Abstract No:101 at the recent ASCO Conference
It is sad, but it is true, a subset of men presenting with advanced prostate cancer never receive proper therapy. This can be attributed to a variety of factors including poor functional status, co-morbidities, and patient preference.
The researchers sought to determine the prevalence, and characteristics, of this untreated patient population.
They used The National Cancer Database (NCDB) to identify men diagnosed with stage IV prostate cancer between 2000 and 2008. Men who received no anticancer therapy (including chemotherapy, hormonal therapy, radiation, and surgery) were identified and were further categorized by age, race, insurance status, and income. For these subcategories, prevalence ratios were generated using the proportion of untreated metastatic prostate cancer (uMPC) to metastatic prostate cancer (MPC).
They found that out of the 1,201,732 men with prostate cancer diagnosed between 2000-2008, 59,074 (4.9%) had metastatic prostate cancer MPC at diagnosis. Of those men presenting with MPC, a shocking 6,582 (11.1%) received no anticancer therapy of any sort. With every 10-year increase in age, the prevalence of uMPC increased 43% (PR=1.43; p<0.0001). Blacks (PR=1.32, p<0.0001) and Hispanics (PR=1.41, p<0.0001) were more likely than Caucasians to have uMPC. They also found that with every $10,000 increase in income the prevalence of uMPC decreased by 7% (PR=0.93; p<0.0001).Men with Medicaid were 57% more likely to be untreated, men with Medicare were 82% more likely to be untreated, and uninsured men were 96% more likely to be untreated than those men with private insurance (p<0.0001).The researchers concluded that a large subset of men presenting with MPC never receive anticancer therapy. While tumor biology likely plays a role with regard to rapid disease onset and progression, these data suggest that age, racial and socioeconomic disparities exist in the treatment of MPC.Citation: J Clin Oncol 30, 2012 (suppl 5; abstr 101) Author(s): Alexander C. Small, Che-Kai Tsao, Erin Moshier, James Godbold, Guru Sonpavde, William K. Oh, Matt D. Galsky; Division of Hematology and Medical Oncology, The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY; Texas Oncology, Houston, TX, and Department of Medicine, Section of Medical Oncology, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TXJoel T Nowak, M.A., M.S.W.