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I thought I would like to open a discussion on the chances of dying from prostate cancer once you have been diagnosed. Terry and I disagreed on this about a year ago but I know their is a correct answer.
My understanding is that about one in six men are diagnosed with prostate cancer and of those one in six will die. So once you have been diagnosed with prostate cancer there is about a 17 % (1 in 6) chance you will die of it if you don't know anything else about your cancer. Or is it still 3%, the chances of all men dying of prostate cancer.
I believe it is not mathematicians that are needed, but good data. I'm not sure where your figures come from, over what period they have been collected and, if they represent median estimates what the range is. Do you have any source references?
But even if there were good data, it would still be impossible to apply this data at an individual level because the major key factors in survival/death in prostate cancer are the PCa variant (and there are probably more than 24 of these), age at diagnosis, state of health, lifestyle/occupation. And there are no long term studies, as far as I am aware, that demonstarte the effect of these variances. I touch on these issues in The Elephant In The Room.
The length of time over which the estimate is made is also relevant. Many modern stduies claim very high survival rates for th therapies they support, but when you look at them closely you see that the time period measured is usually very short. Yet we know from the very few long term studies that many men diagnosed with PCa do not die from the disease over periods as long as 20 years.
One of the very few long term US studies is Albertsen PC, Hanley JA, Gleason DF, Barry MJ.
Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer. JAMA 1998 Sep 16;280(11):975-80
This study found:
• Men with tumors that have Gleason scores of 2 to 4 face a 4% to 7% chance of dying from prostate cancer within 15 years of diagnosis depending on their age at diagnosis.
• Men with tumors that have a Gleason score of 5 face a 6% to 11% chance of dying from prostate cancer within 15 years of diagnosis depending on their age at diagnosis
• Men with tumors that have a Gleason score of 6 face a 18% to 30% chance of dying from prostate cancer within 15 years of diagnosis depending on their age at diagnosis
• Men with tumors that have a Gleason scores of 7 face a 42% to 70% chance of dying from prostate cancer within 15 years of diagnosis depending on their age at diagnosis and
• Men with tumors that have Gleason scores of 8 to 10 face a 60% to 87% chance of dying from prostate cancer within 15 years of diagnosis depending on their age at diagnosis.
BUT......it has to be borne in mind that these men were diagnosed in the pre-PSA era. At that time most men (estimated to be between 80% and 90%) were diagnosed with late stage disease. This was because diagnosis would only follow a TURP, a DRE usually because of the development of symptoms.
The other issue is that the Gleason Scores and Grades used in the study would not match modern Grades and Scores, which have 'migrated' to higher levels - thus a GS 5 20 years ago might be a GS 7a today.
