A new study found that because of the excellent survival chances of older men diagnosed with early-stage prostate cancer with low- to moderate-grade tumors, they should not stop looking out for other illnesses like other cancers and cardiovascular diseases, because more often than not it is these that they will die of, just like men without prostate cancer.

The study was the work of Dr James S. Goodwin of the University of Texas Medical Branch, Galveston, and colleagues, and is published in the January 2009 issue of the Journal of the American Geriatrics Society.

For the study, Goodwin and colleagues used data on 208,601 men aged 65 to 84 diagnosed with prostate cancer between 1988 and 2002, living in 11 different regions of the United States. The data came from the Surveillance, Epidemiology and End Results (SEER) Tumor Registry. They compared survival and cause of death in these men with survival and cause of death in a non-cancer (control) population.

For the prostate cancer population they calculated survival as a function of stage of cancer and grade of tumor: low (Gleason grade below 7), moderate (Gleason grade of 7), and high (Gleason grade of 8 to 10) and compared it with survival in the non-cancer population. They also looked at cause of death according to stage and tumor grade.

The results showed that:

  • The survival rate of men with early stage prostate cancer with low to moderate grade tumors (59.1 per cent of the prostate cancer population) was not substantially worse than men without prostate cancer.
  • Also, among those men, the leading cause of death was not prostate cancer (where the mortality rate was 2.1 per cent) but cardiovascular disease (6.4 per cent mortality rate) and other cancers (3.8 per cent).

Goodwin and colleagues concluded that:

“The excellent survival of older men with early-stage, low- to moderate-grade prostate cancer, along with the patterns of causes of death, implies that this population would be well served by an ongoing focus on screening and prevention of cardiovascular disease and other cancers.”

The authors noted that decisions about how to treat early stage prostate cancer should take into account the patient’s age and other health factors likely to impact life expectancy.

For instance, if it is decided to use androgen deprivation therapy (prostate cancer feeds on the male sex hormone), then doctors should consider how this might affect the course of any other conditions.

Goodwin and colleagues wrote that older men with early stage prostate cancer should continue to maintain focus on “screening and prevention of cardiovascular disease and other cancers”.

“Cause of Death in Older Men After the Diagnosis of Prostate Cancer.”
Journal of the American Geriatrics Society Volume 57, Issue 1, Date: January 2009, Pages: 24-30.
Melanie Ketchandji, Yong-Fang Kuo, Vahakn B. Shahinian, James S. Goodwin.
DOI: 10.1111/j.1532-5415.2008.02091.x

Click here for Abstract.

Sources: Journal Article.

Written by: Catharine Paddock, PhD