0,000 AMERICAN MEN ARERE

PROSTATE CANCER,R,HOUGH MOST OF

THOSE DIAGNOSED WIWI IT DON'T

DIE FROM IT.T.

CANCER AWARENESSSSONTH, ALITE

ROGIGITAKES A LOOK AT SCREENENG,

DIAGNOSIS AND D EATMENT OF THE

DISEASASAND WHAT IT MEANS TO

LIVE WITH IT.

ALI: PROSTATE CANCER I ITHE MOST

COMMON C CCER AMONG MEN IN THE

CAUSE OF CANCER-R-LATED DEATHS.

AND, GLARING RACIAL L SPARITIES

IST WITH THE DISEASE: : IN 8

MEMEWILL BE DIAGNOSED WITHTH

PROSTATE CANANR DURING THEIR

LIFETIME, BUT T AT RATE

ININEASES TO 1 IN 6 FOR AFAFCAN

AMERICANANEN.

BUT, A DIAGNOSIS DOEOE'T HAVE TO

BE LIFE-CHCHGING.

IN F FT, MANY MEN WITH CERTATA

TYPES S SLOW-GROWING PROSTATETE

CANCER ARE A AE TO FOREGO

SURGERY Y D TREATMENT

ALTOGETHER.

DR. CHARLES RYAN I IA

HEADS THE PROSTATA CANCER AND HE

FOFODATION.

DRDRRYAN, THANK YOU SO MUCUCFOR

JOINININUS.

LET'S START WITH THE ABSOLOLE

BASICS..

WHAT IS PROSOSTE CANCER AND

WHERE DOES I IORIGINATE IN THE

BODY?

WELL, THANK YOU U R HAVING ME ON

THE PROSTATE IS S GLAND THAT IS.

VERY IMPORTANT IN MAMA

REPRPRUCTION.

ITITSSENTIALLY PRODUCES THTH

SO WITHOUT IT, W WARE NOT ABLE

REPRODUCE.

IT EXISTS AT THE B BE OF THE

BLADDER.

AND IT IS REALLY PART T THE

MALE U UNARY TRACT, BUT ALSO T T

MALELEENITAL TRACT ALLOWINGG

SPERM TO BE RELEASAS FROM THE

DY.

ALAL AND I KNOW THE OPTIONONFOR

PROSTATA CANCER SCREENING ANDD

WHETHER OROROT SOMEONE IS A GOOD

CANDIDATE FOR IT I IA

COMPLICACAD ISSUE.

THERE ARARLOTS OF FACTORS THAT

GO INTO THATAT

OF SCREENING IS S AILABLE FOR

PROSTATE CANCER.

. RYAN: RIGHT, SO THE E OSTATE

CANCERERCREENING HAS LONG

INVOLVED A AEST, THE BLOOD TEST

CALLED THE PSASAEST AND FOR MANY

YEARS INVOLVED A D DITAL RECTAL

EXAM, WHICH IS ALSO O LLED THE

FINGER TEST.

SO, A DOCTOR I IERTING HIS

FINGER INTO THE RECTCT OF THE

TUMOR THAT ONE C C FEEL.S A

WE ALSO NOW INCORPORORE MRI

SCANANNG AND OVER TIME, THE E I

SCAN IS REALLYLYEPLACING THE

LESS UNCOMFORTABAB AND IT'S IT'S

ALI: THE U.S. PRPRENTATIVE

SERVICES TASK FORCE,E,HICH IS AN

DEPENDENT BODY THAT MAMAS

RECOMMENENTIONS ON DISEASE

PREVENTION, RECOMMMMDS CURRENTLY

THAT MEN AGED 55 TO 6969OT GET

AUTOMATICACAY SCREENED, BUT

RATHER DISCUSS THEHEROS AND CONS

OF SCREENING WITH THEIEI

PROVIDID.

SCREENING AT ALLLLOR MEN OVER

BUT, MY QUESTIONONS, IF PROSTATE

WIDESPREAD, WHY Y OULDN'T ALL

MEN GET TESTED?

. RYAN: WELL, IT'IMPORTANT

TO REMEMBER THAT WITH H GARDS TO

SCSCENING THAT THERE ARE T TEE

DISTINCTCTROUPS OF INDIVIDUALS

WHO CACA-- WHO CAN GET PROSTATAT

CANCER..

