In 2009, more than 192,000 men will be diagnosed with prostate cancer, and more than 27,000 men will die from the disease. One new case occurs every 2.7 minutes and a man dies from prostate cancer every 19 minutes.
A non-smoking man is more likely to develop prostate cancer than he is to develop colon, bladder, melanoma, lymphoma and kidney cancers combined. In fact, a man is 35% more likely to be diagnosed with prostate cancer than a woman is to be diagnosed with breast cancer.
Older age, African American race, and a family history of the disease can all increase the likelihood of a man being diagnosed with the disease.
As men increase in age, their risk of developing prostate cancer increases exponentially. Although only 1 in 10,000 under age 40 will be diagnosed, the rate shoots up to 1 in 39 for ages 40 to 59, and 1 in 14 for ages 60 to 69. More than 65% of all prostate cancers are diagnosed in men over the age of 65.
African American men are 56% more likely to develop prostate cancer compared with Caucasian men and nearly 2.5 times as likely to die from the disease.
Men with a single first-degree relative—father, brother or son—with a history of prostate cancer are twice as likely to develop the disease, while those with two or more relatives are nearly four times as likely to be diagnosed. The risk is highest in men whose family members were diagnosed before age 65. Visit the Risk Factors for Prostate Cancer section for more information.
As with all cancers, "cure" rates for prostate cancer describe the percentage of patients likely remaining disease-free for a specific time. In general, the earlier the cancer is caught, the more likely it is for the patient to remain disease-free.
Because approximately 90% of all prostate cancers are detected in the local and regional stages, the cure rate for prostate cancer is very high—nearly 100% of men diagnosed at this stage will be disease-free after five years. By contrast, in the 1970s, only 67% of men diagnosed with local or regional prostate cancer were disease-free after five years.
Screening for prostate cancer can be performed in a physician’s office using two tests: the PSA (prostate-specific antigen) blood test and the digital rectal exam (DRE).
The American Cancer Society recommends that both the PSA and DRE should be offered annually, beginning at age 50, to men who have at least a 10-year life expectancy. Men at high risk, such as African American men and men with a strong family history of one or more first-degree relatives diagnosed at an early age should begin testing at age 45. Men at even higher risk, due to multiple first-degree relatives affected at an early age, could begin testing at age 40.
There are a wide variety of treatment options available for men with prostate cancer, including surgery, radiation therapy, hormone therapy and chemotherapy, any or all of which might be used at different times depending on the stage of disease and the need for treatment.
Consultation with all three types of prostate cancer specialists—a urologist, a radiation oncologist and a medical oncologist—will offer the most comprehensive assessment of the available treatments and expected outcomes.
Sunday, September 20, 2009
If you have recently been diagnosed with prostate cancer...
...you have by now become acquainted with the plethora of information available – from many sources. But how about your doctor. How much information have you received from him or her? That has been the subject of a number of articles recently under the heading of “shared-decision-making-aids.”
These are groups of materials dealing with your disease state and its treatment options. A recent article in the Wall Street Journal examined the trend as it related to prostate cancer. Quoting from the Journal:
Thomas Stormont, a urologist and surgeon at Stillwater Medical Group in Stillwater, Minn., was skeptical at first when the group agreed to use shared-decision-making aids provided by the Foundation for Informed Medical Decision Making as part of a demonstration project.
Although the material is reviewed semi-annually for possible updating, Dr. Stormont felt the video and booklet on prostate cancer were incomplete. They didn’t cover some of the newer treatments, for instance, such as prostate cryoablation, the freezing of the prostate to treat localized cancer.
“I thought it would be a waste of time, another barrier between me and the patient, and more literature I wasn’t in control of,” he says.
Dr. Stormont agreed to use the programs, but supplements them with his own literature that includes information on newer treatment options. He says he has found that the decision aids help patients and their spouses get better educated about early prostate cancer, so his time with them is “more relaxed, efficient and focused.”
Patients have more realistic expectations about their treatment and side effects and are less likely to seek out second opinions, he says. They also are more comfortable choosing less-invasive treatments after reviewing the decision aids, he says.
“On one hand, while I am losing some surgical patients because of this process, on the other, we both are more comfortable that they are choosing the best treatment for them—one that they are more informed about, more comfortable with and less likely to regret later on,” he says.
