According to a study funded by Amgen Inc., the incidence of stage IV prostate cancer has significantly declined and survival has improved, but the scary side of the equation is that younger men represent an increasing proportion of those diagnosed. The study was published in the June issue of Urology.
Amgen researchers analyzed cancer epidemiological data from the Surveillance, Epidemiology, and End Results Program for the period 1988 to 2003 as well as follow-up data through 2005. The researchers evaluated incidence rates, assessed trends in patient and tumor characteristics, treatment, and survival.
1- They found that age-adjusted overall incidence of stage IV prostate cancer declined by 6.4 percent per year.
2- Five year relative survival increased from 41.6 to 62.3 percent.
3- The incidence of the subset of stage IV disease with distant metastases, declined by 8.0 percent per year.
4- There was a significant increase in the proportion of men diagnosed at younger ages, in those who had a radical prostatectomy,
and in those with poorly differentiated tumors.
5- After controlling for patient, tumor and treatment characteristics, later years of diagnosis had an independent association with
decreased risk of death.
6- One of the most striking findings is that younger men are developing an increasingly higher proportion of stage IV
prostate cancer tumors but survival in this group is improving.
The bottom line is that younger men may expect to live longer with advanced prostate cancer, so long-term management of their condition must be carefully planned, particularly with respect to quality of life.
Despite the declining of the age of on-set of stage IV prostate cancer, prostate cancer still has the rap of being an old person’s disease. This inaccurate reputation makes getting additional research dollars available for prostate cancer much more difficult. It behooves us to let funders know that younger men, men with young children, are being stricken on a regular basis.
Joel T Nowak, MA, MSW
Another factor in this equation for younger men is to make sure they have a doctor who is willing to perform tests early including a biopsy in order to catch this disease early. Men need to insist on tests early from their doctors if PSA moves up no matter what the number is or get a new doctor asap. Delaying tests could cause them to miss a cure opportunity. As you and I both know Joel, you do not want to live with this disease. Ron