Prostate Can­cer: Not a Death Sen­tence

Wellness Update - - What Doctors Know And Your Should, Too! - -This in­for­ma­tion pro­vided courtesy of Har­vard School of Pub­lic Health

Men di­ag­nosed with prostate can­cer are less likely to die from the dis­ease than from largely pre­ventable con­di­tions such as heart dis­ease, ac­cord­ing to a new study from Har­vard School of Pub­lic Health (HSPH). It is the largest study to date that looks at causes of death among men with prostate can­cer, and sug­gests that en­cour­ag­ing healthy life­style changes should play an im­por­tant role in prostate can­cer man­age­ment. “Our re­sults are rel­e­vant for sev­eral mil­lion men liv­ing with prostate can­cer in the United States,” said first author Mara Ep­stein, a post­doc­toral re­searcher at HSPH. “We hope this study will en­cour­age physi­cians to use a prostate can­cer di­ag­no­sis as a teach­able mo­ment to en­cour­age a health­ier life­style, which could im­prove the over­all health of men with prostate can­cer, in­creas­ing both the du­ra­tion and qual­ity of their life.” The study was pub­lished July 25, 2012 in the Ad­vance Ac­cess on­line Jour­nal of the National Can­cer In­sti­tute. Prostate can­cer is the most fre­quently di­ag­nosed form of can­cer, af­fect­ing one in six men dur­ing their life­time. While in­ci­dence of prostate can­cer has greatly in­creased in the United States, Swe­den, and other Western coun­tries in re­cent decades, the like­li­hood that a newly di­ag­nosed man in th­ese coun­tries will die from the dis­ease has de­clined. The re­searchers at­tribute this to the wide­spread use of the prostate­spe­cific anti­gen (PSA) test, which has re­sulted in a higher pro­por­tion of men di­ag­nosed with low­er­risk forms of the dis­ease. The re­searchers ex­am­ined causes of death among prostate can­cer cases recorded in the U.S. Sur­veil­lance, Epi­demi­ol­ogy, and End Re­sults Pro­gram (over 490,000 men from 1973 to 2008) and the na­tion­wide Swedish Can­cer and Cause of Death reg­istries (over 210,000 men from 1961 to 2008). The re­sults showed that dur­ing the study pe­riod, prostate can­cer ac­counted for 52% of all re­ported deaths in Swe­den and 30% of re­ported deaths in the United States among men with prostate can­cer; how­ever, only 35% of Swedish men and 16% of U.S. men di­ag­nosed with prostate can­cer died from this dis­ease. In both pop­u­la­tions, the risk of prostate can­cer-spe­cific death de­clined, while the risk of death from heart dis­ease and non-prostate can­cer re­mained con­stant. The five-year cu­mu­la­tive in­ci­dence of death from prostate can­cer was 29% in Swe­den and 11% in the United States. Death rates from prostate can­cer var­ied by age and cal­en­dar year of di­ag­no­sis, with the high­est num­ber of deaths from the dis­ease among men di­ag­nosed at older ages and those di­ag­nosed in the ear­lier years of the sur­veys (es­pe­cially in the years be­fore the in­tro­duc­tion of PSA screen­ing). “Our study shows that life­style changes such as los­ing weight, in­creas­ing phys­i­cal ac­tiv­ity, and quit­ting smok­ing, may in­deed have a greater im­pact on pa­tients’ sur­vival than the treat­ment they re­ceive for their prostate can­cer,” said se­nior author Hans-Olov Adami, pro­fes­sor of epi­demi­ol­ogy at HSPH.

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