Sunday, June 29, 2008

Breast and Prostate Cancer: Build the Pie Higher

Photo by Flickr user ILoveButter, used under a Creative Commons license.

I've previously lamented the tendency for prostate cancer and breast cancer to be pitted against each other. It's understandable - and completely appropriate - that prostate cancer sufferers would resent the miserly treatment of their disease when it comes to both research and treatment. Considering that one in five American men will get the disease and that current treatments typically leave men with an unacceptable side effect - permanent erectile dysfunction - it's disgracefully underfunded.

The solution, though, is not for the two diseases to compete for the same scarce resources. We shouldn't view this as a zero-sum game. Men afflicted by prostate cancer, and their partners who lives are also deeply affected, need to build a strong lobby. There are millions of prostate cancer survivors in the United States alone, yet the petition to increase government spending on it has not even gathered 10,000 signatures. (So go here and sign it!)

Another possible tactic is for the prostate and breast cancer lobbies to join hands. They're natural allies. While I don't want to deny the obvious differences between them, the similarities between these two cancers are also pretty striking. Both diseases were once too taboo to discuss (and to a great extent, that's still true for prostate cancer). Both are extremely common diseases. Both strike mostly older people but also a very significant number of people in midlife. And both intrude cruelly on people's sexuality, albeit in substantially different ways.

Now comes a small but significant scientific breakthrough that shows there's even an affinity on the biological level, as well:
A faulty gene closely associated with breast cancer is also responsible for a particularly dangerous form of prostate cancer, research has confirmed.

A University of Toronto team found prostate cancer patients carrying the BRCA2 gene lived on average for four years after diagnosis.

The average survival time for a man with prostate cancer is 12 years. ...

The latest study - based on 301 patients - examined two closely related faulty genes, BRCA1 and BRCA2, both of which greatly increase a woman's risk of breast cancer, and are linked to ovarian cancer.

Both genes cut average survival times in men with prostate cancer who carried them - for men carrying BRCA1 the average survival time was eight years after diagnosis.

BRCA2 has already been linked to deadly prostate cancer, with an Icelandic study recording an average survival time among prostate cancer patients carrying the gene of just 2.1 years. ...

Lead researcher Dr Steven Narod said: "We know that carrying a faulty BRCA2 gene increases a man's risk of getting prostate cancer, and our study shows that it also affects how long he will survive a diagnosis of the disease."

(Source: BBC News)
I don't know why this would be so; I'm not an expert, and it seems like even the real experts don't understand the mechanisms. It's intriguing that the BRCA2 mutation is the nastier of the two in prostate cancer, while BRCA1 is worse when it comes to breast cancer.

But on the policy level, there might be some real synergies in funding further research into these mutations. One of the fascinating trends in cancer research is that we're beginning to recognize how many different flavors a "single" disease such as breast cancer can have, depending on whether it's estrogen-sensitive, HER-positive, etc. At the same time, scientists are finding cross-linkages between apparently disparate forms of cancer, as this BRCA study shows.

So instead of fighting over an ostensibly limited pie, I'd love to see the boys and girls together and lobby jointly to "build the pie higher," to quote one of the best Bushisms ever.


Hesperis said...

I know this is a hopelessly idealistic comment, but wouldn't it be just so nice to have a health care system that responds to need rather than having to mobilize sick people and their families and friends to fight for their right to research dollars and treatment? Oh sigh!

Sungold said...

And you say this as a Canadian, or am I incorrect in assuming that?

At any rate, you're in good company; I know you're not the only hopeless idealist here.

Smirking Cat said...

It would also be nice to not have some health issues "trendier" than others. Actually there are a LOT of things that would be a nice change in our health care system.

Sungold said...

Wouldn't it be wonderful if *all* health problems were adequately funded? Breast cancer does relatively well only because patients and their families worked their asses off to make it so. They poached from the *defense budget* - which was an awesome idea and one that could be expanded upon, I think!