September 2023 — MHCE Newsletter

14 | MHCE - News www.mhce.us SEPTEMBER 2023 EDITION
New Treatments for
‘Quiet Disease’ Prostate
Cancer
Prostate cancer is one of the most
common cancers in men, with the
National Cancer InstituteOpens
Cancer.gov site estimating
over 280,000 diagnoses in
2023. However, promising new
treatments and updated testing
guidelines are leading to better
patient outcomes.
"Prostate cancer accounts for
nearly 27% of all new cancer
diagnoses and more than 10%
of cancer deaths in men,"
said Dr. Gregory Chesnut, a
urologic oncologist and associate
professor of surgery at the
Uniformed Services University
of the Health SciencesOpens
USUHS site. “It’s a very real
disease.”
New Treatments Approved
by the U.S Food and Drug
Administration
According to Chesnut, two recent
advances in prostate cancer
treatment may lead to improved
outcomes for patients. One is a
method for more precise detection
of cancer cellsOpens FDA site
outside the prostate, using an
imaging test for prostate-specific
membrane antigen protein.
"It was approved by the U.S. Food
and Drug AdministrationOpens
FDA site to find recurrent or
metastatic prostate cancer, or
to guide primary treatment
in certain high-risk prostate
cancers," said Chesnut. "It’s now
offered widely throughout the
United States."
The second new advancement
is in radiologic treatment of
prostate cancer that is metastatic,
which means cancer cells can
spread to other parts of the body.
A medicine that uses a small
amount of radioactivity to kill
cancer cells was approved by the
FDA in March 2022, according
to Dr. Kevin Banks, a radiologist
and nuclear medicine physician
at the San Antonio Military
Medical Center.
"It travels through the blood
stream, seeking out prostate
cells wherever they are in the
body," said Banks. "It binds to
the prostate-specific membrane
antigen protein on the prostate
cancer cell surface and delivers a
microscopic amount of radiation.
The specific type of radiation
given generally travels less than
one millimeter, and no more than
a maximum of two millimeters,
allowing it to kill the cancer
cells while leaving surrounding
healthy tissue unharmed."
Prostate Cancer Survival Rate
Higher for Military Health
System Beneficiaries
In addition to new treatments, a
study from USUHSOpens article
on PubMed offers good news for
men being treated for prostate
cancer within the MHS. The
study found the five-year survival
rate for late-stage prostate cancer
is higher for MHS beneficiaries
than for the general public.
"Ultimately, all men, whether
you had high-risk or high-stage
prostate cancer did better across
all age groups and across all
ethnicities within the MHS,"
said Chesnut.
"The disease rates were the same
whether they were treated inside
or outside of the MHS, but the
outcomes were better. I think
that's a recognition of what we
do well in the military," said
Chesnut. "We screen patients
well, we have access to primary
care for appropriate screening
and counseling, and access to
specialty care. Patients have
access to urology care, to medical
oncology care, to radiation
oncology care. It’s often all in
the same building."
Banks thinks there could even be
better results to come.
"The results are certainly positive
and show the quality of care
being provided by the Defense
Health Agency," he said. "The
data would have been from
before [the medicine] entered
use in the MHS, so hopefully any
follow-up research would show
an even better five-year survival
rate for our beneficiaries."
Changes in Testing Guidelines
Chesnut said changes to prostate
cancer screening guidelines, and
a new understanding of how
to treat prostate cancer in early
stages, is also helping patients.
"Testing for prostate cancer is
important because it’s a disease
which is treatable and curable if
detected at an early stage, and it's
localized to the prostate," said
Chesnut. "Our intention is for
curative treatment, and we have
excellent outcomes."
However, Chesnut said prostatespecific
antigen tests, the primary
prostate cancer screening test,
were not being recommended
from 2012 through 2018.
"For patients and doctors,
when there’s a prostate cancer
diagnosis, the instinct is, we need
to go to general quarters and we
need to treat this," said Chesnut.
"Prior to 2012, patients were
sometimes being treated when
they didn’t need treatment. Now
we know better. You don't have
to treat every prostate cancer.
We serve our patients best when
we diagnose prostate cancer
in a timely manner, when we
correctly identify which cancers
need immediate treatment
and which can safely undergo
surveillance. Personalized
treatment decisions and use of
emerging technologies for the
individualized treatment plan is
best for each patient."
The U.S. Preventive Services
Task Force now recommends
men ages 55 to 69 make individual
decisions about screening for
prostate cancerOpens CDC site
after discussing the benefits and
harms with their doctor.
Chesnut recommends prostate
cancer screening be a routine part
of men's health conversations
like mammograms are for
women. "It’s easy for us to talk
past prostate cancer, because it's
not going to get the big headlines.
It’s a sort of a quiet disease."