On the 18th (local time), former U.S. President Joe Biden disclosed that he has been diagnosed with prostate cancer. It has already been reported to be in its advanced stage, with the cancer having metastasized to the bones, shocking many. Experts note that prostate cancer typically does not present specific symptoms, but early diagnosis is possible through blood tests. Treatment methods are also continually evolving.
Professor Seo Jun-kyu of the Department of Urology at Seoul Asan Medical Center stated on the 19th, “The five-year survival rate for early-stage prostate cancer is as high as 96.4%, making it more favorable compared to other cancers. However, in the case of stage 4 cancer accompanied by metastasis, the five-year survival rate drops to less than half.” In the United States, the number of patients who die from prostate cancer exceeds 35,000 annually.
The prostate is located deep in the pelvis under the bladder. It is a male reproductive organ that produces some of the fluid in semen and enhances the motility and viability of sperm. Prostate cancer is the most commonly diagnosed cancer in men after lung cancer. According to the Ministry of Health and Welfare, the number of new prostate cancer patients in the country in 2022 was 20,754, an increase of 58.11% compared to five years ago.
Prostate cancer has a low mortality rate if detected early, but it is easy to miss in the early stages since there are no specific symptoms. Symptoms such as difficulty in urination, increased frequency of urination, pain, and blood in urine, as well as weight loss, often indicate that the disease is already at stage 3 or higher.
The prostate cancer of former President Biden is also evaluated to be at stage 3 or higher. Biden's team recently stated that related symptoms appeared, and after undergoing tests, he received a diagnosis of prostate cancer that has metastasized to the bones.
Experts believe that if health checkups are not missed, prostate cancer can be detected early. This is because risk signals can be captured through blood tests.
Heo Joon-seok, head of the Precision Medicine Research Center at Korea University Anam Hospital, explained, “The representative biomarker for prostate cancer is PSA (prostate-specific antigen),” adding that “like most protein biomarkers, there are limitations.”
PSA is a protein produced in the prostate that is involved in the liquefaction of semen. If the level of PSA is high, there is an increased likelihood of prostate cancer, but levels can also rise due to other conditions such as benign prostatic hyperplasia or prostatitis.
Professor Heo noted, “If an abnormal PSA level is found, additional tests are usually conducted, so the likelihood of someone undergoing regular checkups missing cancer is low. However, early diagnosis still has its limitations,” stating that “cases like President Biden's, where advanced prostate cancer is discovered, illustrate that limitation.”
Treatment methods for prostate cancer can largely be divided into surgery and drug therapy. Professor Ha Yoo-shin from the Department of Urology at Catholic University Seoul St. Mary’s Hospital explained, “If the cancer has not metastasized and remains confined to the prostate, surgery is aimed at achieving a cure. However, if cancerous tissue has spread beyond the prostate, drug therapy is prioritized.”
Prostate cancer surgery involves the complete removal of the prostate and the method of connecting the severed urethra and bladder. Recently, robotic surgery, which allows for precise movements in confined spaces, has been actively utilized. Depending on the patient's condition, high-energy radiation may be delivered to prostate tissue to kill cancer cells. In cases of advanced prostate cancer, hormone therapy that blocks hormones affecting the progression of prostate cancer is combined with radiation therapy.
If prostate cancer recurs after surgery or if metastasis is confirmed from the time of diagnosis, drug therapy is administered. This therapy focuses on reducing the size of tumors and preventing their growth. Notable prostate cancer treatments include Erlida, Zytiga, and Xtandi, developed by U.S. pharmaceutical company Janssen.
The primary medications used mainly block male hormones to inhibit the growth and progression of cancer tissues. This is because male hormones stimulate cancer tissues to grow and advance. However, elderly prostate cancer patients tend to develop resistance to hormone-blocking therapies, making them at a higher risk of side effects compared to younger patients even when undergoing cancer treatment.
A new prostate cancer drug has also emerged. Pluvicto, a radioactive pharmaceutical product from Swiss company Novartis, received approval from the U.S. Food and Drug Administration (FDA) in 2022 and was officially authorized in the country last May.
Pluvicto works differently from existing drugs. It emits radiation specifically to kill cancer cells. Pluvicto is a treatment that combines a therapeutic radioactive isotope, Lutetium (Lu-177), with a substance that binds to cancer cells. Since its launch, Pluvicto has rapidly become a blockbuster, surpassing $1 billion in annual sales in 2023 (about 1.4 trillion won), with last year's sales reaching $1.39 billion (1.9 trillion won).
In the country, efforts to develop new prostate cancer drugs are also underway. Yuhan Corporation introduced a prostate cancer treatment candidate substance UBX-103 (currently YH45057) from the domestic biotech company Ubix Therapeutics in July last year and is currently developing it. JW Pharmaceutical's subsidiary C&C New Drug Research Institute is looking for a new drug candidate that directly inhibits a protein called XBP1s, which is commonly found in various solid tumors, including prostate cancer.
SK Bioscience has secured a radioactive isotope for prostate cancer treatment. It can receive Actinium-225 (Ac-225), a radioactive isotope for RPT, as per a supply contract with U.S. nuclear company TerraPower, in which SK Group invested last year. Ac-225 can be used in the treatment of various cancer types, including prostate cancer, colorectal cancer, and pancreatic cancer.