Study shows declines in diagnoses of metastatic prostate cancer

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Study shows declines in diagnoses of metastatic prostate cancer

Findings from a recent study presented at the 33rd European Association of Urology Congress in Copenhagen, Denmark, revealed some good news for metastatic prostate cancer rates – early detection of prostate cancer (PCa) in the United States has shown a reduction in the number of men diagnosed with metastatic PCa. 

Metastatic PCa is an advanced form of cancer in which the prostate cancer cells have metastasized or spread beyond the prostate to another area(s) of the body such as the hip, spine, or pelvic bones.  This spread of the cancer cells can be by direct invasion or by traveling through the blood or lymphatic system.  Once relocated, the cells begin to grow and form new tumors.  Even though tumors are in a different location from which they came from, the new growth is still classified as prostate cancer since the cancer first developed in the prostate. 

Data for the study was gathered from the Surveillance, Epidemiology and End Results (SEER) program.  Researchers with the study found that the incidence of de novo metastatic PCa declined from 12.0 cases per 100,000 men in 1980-1984 to 4.4 cases per 100,000 men in 2005-2011.  The 5-year PCa-specific mortality rate for the entire cohort was 56.5%.  It increased from 54.2% in 1980-1984 to 61% in 2005-2009.  This decrease of de novo metastatic PCa was followed by a decrease in overall PCa-specific mortality within 3 years.

The Latin expression de novo literally means something akin to “from the beginning” or “anew.”  When used in reference to PCa (or any other cancer), it refers to the first occurrence of cancer found in the body. 

Comparisons were made from the findings from the SEER program with those from a cohort of men in Denmark using the Danish Prostate Cancer Registry.  Found was that the incidence of de novo metastatic PCa in the Danish Prostate Cancer Registry increased from 6.7 cases per 100,000 men in 1995-1999 to 9.9 per 100,000 in 2005-2011.  The 5-year PCa-specific mortality rate for the entire cohort was 64%.  The rate decreased significantly from 73.4% in 1995-1999 to 56.8% in 2005-2009. 

What this study shows is that early detection helps identify patients with PCa at an earlier stage of the disease before it has spread or metastasized to other areas of the body. 

At the same time, there are some concerns with early detection is that many of the men could have a non-lethal localized PCa that may be over diagnosed and thus over treated with possible side effects from the treatments.  The belief for some researchers is that by not doing early detection, a man who may have a non-lethal localized PCa would never know and thus his life and quality of life would be better if not diagnosed at all.

For now, it is still strongly advised that all men receive a baseline prostate specific antigen (PSA) blood test beginning at age 40. By having a baseline PSA this can help “catch” any abnormal levels.  If the PSA comes back normal, then the next PSA test would not need to be done until age 45 and then yearly screenings after that.  Waiting to screen until age 50 could miss PCa in younger men who tend to be diagnosed with more advanced and less treatable PCa by the time it is diagnosed.  Even if a man has a PSA that comes back abnormal, he can still get a second opinion.  There are many other tests that can be used in addition to the PSA for detecting prostate cancer.