ is that?’ Are you saying that your loss was greater than his ? Reminds me of the quote from Hilary Clinton who said that women are the main victims of war because they lose fathers, husbands and sons. You can always count on a woman to turn the subject back to her favourite subject – HERSELF !

References:

  1.  UK info source : http://prostatecanceruk.org/prostate-information/about-prostate-cancer
  2. For a discussion of related issues see: http://scienceblog.cancerresearchuk.org/2009/03/18/the-psa-test-the-picture-becomes-slightly-clearer/
  3. http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/diagnosis/prostate-cancer-tests
  4. https://www.letsgetchecked.com/gb/en-gb/cancer-screening-kits/prostate-specific-antigen/Media
  5. Original version on PR Newswire, see:http://www.prnewswire.com/news-releases/the-national-coalition-for-men-ncfm-calls-for-congress-to-restore-and-increase-funding-for-prostate-cancer-research-300255255.html
  6. Daily Mail 1st January 2013 http://www.dailymail.co.uk/health/article-2255559/Anger-prostate-cancer-lags-research-spending-despite-common-form-disease-men.html

Footnotes:

  • [1] National Coalition For Men
  • [2] American Cancer Society
  • [3] The Center for Disease Control (CDC)
  • [4] Screening for Prostate Cancer: A Review of the ERSPC and PLCO Trials, (2009), “Prostate, Lung, Colorectal, and Ovarian (PLCO)” Cancer Screening Trial & “European Randomized Study of Screening for Prostate Cancer” (ERSPC) respectively. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2777060/

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