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Posted 8/4/2016 6:39 AM (GMT 0)
Hello All,as I was driving down the expressway the other day,I happened to pass my Urologist office building.There is a huge electric sign at the building that says every 19 minuets someone dies from prostate cancer.Really ? Could that be correct ? If 1 out of six men get prostate cancer,how does that all add up ? Maybe it said every 19 hours,I will have to drive by again and check.Seems pretty grim either way.
Posted 8/4/2016 8:25 AM (GMT 0)
24 hr a day times 60 minutes times 365 days = 525,600 minutes in a year

divided by 35,000 deaths a year = 15 per minute.

I pulled the 35,000 out of thin air...but recall it's fairly close.
Posted 8/4/2016 9:16 AM (GMT 0)
If we consider the whole world Prostate Cancer Estimated Incidence, Mortality and Prevalence Worldwide there is about 307.000 death by prostate cancer (2012) - every 2 minutes someone dies from PCa shakehead
Posted 8/4/2016 10:39 AM (GMT 0)
Either way, no matter how you figure it out, it's a huge number. And, the real tragedy is, that if it had been caught early enough, a large percentage wouldn't have happened....or would have happened much later.
Posted 8/4/2016 11:11 AM (GMT 0)
It is a huge number. It is the second leading cause of cancer death for men in the US. To bad prostate cancer does not get the attention that breast cancer does. Perhaps the issue is all the focus is on saying how curable PC is. A lot of people think it is not a big thing. The issue is that it is curable until it is not. I can not tell you how many people state that my advanced prostate cancer is nothing to worry about as it is the "good cancer". Unfortuntly, it is "good cancer", until it is not. The number I hear is about 30,000 men die a year in the US.
Posted 8/4/2016 12:22 PM (GMT 0)
It's a large number...about 26K/yr in US.

The tragedy is that screening is largely ineffective, and for the "bad" type of PC, the one that a relatively small percentage of those diagnosed actually die from, there is nothing that stops it; only tries to slow it down.
Posted 8/4/2016 2:23 PM (GMT 0)
I have a slightly different view of such signs - fear mongering to get new patients.

It's tragic that men still die of PC, but we also die of accidents, heart disease, lung cancer, stroke, etc with some of these causing far more deaths than PC.

This is a PC cancer forum so naturally we have a laser focus on beating this one thing. However, in my mind the focus such be broader on men's health in general - all aspects.

Signs like this bother me because they seem designed to generate fear and the "Oh My God, I could die from that!" syndrome. Well, you could also die from driving into a parked car while trying to read the sign.

The real tragedy of PC in my mind is the amount of 'miss-information' and downright lies out there on the subject. We have simple screening tests, effective treatments, and with a bit of eduction we can reduce over treatment.

and sadly, no matter how good we are at that, some men will always die of PC.

I am going back to the shop,
Andrew
Posted 8/4/2016 2:25 PM (GMT 0)
Canadian Cancer Society 2015 publication says 41,000 men died of cancer last year, with 10.1%, or 4500, of prostate cancer.
Using the 10x rule, that's 45,000 in USA last year.
Posted 8/4/2016 2:31 PM (GMT 0)
Forgot to mention that 24,000 new cases were diagnosed in Canada in 2015. Again, using the 10x rule, that's 240,000 new cases in USA in 2015.
Those are the basic numbers. Roughly speaking, that's a 19.75% mortality rate.
Mind you, all the relevant data is missing.
Posted 8/4/2016 3:10 PM (GMT 0)

Newton451 said...
Canadian Cancer Society 2015 publication says 41,000 men died of cancer last year, with 10.1%, or 4500, of prostate cancer.


It's interesting that it's so different in the US. With 26,120 estimated PC deaths in the US in 2016, it was only 4.4% of all cancer deaths.


There is a lot of confusion about reported survival rates and what they mean. Tell me if this helps clarify:
    As cancer goes, prostate cancer is often a less serious one. Prostate cancer is frequently slow-growing and slow to spread. For many men, prostate cancer is less serious than their other medical conditions. For these reasons, and perhaps also due to the high rates of detection of smaller-and-smaller bits of PC, prostate cancer has one of the highest survival rates of any type of cancer.

