Causes of Death in Elderly Prostate Cancer Patients and in a Comparison Nonprostate Cancer Cohort

Abstract

Initial treatment may influence the underlying cause of death reported in vital statistics for prostate cancer patients.

Upgrading of Gleason score 6 prostate cancers on biopsy after prostatectomy in the low and intermediate tPSA range

“…Opponents of screening suggest that some men are treated unnecessarily because they would not have been diagnosed with PCa without screening. [15][16][17] Therefore, active monitoring or watchful waiting is sometimes recommended rather than definitive therapy particularly for men who are diagnosed with low volume, low-grade disease and for whom immediate definitive therapy could potentially do more harm than good. 18 We investigated the amount of possible over and under diagnosis in men diagnosed GS 6 at biopsy.…”

Radical Prostatectomy versus Observation for Localized Prostate Cancer

“…28,30 The percentage of men with positive surgical margins was similar to that in earlier studies and lower than that in the SPCG-4 trial. 27 The tumor volumes and PSA values in our study population, although higher than in some contemporary series, [31][32][33][34][35] are probably representative of those in the general population of men who received a diagnosis of prostate cancer at the time the study was being conducted. Our choice of all-cause mortality as the primary outcome underscores the importance of improving life expectancy with cancer treatment and eliminates the possibility of biased cause-of-death ascertainment.…”

“…These findings highlight the limitations of using prostate-cancer mortality as an outcome, even with the use of adjudication committees whose members are unaware of treatment assignments and who are following standardized protocols. [25][26][27] The effect of radical prostatectomy on mortality did not vary according to age, race, self-reported performance status, or coexisting conditions, but our findings suggest that it may vary according to PSA value and possibly tumor risk. Positive results were from multiple subgroup comparisons; the tests of interaction typically approached but did not reach significance and may therefore be due to chance.…”

“…Our choice of all-cause mortality as the primary outcome underscores the importance of improving life expectancy with cancer treatment and eliminates the possibility of biased cause-of-death ascertainment. [25][26][27] Our study was conducted in the early era of PSA testing. The current practices of performing repeated PSA testing, using a lower PSA threshold for biopsy, obtaining more tissue-biopsy cores, and performing a repeat biopsy after initially negative findings increase the detection of smallervolume indolent cancers.…”

Impact of diet on prostate cancer: a review

“…He bases his argument largely on the fact that cardiovascular disease is the primary or at least secondary cause of death in the majority of patients diagnosed with prostate cancer. 48 Moyad reasons that the beneficial effect that statins would have on reducing the primary cause of death in patients with prostate cancer, coupled with the possible decrease in prostate cancer related morbidity and mortality, justifies the use of statins in the clinical trial setting.…”