Prostate Cancer Survival - National Cancer Institute Statistics

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Newporter
Regular Member


Date Joined Sep 2010
Total Posts : 225
   Posted 6/14/2011 7:17 AM (GMT -6)   
I like to post this new message for those newly diagnosed. Diagnosed with Prostate Cancer is not a death sentence as in years past, so do not be too depressed and do not panic.

The National Cancer Institute kept statistics of 5 Year Survival for all cancer types. Prostate Cancer's 5 year survival is among the best. In fact looking at the survival by diagnosis year, there has been great improvements since 1960. In the 1960s and early 1970s, 5 year survivals were only about 50%. For some reason, African Americans did not do as well as White, so African American should check their PSA earlier in life, more often and perhaps, consider treatment more aggressively.

5-Year Relative Survival (Percent)

Year of Diagnosis: White, Black
1960-1963: 50, 35
1970-1973: 63, 55
1975-1977: 66.6, 61.0
1978-1980: 69.1, 62.1
1981-1983: 73.5, 63.2
1984-1986: 76.8, 65.8
1987-1989: 84.8, 71.5
1990-1992: 94.4, 84.6
1993-1995: 96.1, 91.7
1996-2000: 98.3, 95.6
2001-2007: 99.9, 97.9

Early detection clearly saved lives as five year survivals improved dramatically since PSA testing started and the following table showed early detection's benefits: If caught early, 5 year survival is 100%.

5-Year Relative Survival (Percent), 2001-2007

Stage:
All Stages: 99.4
Localized: 100.0
Regional: 100.0
Distant: 28.8
Unstaged: 69.9

April6th
Regular Member


Date Joined May 2010
Total Posts : 264
   Posted 6/14/2011 9:05 AM (GMT -6)   
Thanks for posting.

First let me say I believe in routine PSA testing, so I am wondering what the anti routine testing proponents attribute this drop in mortality to.

The mortality rate was dropping from the 60s through the 70s before the PSA test was widely used (the test was invented in 1970) so I can see how some of the drop in mortality can be attributed other reasons but not all of it.



Dan
Here are some of my stats:
Age:54
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 6/14/2011 10:10 AM (GMT -6)   

Adding some "color" to Newporter's posting:

 

5-Year Relative Survival (Percent)

Year of Diagnosis: White, Black

1960-1963: 50, 35       \

1970-1973: 63, 55         \

1975-1977: 66.6, 61.0     \     PC detected only via DRE or symptomatically; men typically present

1978-1980: 69.1, 62.1      /    with advanced cases & mets; many don’t live long as a result

1981-1983: 73.5, 63.2     /

1984-1986: 76.8, 65.8   /

1987-1989: 84.8, 71.5  <- commercialization of PSA test starts late 1986 (Hybritech); fewer than 30% of men diagnosed with organ-confined PC

1990-1992: 94.4, 84.6  <- first-ever “PC Awareness Week” sponsored by apharmaceutical with goal of identifying late-stage PC so as to maximize sales of 1st antiandrogen (flutimide); PSA testing mostly for advanced cases

1993-1995: 96.1, 91.7 <- both incidence mortality reach peak 1993; PC awareness grows and true “screening” for non-symptomatic patients rapidly increases; newly-diagnosed rate soars

1996-2000: 98.3, 95.6

2001-2007: 99.9, 97.9  <- approx 80% of men diagnosed with organ-confined PC

 

 

The fact is that despite the clear reduction in the age-adjusted prostate cancer-specific mortality rate since the early 1990s, the actual number of men dying of prostate cancer has remained, over the same 20-year period, within a remarkably stable range from about 28,000 to 35,000 since the introduction of the PSA test.


Postop
Regular Member


Date Joined Feb 2010
Total Posts : 385
   Posted 6/14/2011 11:44 AM (GMT -6)   
If prostate cancer is detected earlier, the 5 year survival rate will improve, because in the bad old days, much prostate cancer wasn't diagnosed until there were obvious bone metastases. Now, it's detected based on PSA, in early stages. However, the prostate cancer death rate for the country as a whole has been going down for years, but this is not happening in certain other countries that do little PSA testing. www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/cancer-facts-and-figures-2010 . This suggests that at least some of the treatments given to earlier prostate cancer saves lives.

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 735
   Posted 6/14/2011 12:46 PM (GMT -6)   
Casey said: "The fact is that despite the clear reduction in the age-adjusted prostate cancer-specific mortality rate since the early 1990s, the actual number of men dying of prostate cancer has remained, over the same 20-year period, within a remarkably stable range from about 28,000 to 35,000 since the introduction of the PSA test."

Casey,
There are several reasons why this statement is not totally accurate.
First is the issue of the life expectancy difference between 1990 and now (I only have life expectancy data through 2006)

Life expectancy, all races males, US, 1990:
At birth 71.8 years
At 65: 15.1 years
Source: http://tinyurl.com/6yubok

Life expectancy,all races males,US, 2006:
At birth 75.1 years
At 65: 17.0 years
Source: http://tinyurl.com/23afdbm

As you can see men are living longer now and are more susceptible to get and die of PCa at an older age. In spite of that less men are dying of PCa now.

