Inconsistency in Oft-Quoted Statistics

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Char V
New Member


Date Joined May 2009
Total Posts : 2
   Posted 5/21/2009 10:09 AM (GMT -7)   
Hi All,
I have been confused about some statistics that get tossed around quite often, even by the same doctor making a case for each of two different treatment options. One is the "One in six men will be diagnosed with PCa at some point in his life." The other is based on autopsy prostate pathology results, that showed roughly 50% of men who died of other causes had PCa. How does one reconcile these two very different rates? Is anyone familiar with the nuances of the underlying studies of these statistics? Is the sample size small (i.e., unreliable) for the autopsy study? Did the autopsy study sample a population that was disproportionately at-risk for PCa? Is the one-in-six figure biased low, i.e., if all men were autopsied, would the figure be closer to 50% instead of 17% (1 in 6)???

Any insight is appreciated!

Char (newbie)

53 YO / 3+3 / T1C / WW

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4814
   Posted 5/21/2009 10:20 AM (GMT -7)   
One in six men will be diagnosed with PCa at some point in his life."
 
The key word there is "diagnosed."
 
So well over half of the men in the world never got diagnosed and most of them died "with" prostate cancer and not "from" it.
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
 
06/25/08 - Da Vinci robotic laparoscopy
Catheter in for five weeks.
Dry after 3 months.
 
10/03/08 - 1st Quarter PSA -> less then .01
01/16/09 - 2nd Quarter PSA -> less then .01
xx/xx/xx   - 3rd Quater skipped
05/14/09  - 4th Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
 


Char V
New Member


Date Joined May 2009
Total Posts : 2
   Posted 5/21/2009 10:47 AM (GMT -7)   
Ahh, yes, that makes sense now; thanks! I guess urological oncology will be a pretty secure medical field in the future!!

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/21/2009 11:32 AM (GMT -7)   
Char,
Welcome to HealingWell. Sorry you have a reason to be here, but you are most welcome. I see you have decided on Watchful Waiting. I wish you the very best in that avenue. I would assume you are staying in close proximaty of a urologist who is admistering to the "watchful" portion of the protocol. If something should change then I am also assuming you have mapped out what you would do to some degree. But do stay with us and keep us updated.

I believe that many cases won't require treatment, especially in older patients. Diagnosis is 1 in 6, or 1 in 3 or 4 with family history depending on what you read and where you find it. And that is largely because of a very vague PSA testing system. But that does not include guys who just won't go to the doctor. And it does happen. In other words, many men have died of heart failure at 55 and have never been tested for prostate cancer. If the heart failure did not occur, is it possible that they would have died from prostate cancer a few years later instead? These questions we can't answer but I am certain there are some prediction factors that would apply. We can speculate that autopsy statistics are giving us an opportunity to see how prevelent the disease really is. And I have met meny men who were diagnosed in advanced stages, myself included, that had missed an opportunity to be diagnosed younger in an early stage. So until we can come up with a better system, 1 in 6 versus autopsy results gives us a clear picture that we still have work to do. And depending on at what point a person is diagnosed, the sciences in urologic oncology, radiation oncology, hemotologic oncology, have safe jobs. And due to some folks who choose to not subscribe to where we are with the protocols used today, so do internet speculators, snake oil dealers and witch doctors. That to me is tragic.

Very intriguing question.

Tony


 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!

Post Edited (TC-LasVegas) : 5/21/2009 1:20:56 PM (GMT-6)


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 5/21/2009 11:41 AM (GMT -7)   
My internist has been known to say: “If a man lives long enough he will get prostate cancer.” To which I would add: “You will die of prostate cancer unless you die of something else first.”
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/21/2009 12:07 PM (GMT -7)   
Prostate cancer discovery at autopsy statistics presented at the open Conversation in Miami May 9th:

Age 20-30 4%
Age 31-40 9%
Age 41-50 14%
Age 51-60 24%
Age 61-70 32%
Age 71 up 64%

Theses numbers are provided by NCI...So no, far more than 50% of all men don't have prostate cancer and never will.
Tony


 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!

Post Edited (TC-LasVegas) : 5/21/2009 1:21:57 PM (GMT-6)

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