The study is particularly relevant in light of the recent controversy about prostate cancer screening. Earlier this month a government health panel said that healthy men age 50 and older should no longer be routinely tested for prostate cancer because the screening test in its current form does not save lives and sometimes leads to needless suffering and overtreatment. Patient advocates and many clinicians disagreed with the finding.
Although the Rochester study does not address screening directly it does raise questions about the benefits of earlier detection among the elderly.
“Especially for older people, the belief is that if they are diagnosed with prostate cancer it will grow slowly and they will die of something else,” said lead author Guan Wu, M.D., Ph.D., assistant professor of Urology and of Pathology and Laboratory Medicine at the University of Rochester Medical Center.
“We hope our study will raise awareness of the fact that older men are actually dying at high rates from prostate cancer,” he said. “With an aging population it is important to understand this, as doctors and patients will be embarking on more discussions about the pros and cons of treatment.”
Wu and colleagues studied the largest national cohort of cancer patients, called the Surveillance, Epidemiology, and End Results (SEER) database. They analyzed 464,918 records of men diagnosed with prostate cancer between 1998 and 2007, known as the “PSA era” because of a strong inclination to recommend the PSA test during that time.
(The prostate-specific antigen or PSA is a protein produced by the prostate gland, which can be measured in the blood. An elevated PSA is associated with cancer and other noncancerous prostate conditions.)
The analysis showed that when age groups are broken down into smaller sections, men 75 or older represented only 16 percent of the male population above age 50 and 26 percent of all cases of prostate cancer -- but 48 percent of cases of metastatic disease at diagnosis and 53 percent of all deaths. In general, higher grade cancer seemed to increase with age, the study said.
Researchers were looking for associations between age, metastasis and death because in clinical practice, Wu said, several URMC urologists observed that many otherwise healthy older men were presenting with very advanced disease at diagnosis, and reporting that they had never had a PSA test.
Indeed, older men have largely been excluded from prior clinical trials of the benefits of early detection, the study said. This is based on the idea that older men wouldn’t benefit from early detection because of a shorter remaining life expectancy.
But Wu and colleagues contend that overall health, more than age, impacts life expectancy following a cancer diagnosis, and that more studies are needed to identify ways to manage the disease in older patients.
“Due to a lot of natural variation in the biology of prostate cancer,” Wu said, “the URMC study should stimulate the need to develop an algorithm to identify healthy, elderly men who might benefit from an earlier diagnosis.”
The research was funded by the Ashley Family Foundation. Co-investigators are: Edward M. Messing, M.D., chair of the URMC Department of Urology; Emil N. Scosyrev, Ph.D., assistant professor of Urology; Supriya G. Mohile, M.D., M.S., assistant professor of Medicine in Hematology/Oncology with a special interest in geriatrics at the URMC’s James P. Wilmot Cancer Center; and Dragan Golijanin, M.D., a former URMC faculty member in Urology.For Media Inquiries:
Leslie Orr | EurekAlert!
Magnesium deprivation stops pathogen growth
22.11.2019 | Universität Basel
Protection for pacemakers
22.11.2019 | ETH Zurich
Conventional light microscopes cannot distinguish structures when they are separated by a distance smaller than, roughly, the wavelength of light. Superresolution microscopy, developed since the 1980s, lifts this limitation, using fluorescent moieties. Scientists at the Max Planck Institute for Polymer Research have now discovered that graphene nano-molecules can be used to improve this microscopy technique. These graphene nano-molecules offer a number of substantial advantages over the materials previously used, making superresolution microscopy even more versatile.
Microscopy is an important investigation method, in physics, biology, medicine, and many other sciences. However, it has one disadvantage: its resolution is...
Nanooptical traps are a promising building block for quantum technologies. Austrian and German scientists have now removed an important obstacle to their practical use. They were able to show that a special form of mechanical vibration heats trapped particles in a very short time and knocks them out of the trap.
By controlling individual atoms, quantum properties can be investigated and made usable for technological applications. For about ten years, physicists have...
An international team of scientists, including three researchers from New Jersey Institute of Technology (NJIT), has shed new light on one of the central mysteries of solar physics: how energy from the Sun is transferred to the star's upper atmosphere, heating it to 1 million degrees Fahrenheit and higher in some regions, temperatures that are vastly hotter than the Sun's surface.
With new images from NJIT's Big Bear Solar Observatory (BBSO), the researchers have revealed in groundbreaking, granular detail what appears to be a likely...
The Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM in Dresden has succeeded in using Selective Electron Beam Melting (SEBM) to...
15.11.2019 | Event News
15.11.2019 | Event News
05.11.2019 | Event News
22.11.2019 | Life Sciences
22.11.2019 | Health and Medicine
22.11.2019 | Studies and Analyses