Charlie Taylor has been cancer-free for eight years after being diagnosed with prostate cancer in 2013.Handout
Advancements in medical imaging and improved treatments have helped slash the death rate from prostate cancer in half since its peak in the mid-1990s, with researchers saying breakthroughs over the years are now paying off.
The number of deaths from prostate cancer reached 45.1 per 100,000 men in 1995 and has fallen to 22.7 per 100,000, according to the Canadian Cancer Statistics 2021 report, which is being released on Wednesday. The Canadian Cancer Society (CCS) produced the report in partnership with Statistics Canada and the Public Health Agency of Canada.
Cynthia Ménard, head of department of radiation oncology at the University of Montreal Hospital Centre, said the achievement comes not from a single development, but breakthroughs that have compounded over time to allow oncologists to better characterize and treat the disease.
“We have better imaging, which leads to better targeted biopsies, which leads to better pathological sampling, better microscopic understanding of the disease and better characterization of the molecular profile,” she said.
“This in turn guides us in the subsequent imaging that we do, which is better quality than it was, to have an accurate picture of the extent of the disease so we can react appropriately.”
Prostate cancer is the most commonly diagnosed cancer and third leading cause of cancer-related death among Canadian men, according to the Cancer Society. An estimated 24,000 Canadian men are expected to be diagnosed with the disease in 2021 – about 20 per cent of all cancer cases diagnosed among men – and 4,500 will die from it.
The report says that prostate, lung, breast and colorectal cancers will account for almost half of all new cases diagnosed in Canada this year.
Prostate cancer is one of the least preventable cancers, which underscores the importance of advancements in treatment, but is almost 100-per-cent survivable if detected before it spreads.
Stuart Edmonds, executive vice-president of mission, research and advocacy at the Canadian Cancer Society, says Canada has made advances that have changed practices around the world.
“When the prostate cancer death rate was at its peak in the mid-1990s, there was little attention given to research for the disease,” Dr. Edmonds said in a statement. He added that since then, financial contributions from organizations such as the Cancer Society toward research in targeted areas has led to tremendous progress.
Charlie Taylor’s father died of prostate cancer at 68, just six weeks after he was diagnosed. That jarred Mr. Taylor, and led to him begin regular screening at around age 42.
Beginning at age 46, blood tests detected a rise in his prostate-specific antigen (PSA) levels from about 2.3 nanograms per millilitre to 4.6 ng/mL in a couple of years. An elevated PSA level can be caused by prostate cancer, or a number of benign conditions. He saw a urologist in January, 2013, was sent for biopsies in February and diagnosed with prostate cancer in March.
“For me and my wife, it was, ‘Uh oh, how much time do I have left?’ because of how quick Dad went,” Mr. Taylor, now 58, recalled in an interview from New Brunswick on Tuesday. “It was tough. Our daughter had just told us we were expecting our first grandchild. There were a few tears, and then all of a sudden we said, ‘No, we’re going to fight this.’ ”
Mr. Taylor had a radical prostatectomy to remove the prostate gland. He went back for bloodwork every six weeks at first, then three months, then six months. His PSA levels were undetectable; he has been cancer-free for eight years.
He advises men to get tested, especially those with a family history of cancer.
“The biggest problem with guys is they don’t like talking about their health, period – but especially when you’re talking below-the-belt,” said Mr. Taylor, who works in sales in the automotive industry.
“Guys will take better care of their cars than they take care of themselves. They’ll take their car in annually for a safety inspection or whatever. Do the same thing for your body. Early detection saves lives. This goes with any cancer, but with prostate cancer, if you detect it early, you’ve got a 90-per-cent survival rate.”
The COVID-19 pandemic has disrupted cancer care and other areas of health. The Canadian Institute for Health Information found that 20 per cent fewer cancer surgeries were done between April and September, 2020, than the same period in 2019. A CCS-led survey in July, 2020, found that 47 per cent of cancer patients reported having appointments cancelled or postponed.
Dr. Ménard said she worries about these disruptions, whose effects will be known in the next year or two, adding that fewer men have been getting screened or seeking medical attention.
“Thankfully, prostate cancer is generally a slow-moving disease in its earliest stages. We still hope the impact will be mitigated by the natural history of this disease compared to other cancers.”
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Andrea Woo