    One in 36 men dies from prostate cancer in the US, although it it the second most frequently diagnosed cancer in men after skin cancer. Far more men actually have PC and are never diagnosed, and it never affects them.

    A clear explanation of survival rate calculations is important because the average age of PC diagnosis is around 70. Over, say, five years, many of these men will die from other medical problems unrelated to their generally slow growing PC. To determine the prostate cancer survival rate, these men are subtracted out of the calculations. Counting only the men who are left provides what's called the relative survival rate for PC.

    Taking that into consideration, the relative survival rates for most kinds of prostate cancer are actually pretty good. 90% of men with PC have localized cancer, and almost none of these men will die from their PC over 5-years. Fewer men (about 5%) have more advanced PC at the time of diagnosis; survival rates fall for men with distant spread (mets); as mentioned in my earlier post, for these relatively rare cases, there is no cure. Overall relative survival in the US is 99% at 5-years, 91% at 10-years and 76% at 15-years. In 1990, when fewer men with localized PC were being added to the pool of "diagnosed," the 5-year survival rate was 92.9% versus 99% today.

Post Edited (JackH) : 8/4/2016 9:16:15 AM (GMT-6)

Posted 8/4/2016 3:19 PM (GMT 0)
Andrew,fear mongering to drum up business? Fear mongering to make more men aware?Its a very huge sign on Interstate 80 that"Advanced Urology" has on that looks like a Las Vegas billboard.Either way PC is here to stay and men should be checked often.They found mine with my annual psa treatment .Thanks
Posted 8/4/2016 3:28 PM (GMT 0)
Good information JackH,I would like to live to eighty.Thats 15 more years and I have a 76% chance of getting there if something else dont get me. Thanks
Posted 8/4/2016 3:32 PM (GMT 0)
That's a pretty good outlook!
Unfortunately, there's a lot of other things that might get you (and me) in the mean time!
In our particular cases, it appears quite certain that it will eventually be something other than PC...plan accordingly!
Posted 8/5/2016 3:49 AM (GMT 0)
It is most likely correct ( 1 every 19 minutes) in this country. That is roughly 3.15 per hour or 75.78 per day or 27,633 per year. That sounds about like the number known to die per year of PCa, a tad higher than what I thought. It is also somewhat lower than the # that die in auto accidents(32675/year or 1 every 16 minutes), even though that # is WAY down from 1970. Also, about 29 times more die in any given time period from heart attack. (787,000 per year or about 1.5 per minute or 1 about every 40 seconds )

Post Edited (BillyBob@388) : 8/4/2016 10:04:00 PM (GMT-6)

Posted 8/5/2016 4:38 AM (GMT 0)
I haven't had to deal with this very long, but it didn't take me long to figure out that almost everyone that found out I had PC said ,"oh that's the best cancer to have ,or that's easy to treat, or I have a friend,brother ,someone I know that had that it's not that bad. Generally I think most are just trying to be positive, but I agree with DR.Who.... it really takes the the focus off of how devastating this can be. I find myself trying to explain, " NO, mine is aggressive and very high risk", and I really don't want to have to go through all that.

Anyways, off to have an endoscopy tomorrow because of my gastro issues. Dr thought it would be prudent to check just in case. This will be my 14th endoscopy in the past 8 years.so kind of used to them.
Mark
Posted 8/5/2016 11:48 AM (GMT 0)

InTheShop said...
I have a slightly different view of such signs - fear mongering to get new patients.

It's tragic that men still die of PC, but we also die of accidents, heart disease, lung cancer, stroke, etc with some of these causing far more deaths than PC.

Too bad there isn't a simple blood test that can predict you'll die in a car crash or from a stroke.
Posted 8/5/2016 2:34 PM (GMT 0)
We tend to lump all forms of PC together when we talk about prostate cancer. There are different types of prostate cancer ranging from harmless to just plain nasty, and a whole bunch in between.
The majority of prostate cancers are not serious and most will survive with or without treatment. The high end aggressive cases are on the opposite end of the spectrum and most will die with or without treatment. We don't do anyone justice when we lump all cases into the generic label of prostate cancer.
Posted 8/5/2016 2:39 PM (GMT 0)
Hello John T,you have been on 1 hell of a roller coaster ride.Im happy for you that you seem to have the beast in the cage. SemperFi
Posted 8/5/2016 3:05 PM (GMT 0)

Steve n Dallas said...

