PCa more deadly than previously thought

Great. Another study....

And what about that quote "Men who regularly drink coffee - caffeinated or decaf - are significantly less likely to develop a deadly form of prostate cancer, according to a new study."
I've been drinking grass clippings green tea because that supposedly reduced the chances of developing PCa.

I can only slurp down 400 ml of liquid in the morning or I'll have to pee by 11:00 AM. I can't have a full cup of each. Should I trade off every day? Every week? Should I mix them 50-50. Clearly, a study is needed.
Jeff

Post Edited (Worried Guy) : 6/16/2011 6:48:42 AM (GMT-6)

Thanks kbota,
However it may just be early but these two paragraphs don't quite add up to me.

Experts found that of the 20,181 men with the disease who died between 1997 and 2007, 49 percent of the deaths were attributed to prostate cancer. Some 12 percent of deaths were due to other cancers, 17 percent were due to heart disease, eight percent were due to pneumonia and 13 percent were due to other causes.

and

Prostate cancer is the second most common cancer in men, with 37,000 new cases popping up annually in Britain and more than 10,000 men dying from it every year.

The way I read it is only 20,181 men died in a 10 year stretch but 10k men die from it each year ???????? Dropped a "0" and it should have been 200k men in the first paragraph?

No question that advanced cases have greater mortality as it is often not curable, but can be treatable for the long term. Big advantage over most every other type of cancer.

Alarming that in Britain each year 37,000 dx and 10,000 deaths, or a 27% result. In the US each year 186,320 dx and 28,000 deaths, or a 15% result. Hopefully the superior US results will continue to be as good in the future even as we evolve to more of a British style medical system.

One possible explanation (though I don't know this for a fact) is less screening.   If you don't routlinely screen, many people will live their lives without ever knowing they have prostate cancer -- but of those who are diagnosed, a much higher percentage will have advanced disease and die.   If you screen routlinely, you catch a lot of earlier stage cancers -- so more diagnoses, but lower percentage die. 

Thanks for the correction JohnT.

Ralph,

You said:

This is precisely the point I was making in another thread. Given enough time prostate cancer can progress and kill men...it can be more lethal than advertised...

I have always believed this. I don't think people should always be told that an "entry level" G6 is harmless and unlikely that it's not likely to progress. While this may be true often, certainly not true all the time. That's why I like my new oncologist persepctive, of not treating just a number, but treating the patient's particular case.

David in SC

Casey,

Since you want to be technical, change my word from "always" to "often", and I meant it in the context of advice given right here on HW. I have never heard any of my doctors downplay a G6.

david

Sure makes a big difference in that number, John. The one way is almost 1 out of 5 men dying, as opposed to almost 1 out of 2. The higher number of those dying doesn't seem to fit into the relationship between men being diagnosed, as to those dying, as you stated.

BillyMac said...

John T said...
The press got the numbers wrong, of the 50,000 men in the study about 20,000 died of all causes and of this 9,900 or about 49% died of PC.
The death rate from PC is 9,900 of 50,000, not 20,000, or a more reasonable 20%. The headline was totally wrong and misleading.
JohnT

I guess then John, that means that so far as prostate cancer is concerned, there is no advantage to the more expensive private health system.
Bill

Quite the contrary...

This is still a significantly higher percentage of patients diagnosed with and dying of prostate cancer in the UK today than in the USA today … but it is nowhere near the 49% mortality previously reported.

Those that reported 49% PC mortality are busy wiping the egg off their face. 

JohnT,
In round numbers the study selected 50,000 men from a registry. Of those 20,000 died.
A further breakdown noted that 49% of the dead died of PCa and 51% of other causes.
The cohort selected were the 20,000 men that died and not the other 30,000.
The other 30,000 still living with prostate cancer do not enter in the calculation. If they did, then why not include the 370,000 diagnosed with PCa between 1997 and 2007? Then the mortality would be 2.7%.

The authors of the study made the following comments:
Professor Henrik Moller, study author from King's College London and head of analysis and research at the NCIN, said: "Our data show that a high proportion of men with prostate cancer die from the cancer."

Simon Chowdhury, study author and consultant oncologist at Guy's and St Thomas' NHS Foundation Trust, said: "This confirms that prostate cancer is a major cause of morbidity and mortality for a large number of men and the importance of ongoing and future research into this area."

Professor Malcolm Mason, a UK prostate cancer expert, said: "This is an extremely important study, which highlights that prostate cancer is not a trivial disease for large numbers of men in the UK who suffer from it. It is important for specialists, and for healthcare planners to realise that, particularly for men with advanced prostate cancer, their disease poses a significant threat to their health and their life, and the old notion that 'most men die with it, not of it' is simply not true for men with advanced disease.
"However, since 1997, many more men are being diagnosed at a much earlier stage, and for these men the outlook is excellent, even without any treatment. This is why the notion of the 'tiger and the *****cat' is a helpful way of understanding the contradictions. Many of the men in this study had the 'tiger' form of the disease, and a significant number died of it. In Europe today, most men who are diagnosed have the '*****cat' form, and will have an excellent outlook. There have also been a number of important advances in treatment over this timeframe, so it is possible that not all of the men in this study who died of prostate cancer, would die of it today with modern treatment."

Unfortunately in the UK they are still not using PSA as it is considered a non-specific cancer marker and men continue to be diagnosed with more advanced disease and die more often. In spite of them above saying that now men are diagnosed with earlier stages, if that were the case, why the PCa mortality rate in the UK in 1997 was 32.6/100K and in 2007 was 33.9%. In the absence of some method of early detection and effectively timed treatment, PCa can have a high death rate.

RalphV

As a Brit I think that the problem in the UK may be that there is far less screening than in the US, thus the PCa gets detected by guys going to the doc when they have symptoms, rather than becasue they want a routine PSA test. By the time you can notice symptoms the PCa is likely to be more advanced, and thus harder to treat effectively.

(Yes there is a National Health Service in the UK, but it may be the case that the emphasis has been far too much about trying to cure sick people rather than prevent them getting ill in the first place. The UK is not the only country where there is a lack of prevention.)

Alf

ralfinaz said...
Casey,
I see that you are fast at criticizing (pelting them with eggs) the authors of the study for trying to caution men in the UK of the high PCa mortality there.

 

No…but quick to call-out bad misinformation.

To remain relevant, we need to remain credible…and misinformation is damaging to one’s credibility.

[The egg-in-face published criticism came from the link I provided in the prior posting.]