New Study Results Dangerously Being Oversimplified

[jazj]

Was watching the National News on ABC a day or two ago. One of the major stories was a "breakthrough study" regarding Prostate Cancer. They refer to a recently released New England Journal of Medicine article citing a study done between 1999 and 2009 in the United Kingdom, 82,429 men between 50 and 69 years of age. The way the study was summarized by the news anchor was that it was a major breakthrough study indicating you don't have a higher chance of dying from Prostate Cancer if you did no surgery or radiation than if you did.

WOW

I haven't dove deep into the study but only one third was medium to high risk. Also as we all know typically prostate cancer is diagnosed at an older age 60's and 70's. So a 15-year study like that, a significant portion of the cohort will die of other causes but do you want to be on ADT at the end of your life despite your cause of death? Do a study of patients diagnosed via biopsy with Prostate Cancer in their 50's with even Gleason 6 and follow them for 25 years instead of 15, or limit the study to Stage 2 but Gleason 8 and up and follow them for 15 years, and let me know how that turns out. (rolleyes)

nejm.org/doi/full/10.1056/N...

[DJBUNK]

I read the same information in another news article. The headlines and articles seem misleading. Only 6% of the patients in the study were in Grade Group 3 or higher (Gleason 4+3 or higher). In other words, 94% of the men had either a Gleason 6 or 7 (3+4). And of that low risk group, the Gleason 6 group was 79%. Of the 1610 patients enrolled in the trial, approximately 1/3 were assigned to Active Monitoring, 1/3 to surgery, and the remaining 1/3 to radiation. That tells you all you need to know about the risk level in this patient group. Can you imagine anyone with a G9 or 10 (or even intermediate risk G7 or G8) deciding to roll the dice by accepting a random placement in an Active Monitoring treatment program?

So I interpret this to mean, if you are a Gleason 6 or 3+4 Gleason 7, the 15-year survival rate is nearly the same whether you pursue active monitoring or first line treatment (surgery or radiation). This is NOT what the articles seem to be saying. They imply that anyone with localized PCa, regardless of other risk factors, should consider delaying any treatment to avoid treatment that could be more harmful than helpful (the paper actually makes this statement too). The fact that this only applies to low-risk PCa patients should be made crystal clear. The news articles don't clearly convey the nuance of the low-risk nature of most of the patients in this group.

I'm very interested to hear from those in this group with much more experience interpreting these results than me.

[Gunner2017 in reply to DJBUNK]

Great summary. The article is misleading. Debunked by DJBunk.

[maley2711 in reply to Gunner2017]

link to djbunk????

[maley2711 in reply to DJBUNK]

It found that, when pathologies were done post RP, 33% were medium or high risk....so that is a limitation, but doesn't make the study worthless at all. also, different risk systems varied greatly in risk assignment !!!???

also found little variance in group comparisons when different variables, eg PSA, Gleason grade, etc were evaluated. But, like you, not a professional when attempting to interpret such studies!!

[Gearhead]

A well-meaning friend forwarded me an article summarizing this study. It was probably a downer for him when I replied that it didn't apply to me because, at DX 4 yr ago, PSA=111, G = 8, and met on spine.

Do others sometimes have exchanges like this with friends and relatives?

[Clays711 in reply to Gearhead]

I get, "how are you feeling?" I went for triplet therapy right away and looked like crap for 6 months with thinning hair etc. I tell them I'm on autopilot with my treatment for now. And, I expect to live a long time.

[maley2711 in reply to Gearhead]

no...just that they have little understanding of natural progression of PCa compared to, eg, pancreatic cancer!!

[OFPF16]

This, I believe, is the news article on this subject. But what caught my eye for our condition was the texts under skeleton picture (make sure to expand the text). It mentioned a new drug called Alpharadin that treats PC with Mets. I haven’t heard of this drug, has anybody else heard of it? Here is the article:

foxnews.com/health/most-men...

As usual, thanks to everyone for your advice and support.

[gsun in reply to OFPF16]

Alpharadin is Radium 223.

[j-o-h-n]

They forgot to mention that if you die.....You're technically dead....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 03/13/2023 3:50 PM DST