Specialty Medicine
Prostate Cancer
Prostate cancer is the second most common malignant cancer in men worldwide1,2. In 2020, around 1.4 million men were diagnosed with prostate cancer, and about 375,000 men died from it1. It is the fifth leading cause of cancer-related deaths in men1. The number of cases is increasing, likely due to longer life expectancy and improved diagnostic methods1.
The exact cause of prostate cancer is unknown
However, family history plays a role—if a father or brother has had prostate cancer, the risk is higher3. The chances of developing this disease also increase with age. It is rare in men below 503.
About the prostate gland
The prostate gland is a small organ, about the size of a walnut3,4. Its main job is to produce seminal fluid, which helps transport sperm through the urethra3. It is also the point where the vas deferens and the ureter connect3.
Detecting prostate cancer
Early prostate cancer usually does not show any symptoms3,5. However, in more advanced stages, some signs may appear3,5. Pain or discomfort during urination or ejaculation should not be ignored3.5. Other possible symptoms include a frequent urge to urinate, difficulty in completely emptying the bladder, and blood in the urine or semen3.5. However, these symptoms do not always mean cancer, as they can also be caused by infections or a common non-cancerous enlargement of the prostate (benign prostatic hyperplasia or BPH)3,5. It is important to consult a urologist for an accurate diagnosis5.
Most prostate cancers are detected through a blood test for prostate-specific antigen (PSA) or a digital rectal exam (DRE)3,5. High levels of PSA can be an early sign of prostate cancer3,5. Some guidelines suggest starting with a multiparametric prostate MRI, and based on the MRI results, a biopsy may be recommended6. Additional tests, including other imaging methods, may be required to confirm the diagnosis, determine the stage of cancer, and monitor the patient with malignancy6.
Treating prostate cancer
There are several treatment options available for prostate cancer when diagnosed early3,5. These include surgery, radiation therapy, and hormone therapy using substances that either stop the production of testosterone or block its effect on the prostate3,5. These treatments can help slow down or stop the growth of prostate cancer3,5. In some cases, these treatments are combined for better results3.
Advice for patients
Each person’s body responds differently to medications, so it’s not possible to determine which treatment will work best for you2,5. It’s important to consult your physician for personalized advice5.
Unmet need
If prostate cancer reaches an advanced stage, it may become difficult to cure7. This stage is known as castration-resistant prostate cancer (CRPC)7. CRPC is characterized by the continued activity of androgen receptors (AR) and resistance to standard anti-androgen treatments7. Treatment options for CRPC are rapidly evolving7. There is no standard treatment for CRPC patients who have rising PSA levels despite androgen-deprivation therapy and no detectable metastases7. In men with progressive non-metastatic CRPC, a quick rise in PSA levels is linked to a higher risk of metastasis and early death7.
Most men with CRPC develop bone metastases, which can cause pain, fractures, spinal cord compression, and reduced survival3,7. Bone metastases significantly increase the risk of complications and death in patients with CRPC3,7.
Bayer’s diagnostic options for prostate cancer
Every treatment begins with an accurate diagnosis8. Imaging tests like magnetic resonance imaging (MRI), positron emission tomography (PET), ultrasound, and contrast-enhanced computed tomography (CT) help create detailed images of the inside of your body8. One or more tests can be used to detect prostate cancer, guide doctors during procedures like biopsies or treatments, or check if cancer has spread to other areas8. The specific tests you need will depend on your situation8. Bayer’s radiology portfolio includes contrast agents and devices that assist radiologists in providing early diagnosis and targeted treatment8.
References
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Diabetic Macular Edema (DME)
People with diabetes are at a higher risk of developing a condition that could harm their eyesight1. One such condition is diabetic macular edema, which impacts one in every three long-term diabetics2.
The eye, retina, and macula
Your retina is the tissue at the back of your eye that enables vision. It consists of photoreceptor cells that convert incoming light into signals your brain can interpret. There are two types of photoreceptors: rod cells, which are sensitive to low light, and cone cells, which allow you to perceive color.
Cone cells are densely packed in an area of the retina called the macula, which provides central vision and is crucial for many everyday tasks like reading or driving a car.
What is diabetic macular edema (DME)?
The retina holds small, delicate blood vessels called capillaries that provide oxygen and nutrients to the photoreceptors. In diabetes, blood sugar levels rise above normal. Elevated blood sugar, if not controlled, can damage the capillaries in the retina.
Damaged capillaries release a protein known as vascular endothelial growth factor (VEGF). VEGF causes capillaries to leak fluid into the macula, the area responsible for sharpest vision on the retina. It also triggers the growth of new blood vessels (neovascularization), which may also leak fluid.
The leaked fluid causes swelling (edema) – known as diabetic macular edema (DME) – which distorts the macula, leading to blurred vision. If left untreated, DME can result in total loss of central vision.
Around one in every three people with diabetes for 20 years or more are likely to develop DME3. Today, about 27 million people globally are affected by DME4.
Recent estimates suggest that there are 77 million persons with DM in India. Considering conservative estimate of 2% persons with DM having DME, likely magnitude of treatable DME is 15,40,000 persons5.
