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One of my observations over the years is that if I quote 'awkward' statistics that seem to point away from a cherished belief, I am told that there is no value in statistics, etc etc. On the other hand if there are statistics that support the status quo, they are regarded as genuine and acceptable.
For anyone interested in the subject of the broad statistics of PCa, this report may be useful - Cancer Statistics, 2009
There are a couple of points to highlight:
1. Figure 3 shows how the incidence of PCa rocketed in the late 80s when PSA testing was introduced. It then fell (presumably because the first 'sweeps' had netted a large number of cases and started rising again until about 2002/3 when it started falling again. It may be only coincidental that there was a significant change in the definition of PCa in 2002 when material graded as Gleason Grade 2 was no longer labelled as prostate cancer - and Gleason Score 5 diseases all but disappeared.
2. Figure 4 shows how the mortality rate rose sharply in conjunction with the increased incidence and then started falling back to levels last seen in the 1950s. This graphs shows very clearly the enormous gap between the leading death dealing cancer - lung cancer - and prostate cancer.
3. Figure 9 shows the number of male deaths (1,201,942 in all) by the ten leading causes. Table 8 shows the number of prostate cancer deaths as 28,372 (4,000 less than in 1990), which is to say 2.36% of male deaths were from prostate cancer. If you look at the numbers of deaths in each of the top ten categories, you will see that the number of deaths from PCa is only a little higher than the number from suicide and influenza and way below causes such as heart failure (315,706 deaths), other cancers (261,697 deaths) and even accidents (78,941). The actual causes do, of course, vary with age but at every age there is a much greater chance of dying from something other than PCa - even for men diagnosed with the disease.
Of course it is not possible for an individual to say that any populations statistic applies specifically to them. That is why it is important to gain a better understanding of how a dangerous, life threatening form of prostate cancer is defined, and how your own diagnosis compares to that definition. It is only then that you can start making a logical decision as to what is best for you as an individual and not to automatically assume that a definition of an early stage, very low risk cancer will lead to your death.
It should be borne in mind that in terms of the new interpretation of Gleason Grades a score of 3+3=6 is the 'entry level' for a definition of PCa diagnosed from a needle biopsy. There is nothing lower. So, although 7a or 7b diagnoses (3+4=7 or 4+3=7) are more aggressive, they are only marginally so.
I just wish every man should gain a better understanding of the various factors that go into a PCa diagnosis and the estimation of longevity and just where they fit in to those broad statistics before they make a decision that might not be in their best long term interests.
All the best Prostate men need enlightening, not frightening
Ummm,
So if you have P.Ca. and treatment. But die of a heart attack, stroke or even an accident for example, what goes down on the certificate as cause of death ?
There is a very complex set of codes by whcih deaths are classified.
For example, if you choose surgery for your diagnosed PCa and die on the table, that will be logged as a surgical death. From memory, your death within two days of the surgery will still be logged that way. After that....well, it all depends. If you were unfortunate enough to get one of these awful diseases that hang around hospitals these days your death would be clasified as that disease....and so it goes.
In a recent press conference discussing the question of whether PSA screening did reduce the number of deaths, Dr Walsh, who supported that view, was asked why the mortality rate had dropped in the UK, when there had not been the same level of PSA screening there. His response was that in the UK, the death of PCa men from pneumonia had been removed from the PCa Death classification, and that made a signficant difference to the outcome.
I suppose my main thought is that if the records & subsequent statistics could show what men were actually suffering ( with/without current treatment )from P.Ca., then would such statistics such as "Death from ", alter a lot ?
Put another way; if the said heart attack etc. had not taken the men, would the problem of P.Ca. be larger in the statistics ? And it's just the 'luck' of another cause of death that shows P.Ca. as a running problem for many, but not actual straight cause of death ?
If so, it would be possible to reduce the statistical significances of P.Ca. wheras in reality it would be a larger problem for many men.