E FIRST IS A GROUP THAHAHAVE

SUCH L L RISK DISEASE THAT THEHE

MAY NOT REQUIRE ANANTREATMENT.

AND OUR CURRENT ESTIMAMAS ARE

THATATHAT MAY CONSTITUTE 20%0%O

25% OF ALL OF F E MEN DIAGNOSED

WITH PROSTATE CANCNC IN THE

UNITED STATES.

THERE'S S SECOND GROUP, WHICH IS

TIENTS WHO ARE CURABLELEITH

TREATMENT OPTITIS AS LONG AS THE

DISEASE IS CONFINENETO THE

PROSOSTE.

SO THOSE ARE THE O OS WHO REALLY

BENEFIT T E MOST FROM SCREENINGG

D EARLY DETECTION.

THERE'S A A IRD GROUP FOR WHOM

THE TREATMENT OPTITIS ARE NOT

OPTIMAL AND THTH ARE NOT

GUARARTEED A CURE WITH CURRERE

-- CURRERE TREATMENT OPTIONS.

ANANFOR THOSE WE NEED, WE E ED

TO DO MOMO RESEARCH AND DEVELOPP

BETTER TREATMEME OPTIONS.

IT'IMPORTANT TO REMEMBER R SO

THAT SCRCRNING DOES NOT

NECESSARILY AUTOMATITILLY LEAD

TO A CERTAININYPE OF TREATMENT.

AND D AT'S BEEN SOME OFOFHE

SUNDERSTANDING THAT'S CREATED

THE PROBLEMS THAT WEW'RE SEEING

NOW WITH A RISING ININDENCE OF

PRPRTATE CANCER IN ITS ADVDVCED

STAGES.

ALI: AND W WT ARE THE CURRENT

TREATMENT OPTIONS FOR R OPLE

THAT ARE IN N OSE COHORTS FOR

WHWH TREATMENT WOULD WORK?K?

DR. RYAN: SO F F THE LOW RISK

GROUP, WE HAVE A PROROAM CALLED

ACACVE SURVEILLANCE, WHICHCHS

AND IT'S NONOTHAT THEY NEVER

SOME OF THEM ANDNDANY OF THEM

ACTUALLY DO, BUT I 'S DELAYED

UNTIL LATER.

THOSE INVOLVE REPEATATIOPSIES,

MRMRSCANS AND CLOSE SURVEIEIANCE

FROM A TREATING PHPHICIAN

PHYSICIAN.

BUT FOR R N WHO ARE IN THE

CURABLE GROUP,P,HE MAIN

TRTRTMENTS REMAIN SURGICALAL

REMOVAL OF T T PROSTATE.

RADIATION N ERAPY TO THE

PROSTATE, WHICH HAS RERELY

EVOLOLD A LOT OVER RECENT YEYES,

AND THEN COMBINATIONS S TH OTHER

APPROACHES, SUCH AS S RMONAL

APPRPRCHES THAT MAY HELP

RADIATION DO A BETTETEJOB.

IN ADVANCED DISEASE,E,E'VE SEEN

A TREMENDOUS GROWTH H A NUMBER

OF THERAPIES WITH H WHOLE

VARIETETOF DIFFERENT MECHANISMSM

OF ACTION N AT EXTEND LIFE AND

IMPROVE ITS QUQUITY FOR MEN,

EN WITH ADVANCED STAGEGE

TASTATIC PROSTATE CANCNC.

ALI: WE MENTIONED ININHE

INTRODUCTION THIS PERSRSTENT

RACIAL DISPARITY IN N RMS OF

DIAGAGSES AND OUTCOMES.

WHY DOES IT SESE THAT BLACK MEN

CONTININ TO BE

SPROPORTIONATELY AFFECECD BY

PROSTATE CANCECE

DR. RYAN: THTHCAUSE OF THAT

DISPARITY ARARCOMPLEX AND

PROBABLY INCLUDE A COMOMNATION

OFOFOTH BIOLOGICAL FACTORSRS

GENENEC FACTORS, AS WELL ASS

SOCIETALALACTORS.