Another important consideration is that here in the U.S. it is commonly claimed that PSA is in widespread use. The "real" evidence suggests that in spite of the expressed "widespread" use of PSA testing only 41% of men age 50 or above admits having a PSA within the last year. Men age 50 to 64 had a worse score. Only 33.6% admitted to have a test within the last year. In men 65 and above the figure is 51.3%. This alone is an indication that the 40% reduction in the PCa mortality rate is limited and a wider use of PSA testing could further improve results.

Source: Swan J, Breen N, Coates RJ, Rimer BK, Lee NC. Progress in cancer screening
practices in the United States: results from the 2000 National Health Interview Survey.
Cancer. 2003 Mar 15;97(6):1528-40. PMID: 12627518

Last but not least, these are the actual PCa death figures:
1989 30,520
1990 32,378
1991 33,564
1992 34,240
1993 34,865
1994 34,902
1995 34,475
1996 34,123
1997 32,891
1998 32,203
1999 31,729
2000 31,078
2001 30,510
2002 29953
2003 29406
2004 28869
2005 28312
2006 27775
2007 27050

RalphV
Phoenix, Arizona
Surviving prostate cancer since 1992 at age 58. RP; Orchiectomy; GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall; Stage T4; Last PSA September, 2010: <0.1 ng/ml
Laughter is still the best medicine!
www.pcainaz.org/phpBB304

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/14/2011 1:59 PM (GMT -6)   
Ralph,

You said:

Men age 50 to 64 had a worse score. Only 33.6% admitted to have a test

I am curious why that age band is the lowest by percentile. I believe the number, but even with regular GP's, it's age 50 when most men that have regular physical exams start getting their PSA tested. I was a case of exactly that, on my 50th birthday, as part of my yearly exam, my GP checked off the PSA box for the first time, and thus started my trending of having my PSA checked every year. Logic (again, not doubting stats) would make you think that the younger group would be in the least percentile, as men under 50 aren't normally checked for PSA. Any reasonable explanation>

David
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 6/14/2011 2:06 PM (GMT -6)   
Good stuff Ralph. Thanks for posting. If I read this right there is over a 20% drop in deaths over the ten year period ending in 2006.
Dx Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4)
Robotic RP March 2009
Path Report: T2c, G8, organ confined, neg margins, lymph nodes - tumor vol 9%
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT/SRT .01, < .01
End ADT3 5/11 PSA < .01

Newporter
Regular Member


Date Joined Sep 2010
Total Posts : 225
   Posted 6/14/2011 2:21 PM (GMT -6)   
The sad part is, even though most of us are entitled to annual physical exam, not all of us (men, especially) take part. I skipped quite a few over the years. Of course now I dare not skip any tests.

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 735
   Posted 6/14/2011 3:04 PM (GMT -6)   
Purgatory said...
Ralph,

You said:

Men age 50 to 64 had a worse score. Only 33.6% admitted to have a test

I am curious why that age band is the lowest by percentile. I believe the number, but even with regular GP's, it's age 50 when most men that have regular physical exams start getting their PSA tested. I was a case of exactly that, on my 50th birthday, as part of my yearly exam, my GP checked off the PSA box for the first time, and thus started my trending of having my PSA checked every year. Logic (again, not doubting stats) would make you think that the younger group would be in the least percentile, as men under 50 aren't normally checked for PSA. Any reasonable explanation>

David


David,
Those percentages are the result of a survey by NIH. The only explanation for such low use in younger men at risk is that many GPs follow the recommendations of the USPSTF which is not recommending testing men without symptoms. Actually in the past two years less men have been tested with PSA as a result of the public campaign to minimize the utility of PSA in early detection and to expose the over diagnosis/over treatment of the disease.

A better marker to identify those that need treatment is badly needed. but until then urologists should act responsibly and recommend AS to men that qualify for such protocol.

RalphV
Phoenix, Arizona
Surviving prostate cancer since 1992 at age 58. RP; Orchiectomy; GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall; Stage T4; Last PSA September, 2010: <0.1 ng/ml
Laughter is still the best medicine!
www.pcainaz.org/phpBB304

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 735
   Posted 6/14/2011 3:25 PM (GMT -6)   
BB_Fan said...
Good stuff Ralph. Thanks for posting. If I read this right there is over a 20% drop in deaths over the ten year period ending in 2006.


Hi BB_Fan,
The 40% reduction is related to the mortality rate. This is defined as the ratio of deaths to 100,000 male population. As actual deaths dropped men lived longer so the denominator of the ratio became larger and the net result was that significant reduction in the rate.

The reduction in actual deaths is like you said around 22.5%. That means that some 22 less men are dying every day…no small potatoes in my book…

RalphV
Phoenix, Arizona
Surviving prostate cancer since 1992 at age 58. RP; Orchiectomy; GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall; Stage T4; Last PSA September, 2010: <0.1 ng/ml
Laughter is still the best medicine!
www.pcainaz.org/phpBB304

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/14/2011 5:15 PM (GMT -6)   
ralph,

thanks for the explanation. i liked your last sentence in particular, makes perfect sense
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10
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