The Nation (Nairobi)
Daniel Wesangula
4 July 2009
Nairobi — The war against prostate cancer could soon be won if a drug developed in America works.
The drug, Ipilimumab, developed at the Mayo Clinic in the US, is said to have had such an unexpected effect on patients who agreed to the clinical trials that researchers decided to release the details of the two cases before the tests were even complete.
According to the UK's Independent newspaper, two patients with inoperable prostate cancer made dramatic recoveries after receiving a single dose of the experimental drug. The two were part of 108 men who had volunteered to undergo clinical tests of the drug at the clinic.
The Ipilimumab trial is being equated to that of the first pilot breaking the sound barrier.
"This is one of the Holy Grails of prostate cancer research. We have been looking for this for years," said Dr Eugene Kwon, the urologist in charge of the two men's treatment on a report appearing on Discovery's Edge, the clinic's online research magazine.
Another member of the team, according to a Mayo Clinic report, was so surprised by the outcome of the treatment that he asked his colleagues if they were certain that tissue samples they were looking at were from the same patients.
Through the use of the drug as well as hormone and radiation treatments, the otherwise aggressive tumours in the two patients were eliminated even though they had already spread to the patients' abdominal areas.
Both patients are now said to be cancer-free. The Minnesota-based clinic is regarded as one of the top medical centres in the world. If the drug proves to be successful, it will have far-reaching effects in the well-being of the male population.
Leading cause
The World Health Organisation lists cancer as the leading cause of death globally, accounting for 13 per cent -- 7.9 million -- of all deaths annually. More than 2.3 million of these deaths could have been prevented.
Cancer specialists estimate that the annual cancer deaths are in the thousands and prostate cancer is third biggest killer after cervical and breast cancer. Among men, however, prostrate cancer is the number one killer.
"From the sparse data we get from private practice and our own hospice data, annual deaths are well into their thousands, but we know they are much higher because more than half of cancer fatalities are never reported," said Dr John Weru of the Nairobi Hospice.
Anne Korrir of the National Cancer Registry also said the correct national picture as far as prostate cancer is concerned has never been captured.
"We mainly deal with data collected from in and around Nairobi and other major towns around the country. Many more afflicted with the disease do not get to the diagnosis stage, as they are unable to reach a health facility. Others are simply misdiagnosed," she said.
Though many men suffer from prostate cancer in their twilight years, the cancer usually does not progress quickly enough to become life-threatening.
But some other forms of the disease are so aggressive that in most cases its diagnosis, if one is made, comes too late. As a result, treatment has always thought of to be palliative - until now.
"If the drug is tested and proved to be a success in curing prostate cancer, this will be a big plus for the war against cancer. So many lives will be saved," said Dr Weru.
He added that about a quarter of those under the care of various hospices are prostate cancer patients.
Despite the apparent success witnessed in the two patients, doctors at the Mayo Clinic have taken a cautious approach, saying the outcome of the cases need to be validated through more studies. Already, the clinic says plans are under way to extend the trials and determine the exact dosage.
"It's important for us to understand the mechanism of favourable response in these patients," said Dr Michael Blute, who was also part of the clinical trials.
He added that understanding how the drug works will have significant implications on the treatment of breast and ovarian cancer as well.
Although Ipilimumab has only been tested on two people, many say that findings of subsequent tests will go a long way in pointing cancer research towards the right direction.
"Regardless of the outcome of the other trials, whatever has happened will definitely be of use to researchers on a quest to find a cancer cure," said Dr Weru.
But he warned against putting too much faith in the drug. "It is important to understand that the treatment might or might not work. All we can do now is wait and see results from clinical trials."
Success rate
Some urologists say the success rate of only two out of an initial 108 patients is not encouraging news and is not enough to deem the drug a cure.
"This might be a case of putting the cart before the horse. Before the treatment is approved it needs to go through a peer review process and tested on different groups of patients," said Dr Maurice Wambani, a urologist based in Nairobi.
"Simply put, the drug needs to undergo more tests before we know whether it works or not. More control trials should be conducted," said Dr Weru.
While acknowledging that there are hurdles to be jumped by researchers, Dr Weru said if Ipilimumab treats prostate cancer, it will only be a matter of time before other cancers "fall to science".
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