ONONKEY OBSERVATION IS THAHA

PROSTATETEANCER OCCURRING IN A

BLACK K N IS LIKELY TO OCCUR

EARLIEIEIN LIFE AND SUCH THAT T

SCREENING, WHEN PEPEORMED

EARLRLR, MAY DETECT CURABLEE

CANCER E ELIER THAN IT WOULD

BEFORE F F, FOR EXAMPLE, A

NON-BLACK MAN.

AGE OF 50 MAY NONOBE ADEQUATE.

FOR EXEXPLE, FOR A POPULATIONN

ERE THE DISEASE IS LIKIKY TO

BEBEN EVEN AS EARLY AS AGEGE0.

ALI: I W WT TO RETURN TO THE

SUE OF ACTIVE SURVEILLLLCE

THAT Y Y MENTIONED.

SOME STUDIES HAVE SHOWOWTHAT

SOME P PPLE ON ACTIVE

SURVEILLANCE WHEN THTH'RE NOT

RECEIVING TREATMENEN THEY

EVENTUALAL DO HAVE TO UNDERGO

SOME SORT OF T TATMENT.

DOESESHAT INDICATE THAT TESTSTG

NEEDS TOTODVANCE IN TERMS OF

BEING ABLE TO DETETEINE THE

POPONTIAL SERIOUSNESS OF S SW

GROWING G OSTATE CANCER?

DR. RYAN: WEWE, IT'S A WONDERFUU

QUESTION B BAUSE WE, IN FACT,

THE BIOLOGICAL H HEROGENEITY OF

THIS DISEASE.

DECISION ABOUT W WTHER A PATIENT

ULD BE AN IDEAL CANDIDIDE FOR

ACTIVE SURURILLANCE, WE

INCORPRPATE GENETIC STUDIES NONO

AND GENETIC FACTORORTHAT LOOK AT

THE INTERPRPY OF A NUMBER OF

PATIENT FOR IMMEMEATE TREATMENT

OR DEFERRERETREATMENT.

ALI: THE TREATMENTS ANANTHE

RGERIES THAT CURRENTLYLYXIST

CANCER TEND TO B BVERY SERIOUS

WHAT ARE THE PROROECTS THAT YOU

SEE FOR THTHFUTURE OF THAT

DISCIPLINE?

IS IT GEGEING BETTER?

IS IT ALLOWING MEN TO O NTINUE

TO HAVE HAHAY AND HEALTHY LIVES?

DR. RYAN: BECACAE OF THE

LOCACAON OF THE PROSTATE AT T E

BASE OF F E BLADDER AND AS A ---

AS A KEY COMOMNENT TO THE MALE

SEXUAL FUNCTION THTHWORRIES

AROUND T TATMENT SIDE EFFECTS DO

INCLUDUDURINARY FUNCTION AND

SEXUAL FUNCTIOIO

OVER THE COUOUE OF THE PAST

COUPLE OF DEDEDES, THE SURGICAL

FIELD HAS MADE TREMEMEOUS

STRIDES IN P PSERVING SEXUAL

FUNCTIONONND IMPROVING AND

FUNCTION.G GOOD URINARY

SO ONE OF THE PROBOBMS WE HAVE

WHEN WE'RE THINKNKG ABOUT THE

TREATMENT RELATED SIDEDEFFECTS

IS WHERE A A WE GETTING OUR DATA

FROM?

IF WE'E'RE TALKING TO PATIENEN O

HAD THTHR TREATMENT 15, 20 YEAEA

AGO,O,T WAS A VERY DIFFERENTNT

SETTING BACKCKHEN THAN WHAT WE

SEE NONO

THE CANCER IS MOMO ADVANCED AND

IT'S MOMO DIFFICULT TO PRESERVEE

THOSE FUNCTIONON

BUT -- BUT TODAY, MAMA MEN ARE

ITE OPTIMISTIC ABOUT T TIR

OUT THERE LIVINGNGAPPY, NORMALEN

LIVES AFTER UNDERGRGNG CURATIVE

TREATMENT FOR PROSTATETEANCER.

ALAL DR. CHARLES RYAN, HEAEAOF

THE PROSTATE C CCER FOUNDATION.

THANK YOU SO MUCH H R JOINING

US.

DR. RYAN: MY PLEASASE.

♪