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)
I'm with you on this one. What's surprising (perhaps should not be) is how it's spreading through the media like it's a new cure for cancer. It's one of hundreds of studies released every month and virtually none of them are noticed by the media. Someone did some PR for this one. I just don't understand why.
I read a blurb from FOX "news" re this study...t o be fair, it basically said high risk men should have immediate treatment ...assume that was also included in the study paper. also, to be fair, there are men diagnosed high risk who have deferred treatment until later and who still do well with long survival.....there is unfortunately no way to determine(yet???) which men might fall into that group.....and how do you do such studies?
You can test some high risk parameters in MSK' s nomograms and compare the immediate treatment vs delayed(if any) treatment.
IMHO, all PCa providers should share such info with pre-treatment men....otherwise how to make an INFORMED decision. Docs at our Kaiser have NOT shared such data, and brushed me off when I tried to discuss such study results with them????????? These are experienced Docs I like, respect, and "trust", but........?????
Thanks for the link !!!!!! Looking at Figures, what is a " person-yr" Surely something simple /obvious, except for this old brain!!!!
This is an informative update to the 10 yr update 5 yrs. ago....with a few surprises when compared to expectations upon review of 10 yr results. I especially noted the VERY high Gleason upgrade finding when post-RP pathology was reported!! Perhaps the modern use of targetted biopsies will decrease that upgrade number, but we won't know until studiesof that!!!!
There are other weaknesses of this study...delayed treatment for a large number of men who were assigned to immediated RP or RT is one example. Also noted how newer risk -assignment tools like CAPRA from UCSF and Cambridge group assignment system give significantly different risk results compared to the older D' Amico system.
There must be some other very interesting observations that could be made when looking at all the variables for these men and how related to progression and death.
Highlights the urgent need for diagnostic PCa providers to have much more detailed dscussion of early vs later radical treatment and expectations re side effects when making a decision for early/immediate treatment vs AS and good possibility of later treatment.
A striking fact was how many men died of a different cancer, and of course CV deaths, compared to PCa deaths.
TA has a blog re studies of results for men who delayed treatment 12 months from diagnosis.....basically, statistically, results same as for men choosing immediate treatment.
This ProtecT update aligns with the studies cited by TA. Will our diagnostic providers be honest about these study results, or fearful of fewer procedures. ie $$$$$??????
Are Centers of Excellence being any more forthright than typical community providers???
My doctors told me to act. Gleason 7=4+3, Decipher=0.7, No way to ignore that data! I got adt and 44 proton treatments. Gook Luck to those who ignore risk in hopes no action needed. Males tend to avoid doctors already and I fear this study may be used as an excuse to avoid action. I for one do not wish to see my bones set up as luxury homes for metastacized prostate cancer cells.
This is really spreading - it's appeared in publications within the medical community, posted as fact. The fact they're spreading is going to cause men to put off treatment while their cancer advances, hoping to die from something before the PCa kills them. That's BS.
I came here because I just saw the study on multiple news sources. What do they consider a PC level needing treatment? Because all of the media seem to paint it that unless you have advanced PC you shouldn't do anything at all. Husband had Gleason 3+4, and surgery + radiation due to positive margins. Was this all a mistake?!!
I compared his bio to mine and although in principle he seems a milder case than I, his PSA trajectory post RP has been steeper. Consequently, even if I am currently "taking chances" with moving salvage irradiation into the future, I can't claim that I would have done the same in your husband's shoes. Just my 2 Euro centimes.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Biopsy Results -- Treatment time
New -- a little over a year after surgery, 6 mos after radiation
Another one has left this earth
Gleason score change from 3+4 to 3+3 with perineural invasion noted under Active Surveillance 
