Prostate cancer is the most frequently diagnosed form of cancer. Yet, according to a recent study, men diagnosed with prostate cancer are more likely to die from largely preventable conditions such as heart disease. The new study, from Harvard School of Public Health (HSPH), is the largest study to date that examines causes of death among men with prostate cancer. The data suggest that 1 important aspect of prostate cancer management should be the promotion of healthy lifestyle changes.
“Our results are relevant for several million men living with prostate cancer in the United States,” said first author Mara Epstein, a postdoctoral researcher at HSPH. “We hope this study will encourage physicians to use a prostate cancer diagnosis as a teachable moment to encourage a healthier lifestyle, which could improve the overall health of men with prostate cancer, increasing both the duration and quality of their life.”
Affecting 1 in 6 men during their lifetime, prostate cancer incidence has largely increased in the United States, Sweden, and other Western countries in recent decades. However, the probability that a newly diagnosed man in these countries will die of the disease has declined. Researchers attribute these rates to the widespread use of the prostate-specific antigen (PSA) test. The test has allowed for diagnosis at an earlier stage of disease among a higher proportion of men.
For the study, researchers examined causes of death among over 490,000 prostate cancer cases recorded in the US Surveillance, Epidemiology, and End Results program from 1973 to 2008. Data from the nationwide Swedish Cancer and Cause of Death registries were also used. These included over 210,000 men from 1961 to 2008.
The results, published in the Advance Access online Journal of the National Cancer Institute, showed that among men with prostate cancer, the disease accounted for 52% of all reported deaths in Sweden and 30% of reported deaths in the United States during the study period. Yet, only 35% of Swedish men and 16% of American men diagnosed with prostate cancer died of the disease. Over time, for both populations, the risk of prostate cancer-specific death decreased, and the risk of death from heart disease and non–prostate cancer remained constant. The 5-year cumulative incidence of death from prostate cancer was 29% in Sweden and 11% in the United States.
Researchers also discovered that the highest number of deaths from the disease occurred among men diagnosed at older ages and those diagnosed in the earlier years of the surveys (especially in the years prior to the introduction of PSA screening).
“Our study shows that lifestyle changes such as losing weight, increasing physical activity, and quitting smoking, may indeed have a greater impact on patients’ survival than the treatment they receive for their prostate cancer,” said senior author Hans-Olov Adami, professor of epidemiology at HSPH.
Source: Harvard School of Public Health.