Dr. Robert Pugach Comments on Costly Prostate Cancer Drug

October 25, 2017 11:46 am Published by

As a urologist with a large prostate cancer practice, and as a prostate cancer survivor myself, I found the article “UCLA’s effort to patent a costly prostate cancer drug in India hurts the poor, critics say,”  by James Peltz in the Los Angeles Times on Sunday, October 22, 2017,  fascinating.

Balancing the needs and interests of patients with the economic realities of the pharmaceutical industry is always challenging.  Adding a university’s financial interests for their research adds a new dimension.

I suggest one additional point of view in the prostate cancer discussion: why are we letting so many patients get to the point of needing a $130,000 per year drug like enzalutamide?

In recent years, there have two alarming trends in urology:  1) A decrease in PSA testing to screen for prostate cancer and 2) a decrease in the number of men treated for prostate cancer.  The rationale for both is that some men may not need treatment for this cancer in their lifetime.  But, as we have ventured into the realm of decreased screening and more surveillance of prostate cancer, we are seeing the predictable outcome: ever-increasing numbers of patients with advanced, incurable cancer. (Read my article on “The Case Against Active Surveillance or Watchful Waiting“).

While enzalutamide can prolong a patient’s survival, it cannot cure cancer. And using it brings numerous side effects including extreme fatigue, constipation or diarrhea, muscle and bone pain and extremity swelling to name just a few.

It is time to re-consider aggressive screening programs and adopt more proactive treatment programs to avoid costly pharmaceuticals with the quality of life-altering side effects.

If you have questions about prostate cancer screening, diagnosis or treatment options, I invite you to view my prostate cancer community education seminar.

Article: “UCLA’s effort to patent a costly prostate cancer drug in India hurts the poor, critics say,”   UCLA holds the patent on chemical compounds used to create the drug enzalutamide, sold under the name Xtandi. James F. Peltz, Contact Reporter, LA Times

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