Don Paulson, 74, a patient of Dr. Stormont, learned last week that he has prostate cancer, which he says came as a shock after years of good health. At an initial counseling session, oncology care coordinator Joyce Kramer went over the diagnosis and treatment options with him and his wife, Phyllis. She reassured the couple that the cancer was not life threatening and sent them home with a prostate-cancer DVD and some printed literature to view prior to a visit with Dr. Stormont over the weekend.
“We had a chance to digest it rather than getting it all in one big chunk,” says Mr. Paulson.
After watching the video, Mr. Paulson says he felt he understood his options far better. He is now weighing whether to chose the implantation of radioactive seeds, or try the cryoablation described by Dr. Stormont, who performs the procedure.
“If we had just gone straight to the doctor’s office and heard all of these options it would have been too much. It was good to be knowledgeable and review all of the possible side effects of different treatments first.”
Richard Derr, 75, also was recently diagnosed at Stillwater with prostate cancer. He says the decision aids helped him decide that both surgery and radiation carried risks of side effects that he wasn’t prepared to face, including incontinence and erectile dysfunction. Because his cancer was slow growing, he decided to go for an “active-surveillance” strategy, checking every few months for signs that the cancer is progressing.
Mr. Derr says he wished he’d had similar help last year when he was considering whether to have back surgery for a severe lower-back problem after unsuccessfully trying physical therapy and medications. Though his orthopedic surgeon told him there might be extensive rehabilitation, “he didn’t talk to me a lot about the risks,” Mr. Derr says.
After the surgery, he began feeling numbness and tingling in his feet, a condition, known as neuropathy, that is a potential side effect after back surgery. “I’m not saying the surgery caused it, but no one ever mentioned it was a possible side effect,” Mr. Derr says. “If I had known that it was I might not have made the decision to have the surgery.”
These are groups of materials dealing with your disease state and its treatment options. A recent article in the Wall Street Journal examined the trend as it related to prostate cancer. Quoting from the Journal:
Thomas Stormont, a urologist and surgeon at Stillwater Medical Group in Stillwater, Minn., was skeptical at first when the group agreed to use shared-decision-making aids provided by the Foundation for Informed Medical Decision Making as part of a demonstration project.
Although the material is reviewed semi-annually for possible updating, Dr. Stormont felt the video and booklet on prostate cancer were incomplete. They didn’t cover some of the newer treatments, for instance, such as prostate cryoablation, the freezing of the prostate to treat localized cancer.
“I thought it would be a waste of time, another barrier between me and the patient, and more literature I wasn’t in control of,” he says.
Dr. Stormont agreed to use the programs, but supplements them with his own literature that includes information on newer treatment options. He says he has found that the decision aids help patients and their spouses get better educated about early prostate cancer, so his time with them is “more relaxed, efficient and focused.”
Patients have more realistic expectations about their treatment and side effects and are less likely to seek out second opinions, he says. They also are more comfortable choosing less-invasive treatments after reviewing the decision aids, he says.
“On one hand, while I am losing some surgical patients because of this process, on the other, we both are more comfortable that they are choosing the best treatment for them—one that they are more informed about, more comfortable with and less likely to regret later on,” he says.
Don Paulson, 74, a patient of Dr. Stormont, learned last week that he has prostate cancer, which he says came as a shock after years of good health. At an initial counseling session, oncology care coordinator Joyce Kramer went over the diagnosis and treatment options with him and his wife, Phyllis. She reassured the couple that the cancer was not life threatening and sent them home with a prostate-cancer DVD and some printed literature to view prior to a visit with Dr. Stormont over the weekend.
“We had a chance to digest it rather than getting it all in one big chunk,” says Mr. Paulson.
After watching the video, Mr. Paulson says he felt he understood his options far better. He is now weighing whether to chose the implantation of radioactive seeds, or try the cryoablation described by Dr. Stormont, who performs the procedure.
“If we had just gone straight to the doctor’s office and heard all of these options it would have been too much. It was good to be knowledgeable and review all of the possible side effects of different treatments first.”
Richard Derr, 75, also was recently diagnosed at Stillwater with prostate cancer. He says the decision aids helped him decide that both surgery and radiation carried risks of side effects that he wasn’t prepared to face, including incontinence and erectile dysfunction. Because his cancer was slow growing, he decided to go for an “active-surveillance” strategy, checking every few months for signs that the cancer is progressing.