How can I prevent DME from happening to me?If you have diabetes, the most essential action is to ensure your blood sugar level is well-regulated to prevent damage to the fragile capillaries in your eyes. Your doctor can provide guidance if you have concerns regarding your diabetes management.
Regular visits to an eye specialist are also vital, so any early signs of capillary damage in the retina can be detected and treated. If you experience blurred vision, you should immediately consult an eye specialist. |
How is DME treated?
Various treatment options exist for DME. Some patients receive treatment with a specialized laser that seals leaking capillaries and reduces swelling. Others are treated with steroids injected directly into the eye in order to reduce inflammation.
Another category of medications, called anti-VEGF therapies, target the vascular endothelial growth factor (VEGF). These medications, when injected into the eye, block the VEGF protein and help reduce existing swelling.
Anti-VEGF therapies can reduce existing edemas and shrink newly formed pathological blood vessels in the choroid. This allows photoreceptor cells that have not yet been fully destroyed to be preserved, potentially stopping progressive blindness and even improving visual acuity in some patients.
Traditional anti-VEGF treatments require frequent injections, which can place a significant disease burden on patients. Some DME patients may struggle with adherence. Furthermore, because injections must be given at a healthcare facility, the burden can extend to patients’ caregivers.
Treatment options that offer longer treatment intervals can address a critical unmet need for DME patients by reducing the number of injections needed, enabling patients to spend more time on activities that matter to them.
Bayer is committed to improving treatment options for the benefit of patients in need.
Advice for patients
The information provided here is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.
References
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Click here for Bayer Ophthalmology website
Age-Related Macular Degeneration (AMD)
In age-related macular degeneration, the nerve cells in the macula—the part of the retina responsible for sharp vision—are damaged. This happens due to deposits under the retina caused by local disturbances in retina metabolism.2
Age-Related Macular Degeneration: The Leading Cause of Blindness in People Over 65
As you age, you have more experience, wisdom, and better foresight. But about 170 million people worldwide suffer from age-related macular degeneration (AMD), making it the most common cause of severe visual impairment and blindness in people above 65 in developed countries.2 As societies grow older, the number is expected to rise to 288 million by 2040, with women being affected more than men.3 The overall prevalence of AMD in India ranges from 1.4% to 3.1%4. Vision loss impacts one’s daily life, causing loss of independence, falls, injury, and negatively affects cognition, mental health, and employment.3
Early symptoms of macular degeneration
The first sign of AMD, in most cases, is when straight lines start to look bent. Further symptoms can become evident when reading-letters become blurry, and only a vague shape is visible.2 Over time, the size of this blurry area grows, making it difficult to recognize faces or tell time on a clock. AMD typically starts in one eye, but the second eye is often affected later.2
Different forms of AMD
• Dry AMD: The most common form, it progresses slowly and usually results in limited vision loss.2
• Wet AMD: This more severe form makes up about 10% of AMD cases and can lead to serious vision loss. It occurs when tissue fluid and blood leak from pathologically changed blood vessels into the macula, causing edemas (swellings caused by fluid accumulations).2 Moreover, new, diseased blood vessels develop in the choroid beneath the retina. Consequently, the nerve cells of the retina gradually degenerate, and central vision may be lost within a few years. If excessive bleeding occurs, sight could be completely lost instantly. Measuring the thickness of the retina can help determine how active the disease is.2
An active substance for treating wet AMD
Medications that block the vascular endothelial growth factor (VEGF) are widely used in treating wet age-related macular degeneration (wet AMD). VEGF is a naturally occurring protein in the body. Its typical function in a healthy body is to stimulate the formation of new blood vessels (angiogenesis), supporting the growth of tissues and organs.1 However, it is also linked to the growth of abnormal blood vessels in the eye, which have increased permeability, resulting in edema.1 Anti-VEGF therapy targets and slows down the abnormal growth of new blood vessels in the eye. These therapies, delivered via injection into the eye, can reduce existing edemas (swelling) and reverse newly formed, pathological blood vessels in the choroid.1 This allows photoreceptor cells that haven’t been fully damaged to be preserved, helping to halt progressive blindness and, in some cases, improve visual acuity.1 Conventional anti-VEGF treatments necessitate frequent visits to the hospital or office-based ophthalmologist for injections, placing a considerable burden on both patients and their caregivers.1 The high frequency of injections can also pose challenges to long-term treatment adherence, potentially affecting patient outcomes.1
Treatment options with extended intervals can significantly alleviate the disease burden. Fewer injections and hospital visits, thanks to the extended intervals, cater to a critical patient need, enabling more time for what truly matters to them.1
PDT- Photodynamic Therapy
PDT works by using a light-sensitive medicine called verteporfin that activates when hit by a specific type of laser. Your doctor will shine the laser on a very small area in the back of your eye, causing the verteporfin to break down the blood vessels that are causing your vision loss.5,6,7
Bayer is committed to improving treatment options for the benefit of patients in need.
References
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Click here for Bayer Ophthalmology website