As Asia’s prostate cancer burden grows, so do opportunities for Western medical device companies with products to diagnose and treat the disease. Leading Western medical device firms are moving into markets across the Asian region to promote their most innovative products.

Historically, rates of prostate cancer have been low in Asia compared with rates in North America, Europe and Australia. But a rapidly aging population, economic growth and rising industrialization is driving a steep increase in diagnosis of the disease. Nevertheless, Asian countries are playing catch up with the West when it comes to detection, treatment and survival.

Overview of Prostate Cancer in Asia

About 67% of the world’s population is located in the Asia Pacific. According to the World Health Organization, the region records about 46% of all new cancer cases and more than 55% of cancer deaths worldwide. Among countries in the region, China has the largest cancer burden, followed by India. Prostate cancer is the second most common cancer and the fifth leading cause of cancer deaths globally. However, it has not been a significant factor in cancer deaths in Asia until recent decades. As the continent ages, that is changing, since prostate cancer is a disease that afflicts the elderly. Worldwide, more than 70% of prostate cancer patients are older than 65.

According to various sources, in China there are more than 250 million people older than 65, and that number is increasing by 10 million each year. Since 2000, the number of prostate patients and prostate deaths in China has been increasing at a double digit annual rate. It now ranks as the fifth most common cancer among men in the country. In Korea, incidences of prostate cancer increased 10.5 times between 1983 and 2012. Prostate cancer is still low in India, with an incidence rate 12 times lower than that in the United States. But the cancer is gaining a foothold. Today, it is the third leading cancer in men in India, accounting for 7% of all cancers. Since the 1990s, cases of prostate cancer have shot up by over 220%, according to India’s National Cancer Registry Program.

Along with an aging population, there is a widespread belief among physicians that a shift towards Western diets and lifestyles is driving the increasing rates of cancer in Asia. Across the Asia Pacific region, both the incidence of and mortality from prostate cancer are expected to double by 2030.

Demand Grows for Medical Devices to Treat Prostate Cancer

Treatment for prostate cancer is complex, driving demand for better and more innovative medical technology. In Asia, economic development over the past two decades has fueled earlier diagnoses, increased access to medications, and sophisticated radiation and surgical techniques.

The most significant inroads for prostate cancer have been made by medical device firms specializing in three areas: External radiation therapy, internal radiation therapy and laparoscopic robotic surgery.

External Beam Radiation Therapy (EBRT)
In external beam radiation therapy (EBRT), beams of radiation are focused on the prostate gland from an equipment outside the body. Older EBRT techniques did not do a good job of focusing the radiation precisely on the tumor within the prostate gland. That meant healthy tissue was often exposed to radiation.

A newer EBRT technique, intensity-modulated radiation therapy (IMRT), is increasingly important. In 2017, Palo Alto, California-based Varian Medical Systems launched a particularly sophisticated IMRT system, dubbed Halcyon. Halycon uses a computer-driven machine that moves around the patient as it delivers radiation. It shapes the beams and aims them at the prostate from several angles, allowing the radiation dose to conform more precisely to the three-dimensional shape of the tumor. The intensity of the beams can be adjusted to deliver a higher dose to the cancer, while avoiding normal tissue. It was approved for use in Australia and Japan in 2017 and in Taiwan in January 2018.

Another Varian product, Calypso, is often used in conjunction with the Halycon system. Calypso is a system of soft transponders using real-time targeting and motion management to help clinicians locate tumors more precisely. It, too, has been approved for use in Australia, Japan and Taiwan.

Accuray, Inc., based in Sunnyvale, California, has made inroads in Asia with its CyberKnife, a similar product. CyberKnife destroys tumors by aiming beams of radiation from multiple directions. It has been used in the United States since 2001 and has been approved in many Asian countries.

Internal Radiation Therapy (Brachytherapy)
Brachytherapy, a method in which radiation in the form of Iodine-125 seeds are implanted directly in the prostate, is a treatment that has been around for many years. It remains one of the most effective ways to deliver high doses of radiation to a well-defined target such as the prostate. And nowhere is its use growing faster than in the Asia Pacific region. According to a report by Grand View Research, the brachytherapy market in the region grew at a rate of 3.9% between 2013 and 2018. It is expected to grow at a compound annual growth rate of about 5.5% between now and 2023, despite many side effects of the treatment, including localized bleeding and urinary incontinence.

Major players seeking inroads in the Asia market for brachytherapy products include Varian, Elekta, Boston Scientific Corp., CR Bard, Inc., Cook Medical, Inc. and GE Healthcare.

Robotic-Assisted Laparoscopic Radical Prostatectomy
The main type of surgery for prostate cancer is a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland, plus some of the tissue around it, including the seminal vesicles. Increasingly, the laparoscopic surgery is done using robotic systems. The Chinese robotic assisted surgery market is expected to grow at a compound annual growth rate of more than 14% through 2023.

Intuitive Surgical, another Sunnyvale, California-based company, has a reputation as the leading innovator in the robotic surgical systems market. Its Da Vinci S Surgical System, approved in the United States 18 years ago, now dominates the robotics systems markets in Japan, Hong Kong, China and other Asian markets. Among Intuitive Surgical’s competitors are TransEnterix, with its Senhance Surgical Robotics System; NedTech, with its ROSA robotic surgery system; and Medtronic, which plans to launch its first robotic surgical system sometime in 2019.

Prostate Cancer Symptom Treatment Devices
Several firms manufacturing devices to treat side effects of prostate cancer are also making inroads in Asia. For example, Neotract, Inc., acquired last fall by Teleflex, makes just one product: A tiny device that holds the prostate lobes apart to relieve compression on the urethra. The device, which allows urine to flow normally, has been a success in the United States, and it is now available in South Korea. In addition, medical device giant Boston Scientific opened a large Malaysian manufacturing plant early in 2018. It plans to export urology devices to key growth markets throughout Asia.

Outlook for the Prostate Cancer Treatment Market in Asia

Prostate cancer will continue to be a major healthcare issue in Asia. As governments increase their healthcare spending, populations age, and more patients are diagnosed at earlier stages of the disease, the demand for diagnostic tests and medical device treatments will also increase. These dynamics provide plenty of opportunities for foreign medical device companies looking to increase their business in Asia.