New prostate cancer treatment in Singapore enhances city-state’s reputation as a medical hub
The introduction in Singapore of a promising new treatment for one of the most threatening forms of prostate cancer has underscored the city-state’s reputation as one of the world’s top medical research and treatment centres.
The treatment, for patients who have advanced prostate cancer with bone metastases, received fast-track approval in Singapore just six months after being approved in the United States. It is expected to attract patients from across Asia and further enhance Singapore’s status as a regional hub for medical excellence.
The radium-223 dichloride treatment was developed by Bayer HealthCare Pharmaceuticals Inc and marketed under the tradename Xofigo. Administered by injection, it is considered a breakthrough alpha-radioactive therapy to help men whose prostate cancers have spread to the bones, a condition called bone metastases. The condition affects nearly 90% of men with castration resistant prostate cancer (CRPC).
The injection is administered in an outpatient setting and the patient can go home right after he finishes the treatment. Treatment is just once a month over a period of six months.
Bone metastases are the main cause of morbidity and death in prostate cancer patients. According to a study, the five-year survival rate is 56% in men with prostate cancer without bone metastases and only 3% in those with the condition.
“This is definitely a good start and it shows that Singapore is at the forefront of medical treatment in the region,” said Thomas Steffen, the country head of Bayer HealthCare for Singapore, Malaysia and Brunei.
“The country is grounded with a solid track record of clinical trial experience matched by an efficient health authority review system. The new treatment option holds out new hope and promise to the many patients in Asia suffering from the symptoms.”
With its great infrastructure, well-equipped hospitals and professional doctors, it was no surprise that Singapore was the first site in Asia to launch the treatment.
“Singapore has participated in clinical trial activities since 2008; therefore all the infrastructure has already been set up,” said Mr Steffen. “Apart from this, there are a lot of other treatments available. For radium-223, it is still an ongoing process. It is now being tested to other types of cancers related to bone metastases in order to see if the treatment could also work and be developed further.”
According to Dr Ng Quan Sing, a consultant to the Division of Medical Oncology at the National Cancer Centre of Singapore, the number of patients who suffer from prostate cancer has been increasing dramatically in recent years, reflecting in part the ageing population of Singapore and other countries.
“Age is the single greatest risk factor for prostate cancer. Ten years ago prostate cancer was the fifth most common and now it has become the third most common, overtaking stomach and liver cancer,” he explained.
For men in their 40s the risk of developing prostate cancer is one in 200,000 while in their 50s, the risk jumps to 12 per 100,000. When they hit their 60s, the risk is 14.6 out of 10,000. Prostate cancer is a slow-growing cancer, often exhibiting no symptoms, and many of the patients seek treatment too late.
Treatment for cancer in general is highly individualized, said Dr Ng, and not everybody can receive the same treatment options. And when cancer spreads to other parts of the body it becomes incurable. So the goal of the treatments is to prolong the patients’ lives, while at the same time improve their quality of life.
“The benefits of this drug are that it improves reduces pain and has very minimal side effects. It could help prolong life for about 3.6 months from the start of the process. It may not sound a lot but if you tell the patients who are suffering from advanced prostate cancer, it means much more to them,” he said.
Dr Oliver Sartor, director of the Prostate Cancer Program at Tulane University School of Medicine in the US, said radium-223 would become part of the changing landscape of cancer treatment.
This could be seen as a piece of a puzzle but changes will evolve even more rapidly. It is significant, he said, that all related parties maintain great cooperation and integrate each advance into the treatment landscape in a timely manner and in effective ways.
“Radium-223 does help us succeed in the goal of helping patients live longer and better,” Dr Sartor told Asia Focus. “However, we have much more work to do. We need to remember that our goal is bigger and the expectation is always higher, until we begin to cure people.”
About 14% of all men will be diagnosed with prostate cancer at some point in their lives, but 67% of all prostate cancer cases are diagnosed in men over age 65.
However, besides age, a person’s genetic makeup is also an important risk factor. People whose relatives have had prostate cancer are at a higher risk than those without.
In Thailand, the estimated incidence of prostate cancer is 4.9 per 100,000 and it is the fifth most common cancer in Thai males. The incidence of prostate cancer has risen from 4.59% in 2003 to 7.3% in 2007. There were 2,134 cases in 2008 and 683 deaths.
Even though there is no conclusive evidence of what causes prostate cancer, doctors also advise that people should eat healthily and exercise regularly, as well as try to cut down on smoking and alcohol consumption to reduce their risk.
Source: Bangkok Post
Published: 06 May 2014
