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Slainte an Chlar
Health Education Day
Cancer
20th Feb 2010
Prostate cancer
• Very common
• Over 2500 men diagnosed per year in Ireland
• Over 500 deaths
• Very treatable!
Trends in prostate cancer mortality 1995-2005
Ireland
USA
England and Wales
Australia
AustriaCanada
France
Germany
Finland
New Zealand
Sweden
10
12
14
16
18
20
22
24
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
ag
e-s
tan
da
rdis
ed
mo
rta
lity
rate
(/1
00
,00
0)
Ireland United States of America UK, England and Wales Australia
Austria Canada France Germany
Finland New Zealand Sweden
Trends in prostate cancer incidence 1994-2005
0
25
50
75
100
125
150
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Euro
pean
age
-sta
ndar
dise
d in
cide
nce
rate
(/1
00,0
00)
0
500
1000
1500
2000
2500
3000
case
s pe
r yea
r
rate cases
Prostate Cancer Ireland vs USA
• USA: 186,320 per year, and 28,660 deaths (2008)
Crude death rate 15.3 %
----------------------------------------------------------• Ireland: 1687 per year, and 520 deaths
(1994-2005 average)
Crude death rate 30.8%
----------------------------------------------------------
An Irish man diagnosed with CaP is at least twice as likely to die of his disease than his US counterpart…
Source: SEER database; Cancer in Ireland 1994-2000
Prostate cancer incidence 2004-2006 by County
0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8
WexfordKilkenny
MonaghanWaterfordTipperary
ClareLongford
MeathLimerick
LouthDublin
DonegalCavan
KildareKerry
CarlowWestmeath
WicklowOffalyMayoCork
LaoisRoscommon
SligoLeitrimGalway
observed/expected
What is your prostate and why should you care?
• Secondary sex organ (see breasts)
• Produces seminal fluid
• Commonest male cancer
• DRE
• PSA
• Evaluation
• Treatment options
Are we looking for prostate cancer?
Annual number of PSA tests
0
50,000
100,000
150,000
200,000
250,000
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
test
s pe
r yea
r
all PSA tests first PSA tests
Percentage of men over 50 having a first PSA test
0
10
20
30
40
50
60
70
80
% o
f men
ove
r 50
teste
d
first tests cunulative % of first tests
Prostatic biopsies, by age
0
200
400
600
800
1000
1200
1400
1600
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
numb
er of
biop
sies
<49
50-59
60-69
70-74
75-79
>80
New and suspected prostate cancer cases seen by hospitalIreland 2006 - 2007
HospitalNew prostate cancer cases diagnosed in 2006
New prostate cancer cases diagnosed in 2007
Suspected prostate cancer cases seen in 2006
Suspected prostate cancer cases seen in 2007
Benign:malignantratio 2007
AMNCH 327 273 797 676 2.5:1
Beaumont 151 179 530 453 2.5:1
CUH 186 210 340 382 2:1
Limerick Regional 112 104 301 311 3:1
Mater 220 240 1000 (estimate)
1200(est) 5:1 (est)
MUH 145 171 304 274 1.6:1
St James’ 101 105 Unknown 280 2.6:1
St Vincent’s Unknown 180 Unknown 335 2:1
UCHG 272 365 820 1100 3:1
Waterford 105 107 Unknown 150 1.4:1
Testing for the spread of the cancer
An MRI Machine…and image
A Bone scan Machine…and image
Treatments for Prostate Cancer
• Radical surgery– Open prostatectomy (retropubic/transperineal)– Laparascopic prostatectomy– Robotic laparascopic prostatectomy (“DaVinci”)
• External Beam Radiation Therapy (EBRT)– Conventional– 3D conformal– IMRT– Image guided hypofractionated IMRT
• Brachytherapy– Permanent low dose Temporary HDR– Combinations
• Hormone treatment
• Novel drugs for hormone resistant prostate Cancer badly needed
National planning
• National Cancer Control Program– National Cancer Screening Service
• Standard setting committees– Diagnostic/treatment
recommendations
• “Rapid Access Clinics” – Prostate and Lung – Pilots open
Take home message
• Prostate cancer very common and very treatable
• Early warning devises are available
• Report any symptoms
• Check with your doctor
• Multiple treatment options…one size definitely does not fit all!
• Be aware….
12 New Jersey Women Pose Nude for Prostate Awareness CalendarOctober 28, 2009