InTheShop said...
I have a slightly different view of such signs - fear mongering to get new patients.

It's tragic that men still die of PC, but we also die of accidents, heart disease, lung cancer, stroke, etc with some of these causing far more deaths than PC.

Too bad there isn't a simple blood test that can predict you'll die in a car crash or from a stroke.



Thanks for prompting an interesting perspective, Steve n Dallas. Your comment stimulates the mind which can easily (as it turns out) be satiated by doing a little actual data analysis. Why speculate when there is data? This also ended providing a good big-picture view on PC and all causes of deaths.

What are the top 10 causes of death in the US, and whether they can be successfully screened/detected/predicted:
    1. Heart disease (610K deaths in the US per year) – lots of tests, monitoring & warning signs, but no screen (blood pressure, cholesterol, stress test, and a test I just had: the Coronary Calcium scan)
    2. Cancer, all types (590K) – there are over 100 types which are all different, so I examined the leading types below
    3. Chronic lower respiratory disease (147K) – none; mostly affects elderly
    4. Accidents (136K) – by their very nature, cannot be predicted
    5. Stroke (133K) – quick response helps, once symptoms appear
    6. Alzheimers disease (93K) – early warning signs to watch for; no single test
    7. Diabetes (76K) – yes, can identify disease by blood test which helps people live with the disease more comfortably, but mortality impact is unclear
    8. Influenza and pneumonia (55K) – none; mostly affects elderly
    9. Kidney disease (48K) – tests usually given once symptoms appear, or to those at high risk (diabetics, family history, etc)
    10. Suicide (42K) – early warning signs may appear; hopefully prompting an early intervention

Together, these account for 76% of all causes of death in the US.


Cancer is the 2nd greatest killer in the US, but it is really many different diseases. What tests/screens are effective amongst the top 10:
    1. Lung (150K) – LDCT test for smokers; some say smoking, itself, serves as an "intelligence test"
    2. Colon (50K) – yes, colonoscopy effective
    3. Pancreas (41K) – none
    4. Breast (40K) – studies show mammogram screenings save lives
    5. Liver (26K) – none
    6. Prostate (26K) – studies do not show PSA screenings save lives
    7. Leukemia (20K) – none
    8. Lymphoma (20K) – none
    9. Brain (16K) – none
    10. Kidney (14K) – none

Together, these account for 68% of all causes of cancer death in the US.

So one could say that in summary, amongst both of these lists, Diabetes, Colon Cancer and Breast Cancer has got some decent screening…the others, not so much. As Steve n Dallas said, too bad.

http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-047079.pdf

Post Edited (JackH) : 8/9/2016 9:52:13 AM (GMT-6)

Posted 8/5/2016 5:38 PM (GMT 0)
Fun with numbers. Here's some statistical examples I use when running groups:

1. There are 2.6 million men in the US living with a diagnosis of prostate cancer today. about 26,000 will die of the disease which makes prostate cancers 1.1% mortality rate one of the lowest in all of cancers.

2. In a study, the way statistics were explained to a patient were highly influential in their decision making process. A series of cardiac patients were told either one of two stories:
a. "9 out of 10 of patients do extremely well with this heart procedure. Recoveries are excellent among them".
b. "This procedure has a very high 10% mortality rate. It is very risky and we do not know who will benefit the most."

The statistic is 9 out of 10. Or played in reverse 1 out of 10. In any case the group B had a much lower commitment rate to proceed. Story A would be typical of a surgeons approach. Story B might be typical of an approach outside of surgery. In any case how the data was explained was highly influential to the cohort.

