15 November 2022

The rise of prostate cancer and oral cancers in men

Prostate cancer is nearly on par with lung cancer as the most common cancer in men, while oncologists are also concerned with the rise of HPV-related male cancers.

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Lung cancer is the second most prevalent cancer worldwide and the most commonly diagnosed in men (15.4% of all cancers)  – but the incidence of prostate cancer is almost as high, representing 15.1% of all male cancer diagnosis.

The number of lung cancer cases and related deaths are largely decreasing as more people quit smoking and early detection and treatment protocols improve – at least where these resources exist and where there has been a successful implementation of measures recommended by WHO’s Framework Convention on Tobacco Control to regulate and curbthe consumption of tobacco.

The incidence of prostate cancer, however, is rising significantly. Prof. Jeff Dunn AO, President of UICC and Chief of Mission and Head of Research at the Prostate Cancer Foundation of Australia, highlighted in an opinion piece published in July, a rise of 34% in one year of the number of men diagnosed with prostate cancer in Australia – overtaking breast cancer as the most common form of cancer in the country overall.

Furthermore, this is affecting younger men who are being diagnosed at more advanced stages of the disease. In another article published in September, Prof. Jeff Dunn called for dispelling the myth that prostate cancer is “an old’s man disease” and that “men will die with it, not from it.”

“I have news for you. More than 3,500 men aged under 59 are diagnosed with [prostate cancer] every single year [in Australia], one of them will die roughly every five days, and often younger men get more aggressive forms of the disease”.
–    Prof. Jeff Dunn AO, President of UICC, Chief of Mission and Head of Research at the Prostate Cancer Foundation of Australia

This is not an isolated situation. According to an article published this year in Frontiers Public Health, prostate cancer is the most frequently diagnosed cancer in 112 countries and the leading cause of cancer death in 48 countries, accounting for more than 1.4 million cases and over 375,000 deaths, similar to the number of deaths caused by cervical cancer. These numbers are expected to nearly double by 2040

The early detection of prostate cancer – as with other common cancers – virtually guarantees successful treatment, when the resources exist to do so, as the five-year survival rate for a stage 1 diagnosis is nearly 100%. For this reason, Prof. Dunn called in Australia for the “urgent review of Clinical Guidelines for PSA testing, which measures prostate-specific antigen levels in the bloodstream.”

“Today, more than 70 per cent of men with low-risk non-aggressive cancers will be treated with safe and effective surveillance strategies. And if their prostate cancers change and grow, we take action to treat them, immediately, thereby reducing risks of death.”
–    Prof. Jeff Dunn AO, President of UICC, Chief of Mission and Head of Research at the Prostate Cancer Foundation of Australia

HPV-related male cancers

Head and Neck Cancer (HNC) specialists are also concerned about a rise in the number of middle throat cancers among men, despite declining smoking rates. This increase in oropharyngeal cancers – where the tonsils and base of the tongue are located – is largely attributable to the human papillomavirus (HPV), which causes the majority of cervical cancers in women.

A study published over ten years ago already reported an increase in the US of 225% in the number of HPV-related middle throat cancers between 1988 and 2004, compared to a decline of 50% in non-HPV-related oropharyngeal cancers in the same period. The rise is occurring primarily among non-smoking, white, heterosexual males in their 50s and 60s, according to MD Anderson.

While more significant in high-income countries, this increase is also being seen in lower-income settings. In India, for instance, HNCs are the among the most common forms of cancer, due a high prevalence of tobacco consumption and alcohol intake, according to Prof. Anil D’Cruz, Immediate Past President of UICC and Director of Oncology at Apollo Hospitals. Prof. D’Cruz adds, however – and research shows – that there is also a rising incidence of HPV-related throat cancers in India also.

Oral cancers can often be detected early and at very low cost with a visual examination to check for typical discolourations of the mouth lining. HPV-related throat cancers, however, may grow slowly and only become noticeable as a lump in the neck, since the virus can remain dormant for years.

Since HPV can also cause anal and penile cancers in men, it is among the reasons advanced for extending routine HPV vaccination to boys. Particularly since, unlike pap smears for cervical cancer, there are currently no screening tests to detect HPV in the throat.

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Tuesday 15 November 2022

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