Mr. Derr says he wished he’d had similar help last year when he was considering whether to have back surgery for a severe lower-back problem after unsuccessfully trying physical therapy and medications. Though his orthopedic surgeon told him there might be extensive rehabilitation, “he didn’t talk to me a lot about the risks,” Mr. Derr says.
After the surgery, he began feeling numbness and tingling in his feet, a condition, known as neuropathy, that is a potential side effect after back surgery. “I’m not saying the surgery caused it, but no one ever mentioned it was a possible side effect,” Mr. Derr says. “If I had known that it was I might not have made the decision to have the surgery.”
Advanced Prostate Cancer Poses Deadly Paradox to Younger Men
From an article on Advanced ProstateCancer.net:
Advanced prostate cancer poses a deadly paradox for younger men (aged 35 to 44 years). Younger men diagnosed with advanced prostate cancer will have a shorter remaining life span than older men who develop the disease, despite the fact that in general younger men have a much lower risk of dying from prostate cancer.
Daniel Lin, M.D., of the University of Washington, is studying this paradox. Dr. Lin is specifically interested in the mechanisms that shorten the lifespan of younger men with advanced prostate cancer, but do not have a similar effect in older men. His research utilized data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database.
Dr. Lin has concluded that increasing numbers of younger men are being diagnosed with prostate cancer, likely because of intense PSA screening regime we have in the United States. The ten-year survival rate, from diagnosis of all prostate cancers to death, for young men is better than for older men. Additionally, at diagnosis, younger men usually are found to have less aggressive forms of prostate cancer, again probably attributed to the intense, early PSA screening. However, they did find that younger men if diagnosed with advanced prostate cancer have shorter expected life spans when compared to older men with similar forms of advanced prostate cancer.
From this data pool (SEER) his study identified 318,774 men diagnosed with prostate cancer between 1988 and 2003. Dr. Lin was unable to explain why younger men die earlier from advanced prostate cancer than older men do, but he theorizes it was related to the type and strain of prostate cancer. He stated that perhaps advanced prostate cancer found in younger men is simply biologically more aggressive.
The acknowledgment that younger men diagnosed with advanced prostate cancer are at a higher risk for death is important. It clearly signals that immediate aggressive treatment in these younger men is vital for their survival. It also signals that additional studies (money) are needed to understand why younger men have a shorter lifespan when faced with advanced prostate cancer.
Earlier detection of prostate cancer in younger men is important, especially in cases where they are found to have advanced prostate cancer. Early detection is also important to stop the progression from localized disease to systematic disease in younger men.
Advanced prostate cancer poses a deadly paradox for younger men (aged 35 to 44 years). Younger men diagnosed with advanced prostate cancer will have a shorter remaining life span than older men who develop the disease, despite the fact that in general younger men have a much lower risk of dying from prostate cancer.
Daniel Lin, M.D., of the University of Washington, is studying this paradox. Dr. Lin is specifically interested in the mechanisms that shorten the lifespan of younger men with advanced prostate cancer, but do not have a similar effect in older men. His research utilized data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database.
Dr. Lin has concluded that increasing numbers of younger men are being diagnosed with prostate cancer, likely because of intense PSA screening regime we have in the United States. The ten-year survival rate, from diagnosis of all prostate cancers to death, for young men is better than for older men. Additionally, at diagnosis, younger men usually are found to have less aggressive forms of prostate cancer, again probably attributed to the intense, early PSA screening. However, they did find that younger men if diagnosed with advanced prostate cancer have shorter expected life spans when compared to older men with similar forms of advanced prostate cancer.
From this data pool (SEER) his study identified 318,774 men diagnosed with prostate cancer between 1988 and 2003. Dr. Lin was unable to explain why younger men die earlier from advanced prostate cancer than older men do, but he theorizes it was related to the type and strain of prostate cancer. He stated that perhaps advanced prostate cancer found in younger men is simply biologically more aggressive.
The acknowledgment that younger men diagnosed with advanced prostate cancer are at a higher risk for death is important. It clearly signals that immediate aggressive treatment in these younger men is vital for their survival. It also signals that additional studies (money) are needed to understand why younger men have a shorter lifespan when faced with advanced prostate cancer.
Earlier detection of prostate cancer in younger men is important, especially in cases where they are found to have advanced prostate cancer. Early detection is also important to stop the progression from localized disease to systematic disease in younger men.
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