Old Saying About Prostate Cancer Not True When It's Metastatic (80% die from it)

Medscape / JAMA Netw Open ^ | Sept. 2, 2021 | Nick Mulcahy / Ahmed Elmehrath, MD, Omar Alhalabi, MD, Samuel Merriel, MSc, Tanimola Martins, et al

[ConservativeMind]

Nearly 80% of men with metastatic prostate cancer died from their malignancy, according to a retrospective cohort study.

The findings fill an information gap because, remarkably, "data are lacking" on causes of death among men whose prostate cancer has spread to other sites, say lead author Ahmed Elmehrath, MD.

"It was an important realization by our team that prostate cancer was the cause of death in 78% of patients," said senior author Omar Alhalabi, MD, of University of Texas MD Anderson Cancer Center, Houston, in an email to Medscape Medical News.

The findings represent the near opposite of a commonly held — and comforting — belief about early-stage disease: "You die with prostate cancer, not from it."

That old saying is articulated in various ways, such as this from the Prostate Cancer Foundation: "We can confirm that there are those prostate cancers a man may die with and not of, while others are very aggressive." The American Cancer Society says this: "Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it."

However, these commonplace comments do not cover metastatic disease, which is what the authors of the new study decided to focus on.

The majority of these deaths (77.8%) were from prostate cancer, 5.5% were from other cancers, and 16.7% were from noncancer causes, including cardiovascular diseases, chronic obstructive pulmonary disease, and cerebrovascular diseases.

Most of the prostate cancer deaths (59%) occurred within 2 years. The 5-year overall survival rate in the study group was 26%. The deadliness of metastatic disease "reinforces the need for innovations to promote early-stage diagnosis," comment the editorialists. Striking a hopeful note, they also say that "new tests for prostate cancer detection may reduce the proportion of patients who receive a diagnosis at a late stage."

[markman46]

That would be a psa test for prostate cancer, I usually get it done with the rest of my blood work

[cuban leaf]

What amazes me most about the COVID hype is that it demonstrates on a worldwide scale the utter terror people have of death. It’s not death we should fear but an unholy death.

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Yep. This speaks to what I’ve said for a couple of decades: As our culture becomes less and less Christ centered, the preservation of the length and quality of this life becomes a higher and higher priority. The lost are petrified of death and can become quite depressed as they age. It is just the “natural man” (animal instinct) doing what it was designed to do.

But Christ offers a better way.

[wjcsux]

Later.

[nuconvert]

It’s confusing. When someone says metastatic cancer of any kind, you need to establish if the sort of cancer they’re speaking of is a primary cancer that has spread and therefore become metastatic or if the metastatic cancer is itself the metastatic cancer originating from another (primary) source. People use the term metastatic loosely.

[Wissa]

He’s alive. Still has cancer, numbers are low. His younger brother went whole hog conventional. Chemo and radiation. He died in 2018. Connection?

Possibly. A strong and healthy immune system is capable of killing cancer cells and/or keep the cancer from becoming metastatic. Chemo and radiation both damage the immune system.

[hanamizu]

I’m 68 and have no health insurance (Only medicade A, which I have for free whether I want it or not). I’ve not had a checkup in 20 years.

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I was enjoying good health and had no symptoms when a checkup my GP noted my PSA was high. Took another test a couple of weeks later ant it was even higher. Referred right away to a urologist who diagnosed a rather aggressive prostate cancer.

Get a PSA test. It might well save your life.

[PapaBear3625]

The standard blood test for prostate cancer

https://www.cancer.gov/types/prostate/psa-fact-sheet

I had it with my latest checkup’s blood work.

[A Navy Vet]

"That would be a psa test for prostate cancer, I usually get it done with the rest of my blood work."

I do the same. I've also been taking Saw Palmetto for years. My PSA is normal every yearly blood panel. I'm 71.

[ConservativeMind]

Unfortunately, men don’t typically know when it’s not metastatic. You can have an enlarged prostate or higher PSA levels and it just seems you have only an enlarged prostate, so diving in deeper doesn’t occur.

This is a warning to doctors and patients.

[llevrok]

Guys, please get at least semi-regular check ups to nip this in the bud early

Yup. Am a stage 1 pc survivor. 6 years ago.

PSA check up once a year if 55ish or over. I get mine every 6 months because of my history.

[gloryblaze]

I respect your choice, but consider that you fall or suffer a situation where you are not conscious, and someone else summons an ambulance and you are whooshed off to a hospital. In no time at all, your medical bills can eat your life savings and more. Medical Docs may be sweet and kind and caring, but Medical Debt Collection Departments are not.

[blam]

"That would be a psa test for prostate cancer, I usually get it done with the rest of my blood work"

I'm 78 and get a PSA test every 6 months.

[plain talk]

“Guys, please get at least semi-regular check ups to nip this in the bud early. Symptoms do not generally show up until it’s too late.”

Well said. I keep track of my PSA and other measurements to see how they change over time or not.

[Spok]

I had it and the PSA test diagnosed it before any symptoms were present. Some don’t get the test because there are false positives. The biopsy is not pleasant but it will confirm a positive test. It’s not as unpleasant as dying from the disease.

[ConservativeMind]

Finding it before it’s metastatic is difficult. It often appears as just a benign prostate enlargement.

[43north]

Having worked as a medical provider - including some time as a urology specialist - I agree with this study. Most diagnoses of suspected prostate cancer result in specialized MRI’s and frequently a biopsy to characterize the cancer and see if it has metastasized. When that happens it gets ugly real fast. I recall one patent who went to the ER because he had pain in his forehead - not really a headache. His PSA was extremely high and further investigation revealed that his forehead pain was from bony metastases of a prostate tumor and he had other skeletal lesions as well. He died 3 weeks later. OTOH, most positive diagnoses result in years of monitoring and sometimes hormonal treatments. I am a firm believer in early detection and treatment if applicable. Some of the PC patients I have conferred with have tried fully natural treatment with mixed success (which is about the best you can expect with medical treatment). I read a study years ago where diagnostic autopsies were performed on men who had died in their 90’s of “natural causes”. None of them had been diagnosed with PC but they ALL had it. Its tough to be a man...

[Do_Tar]

> I didn’t want to go when they were doing the old fashioned glove and finger exam.

Be suspicious if he has one hand on each of your shoulders. /jk

[cherry]

I'm not registering to read the whole article...

I'd like to know the ages of these men....

I know Prostate cancer can hit youngish men....my brown was in his early 50's....but I think the average age is much higher..

[for-q-clinton]

Huh? I have spent $0 on prostitues, but spend thousands upon thousands on taxes. Your statement makes no sense and is what is wrong with America.

[webstersII]

Problem is that test only measures inflammation, not cancer. The developer of the test said several years ago it was not a valid test for detecting cancer.