More attention for prostate cancer

Prostate cancer is more common and has a higher mortality rate than breast cancer, but relatively little money is spent on it and not much is understood about its causes, according to an Associated Press story in the Boston Globe.''The prostate cancer community is 10 years behind the breast groups in terms of being acknowledged and coming forward," according to Dr. Ernie Brodie, a surgeon who got a breast cancer stamp approved that has raised $50 million. Dr. Brodie apparently has prostate cancer, and has become aware of the stark funding and attention gap between breast and prostate cancer.The breast cancer community is well organized, and prostate is trying to follow that example. The prostrate group recently held a meeting in Orlando, modeled on the annual San Antonio Breast Cancer Symposium, which has been held for 27 years.As I wrote last week, strong patient advocacy can be the most powerful force in driving innovation in biomedical research. HIV and breast cancer are the best examples. So compared with those, how well suited is prostate cancer as a cause to rally around?On the plus side:

• It tends to strike late middle aged or older men, who have the ability to give money for research or allocate corporate resources. The most notable example is Michael Milken's Prostate Cancer Foundation

On the negative side

• It doesn't usually strike young people in the prime of life, like breast cancer or HIV
• Widespread PSA testing isn't necessarily a good idea --it leads to false positives and inconclusive results, which lead to damage from misdiagnosis and unneeded treatments. Even when there clearly is disease, it doesn't always make sense to treat aggressively
• The behavioral and genetic risk factors aren't clear cut. Better diet, stopping smoking, and losing weight may all help --but that's the same advice as for other conditions such as hypertension
• Older men are less apt to rally around a cause (or wear a ribbon) than other groups

So overall I don't expect prostate cancer awareness and advocacy to be the next big thing.