3. There were 46,000 traffic deaths in the US last year. The #1 cause is speeding. Drunk driving still rates high but also a 5% increase is largely attributed to cellphone usage particularly texting. The NTSB says statistically more than half of traffic deaths are cause by these three very controllable causes. Meanwhile, the prostate cancer industry will have 26,000 men die this year. But 70,000+ will be over treated or over diagnosed each year (using industry and not anecdotal data). If we could get more drivers in America to try to be as "preventive" as we would suggest prostate cancer screening is we would save far more lives.

4. A study on male cadavers that died os something other than prostate cancer revealed that using a TRUS biopsy we could have found:

Men aged between 20-29 would have as high as a 20% detection rate
Between 30 and 39 = 30%
Between 40 and 49 = 40%
Between 50 and 50 = 50%

etc etc.

Yet we know the mortality rate is 1.1% annually when compared to the number of actual diagnosis...

Sigh
Posted 8/5/2016 5:47 PM (GMT 0)
Tony,your BioSketch is amazing.We need you here on planet earth for a long time.Many thanks to you for your dedication to our cancer.SemperFi,John
Posted 8/5/2016 5:57 PM (GMT 0)
TY John,
I need to go and update it. It's a little behind. I am approaching year 10 surviving and 9 years active as a patient advocate/support group leader.
Posted 8/8/2016 1:13 PM (GMT 0)
More "fun with numbers," as Tony said above. These types of big-picture facts should be more readily available to guys at the time of diagnosis...probably fewer would rush into immediate treatment. We should add these to the "Newly diagnosed..." sticky thread.

Here's another way to look at it which may hit home...

    “Imagine you are one of 100 men in a room,” [Dr David Newman, director of clinical research at Mount Sinai School of Medicine in Manhattan] says. “Seventeen of you will be diagnosed with prostate cancer, and three are destined to die from it. But nobody knows which ones.” Now imagine there is a man wearing a white coat on the other side of the door. In his hand are 17 pills, one of which will save the life of one of the men with prostate cancer. “You’d probably want to invite him into the room to deliver the pill, wouldn’t you?” Newman says.

    Statistics for the effects of PSA testing are often represented this way — only in terms of possible benefit. But Newman says that to completely convey the PSA screening story, you have to extend the metaphor. After handing out the pills, the man in the white coat randomly shoots one of the 17 men dead. Then he shoots 10 more in the groin, leaving them impotent or incontinent.

    Newman pauses. “Now would you open that door?” He argues that the only way to measure any screening test or treatment accurately is to examine overall mortality. That means researchers must look not just at the number of deaths from the disease but also at the number of deaths caused by treatment.


Interesting perspective on the numbers, I'd say...
Posted 8/8/2016 3:56 PM (GMT 0)
eh.......it's a lot like bungy jumping from a 500 foot high bridge. Odds are nothing deadly will happen, but if it does happen, it will be catastrophic.
That's why it's hard to convince men who are diagnosed with PCa to do nothing.
So, to argue that if you "just don't test for it", then they won't know and then won't knee jerk to treatment is a fairly unjustifiable and irresponsible position in my personal view.

BTW.....isn't this the broken wheel convo we keep having?
Posted 8/8/2016 4:12 PM (GMT 0)

Newton451 said...
...but if it does happen, it will be catastrophic.
That's why it's hard to convince men who are diagnosed with PCa to do nothing.
So, to argue that if you "just don't test for it"...

Newton, I'm confused by your comments shown above because it seems like you might be talking about a different thread; correct me if I'm wrong but there's been no mention in this thread about "just don't test." Right? This thread is all about the facts and numbers associated with PC.

I also have never seen anyone, anywhere advocate for "do nothing." You might also be mixing more things up here; in this case, mixing up the notion of Active Surveillance, which is a far cry from "doing nothing." Right, again?

If you were mixed up about AS, it is worthwhile to address your comment about the "catastrophe" you alluded to. Are you aware that the long term outcomes of low-risk men who sought immediate treatment is the same as those who went on AS? A low percentage of those who sought immediate treatment "failed," but it was no higher or lower than those who went on AS. The "catastrophe" you allude to is not supported by data.

Most doctor's say it's misinformation which makes it hard for them to convince men to go onto AS.

Post Edited (JackH) : 8/8/2016 1:11:37 PM (GMT-6)

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