Prostate cancer

The prostate gland is one of the male reproductive glands. The others are the testicles and the seminal vesicles. They collectively produce the semen. The prostate gland is located just under the bladder, surrounding the upper part of the urinary tract. The prostate is approximately the size of a walnut. The gland’s growth and function are controlled by the male hormone testosterone, which is mainly produced in the testicles. Testosterone is a precondition for the occurrence of prostate cancer.

Occurrence and mortality

Prostate cancer is the most common form of cancer in men in the western world, particularly in the USA and Nordic Region. Around 8%, or over 1.1 million cases out of a total of 14.1 million new cancer cases (whole world for adult men and women) during 2012, were estimated to be prostate cancer. Just under 4 million men were estimated to be living with prostate cancer in 2012. Around 8.2 million people died of cancer in 2012, and around 8% of these mortalities were related to prostate cancer1.

Around 1.75 million men are estimated to have prostate cancer in the seven biggest drug markets of the USA, Great Britain, Germany, France, Italy, Spain and Japan. Around 20-25%, equivalent to over 400,000 patients with prostate cancer, develop incurable castration resistant prostate cancer (CRPC) with skeletal metastasis2.

Prostate cancer is the most common cancer diagnosis for men in Sweden, with just under 10,000 cases diagnosed per annum. Prostate cancer is the form of cancer in Swedish men that causes the most cancer deaths. In 2012, 2,352 men died as a result of prostate cancer. By way of comparison, around 1,500 women die of breast cancer per annum. Around 85,000 men have or have had prostate cancer in Sweden at this time. The number of diagnosed prostate cancer cases has risen steeply over the last 35 years. The disease is uncommon before the age of 50, but thereafter the occurrence rate rises with age, and half of all cases are found in men over the age of 70. One out of eight men risk contracting prostate cancer before the age of 703. One of the reasons the number of patients has risen is longer life expectancy, which means that more men have time to develop prostate cancer. But the main reason is that more symptom-free men check their PSA values, and thus increase the likelihood of prostate cancer being diagnosed.

Around 25% of men diagnosed with prostate cancer will die as a result of the disease. The common denominator is that those dying of prostate cancer have developed castration resistant disease. Around 90% of such patients are killed by skeletal metastasis, which is why prostate cancer is often considered to be a skeletal disease. Unfortunately, no curative medications for CRPC are available at this time. As such, there is a considerable need for improved medications able to impair the disease more effectively and extend patient survival whilst retaining high quality of life.

Prostate cancer in Sweden4 Number of men
Number of new cases p.a. (mean value 2007−2011) 9,603
Men living with diagnosis as of 31 December 2011 (occurrence) 84,613
Number of all cancer cases (%) 35.2
Risk of dying before the age of 75 (%) 13.0
Number of deaths p.a. (mean value 2008-2012) 2,414
Number of all deaths from cancer (%) 21.1
Risk of dying from the disease before the age of 75 (%) 1.3

1 International Agency for Research on Cancer.
2 The cancer market outlook to 2016, SCRIP Insight June 2011.
3 National Board of Health and Welfare and the Swedish Cancer Society, “Cancer in Figures 2013″.
4 NORDCAN, Association of the Nordic Cancer Registries.