Oh, by the way...Happy National Prostate Cancer Awareness Month

It is no surprise that there is an overwhelmingly muted under-response, even here.

Prostate cancer has a "bad name;" overtreatment has given PC a bad name.

Jack,
Thanks for the reminder, got my PC ribbon on my lapel every day!
Wings aka Dan in so Cal

alephnull said...
It really has.
I wish that they would de-classify G6s as to not cancer.
The mortality rate would immediately double. (as G6s are what 50% of PCa cases)
That might get people's attention.

I agree, NKinney, that overtreatment has given PC a "bad name."


And I don't disagree with your notion, alephnull, of re-branding low-risk PC...

...BUT, I disagree that doubling the mortality PC rate would get people's attention. With a doubling of mortality rate, PC would jump from #22 to #22.

List of cancer mortality rates in the United States
Percentage of patients deceased within five years after diagnosis:

1. Gallbladder cancer – 97%
2. Pancreatic cancer – 93%
3. Liver cancer – 83.9%
4. Lung cancer – 83.4%
5. Esophageal cancer – 82.7%
6. Stomach cancer – 72.3%
7. Brain cancer – 66.5%
8. Ovarian cancer – 55.8%
9. Leukemia – 44.3%
10. Laryngeal cancer – 39.4%
11. Oral cancer – 37.8%
12. Colon cancer – 35.1%
13. Bone cancer – 33.6%
14. Cervical cancer – 32.1%
15. Non-Hodgkin lymphoma – 30.7%
16. Kidney cancer – 28.2%
17. Bladder cancer – 22.1%
18. Uterine cancer – 18.5%
19. Breast cancer – 10.8%
20. Skin cancer – 8.7%
21. Thyroid cancer – 2.3%
22. Prostate cancer – 0.8%

This Wikipedia page nicely summarizes the data from the CDC:
/en.wikipedia.org/wiki/List_of_cancer_mortality_rates_in_the_United_States

I think I got it, I am comparing to new entries into PCa not the population.
238K versus a few million.

Eh????? There is a Happy Prostate Cancer? Didn't know I had that option!

5-year mortality is a common way of expressing cancer statistics. 10-year is also sometimes done, but not as commonly. I've seen 1-year mortality, too. 5-year mortality is most common. This is for all cancers; not just PC.

The issue with the Internet is how the numbers you want to use to are generated. Using a respective sight listed below, my mortality, for example, is a little over six years.

https://www.roswellpark.org/apps/prostate_cancer_estimator/

However, if I look at mortality for people with Ductal prostate cancer, not included in the above formula, it is about 2.5 times worse than that stated above.

Longevity is very dependent on what stage you are. If you are a T2N0M0 you will probably die of something else. If your cancer has spread to distant organs or bones (M1 or higher), your outcome is not as good. If you focus on just men with metathizied cancer far from the pelvic area, the five year survival rate will place it at about #6. The survival rate is very different when you focus on all stages of prostate cancer vs advanced or rare. From a 2016 ACS article: http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-survival-rates
"According to the most recent data, when including ALL stages of prostate cancer:
The 5-year relative survival rate is almost 100%
The 10-year relative survival rate is 98%
The 15-year relative survival rate is 95%
Distant stage includes the rest of the stage IV cancers – cancers that have spread to distant lymph nodes, bones, or other organs (M1). The relative 5-year survival rate for distant stage prostate cancer is about 28%."

Of course there are a lot of men with Stage 4 D2 cancers that have passed the ten plus year mark.

alephnull, As with all statistics, this information is probabilistic, not deterministic. You might die of PC within 2 years (where'd your use of the number "2" come from??), but you probably won't. Any one person's fate is not determined by statistics, but the big picture view is more clear to everyone.

I'm not arguing with you here, just stating my perspective: I think that the 5-year mortality is a very good metric. 1-year is too short--from the time of a serious diagnosis to seeing the results of an aggressive set of treatments can hardly be contained within a year, and 10-years is too long--hard to think that far out (particularly when the median age for PC diagnosis is 67). Most people can envision clearly a 5-year timeframe. This is why, I believe, 5-year mortality is the most commonly used & understood metric.

I can understand how, with PC being so low on the list I previously posted, men's minds would then (after understanding the 5-year stats) naturally turn to the next level of detail and want to know the 10-year or 20-year or 30-year statistics...but the truth is that this just makes it more likely that something else will get them first.



To me, the REAL benefit of "PC AWARENESS" is having more men understand and be aware of the REAL numbers associated with prostate cancer. Not all "cancers" are the same. I think a realistic awareness would further help slow/stop the rush to overtreatment, and frankly helps enlighten men who were already overtreated (cases like mine) to realize that they could do some GOOD for their fellow brothers by raising their hands and saying "don't do what I did!" rather than "looking back" and layering excuse upon self-denial...not pretending it doesn't exist, or that they were somehow immune to overtreatment. (This is not you, alephnull)

Just my humble opinion. Prostate Cancer Awareness Month efforts should help to turn-around the blight that recent history has cast upon the disease in our society.

Post Edited (JackH) : 9/8/2016 1:32:01 PM (GMT-6)

The only number that is meaningful to me is that 26,000 to maybe 30,000 men will die of prostate cancer in the U. S. this year. That's within about five or six thousand of the number of women who will die of breast cancer.

"Mortality rates" seems like a figure chosen to minimize the tragedy of nearly 30,000 deaths. Most of the other cancers listed are less common, so regardless of their "mortality rates," they kill fewer people. Also, most of the are not confined to males. Their numbers include female patients as well.

I know that many on this site are obsessed with "overtreatment" and "over-diagnosis." Their minds are fixed on that perspective.

My mind is fixed on the annual mortality numbers. And lately it's also fixed on my youngest brother, whose G6 diagnosis and a year of AS has now become G7 with surgery scheduled for early next month. And there are still folks on this site who would suggest he continue AS.

Well, he had a year of AS, so that's a year to the good, but somehow that "non-cancer" has now become intermediate risk. Go figure.

So,

Dr WHO said...
The issue with the Internet is ...

hahaha...sorry, Dr Who, I didn't notice your last post until just now.

But it gave me a chuckle the way you started it out (quoted above). When you said you had an "issue with the internet," I thought you might be going into real issues like hackers and cybercriminals, or censorship, or privacy issues, or the lack of equal, universal access...



Ok, so now I see more clearly that your point was not really an "issue with the Internet," rather it was an issue of you understanding numbers you see on the internet. You like the online Estimation of Overall Life Expectancy as a metric, versus the commonly used 5-year cancer-specific mortality metric.

Fair enough. The key is to understand what they mean, and how they are different, and how to use each appropriately.

As I've heard TonyC say, it's 2 sides of the same coin.

Post Edited (JackH) : 9/8/2016 2:49:26 PM (GMT-6)

Sorry Jack, you are right.

I get it, I'm a little slow sometimes.

Yikes! A conspiracy theorist! "They" are out to get you! (JackH said)

I don't really appreciate that comment, JackH, but I've noticed that you really don't seem to care whom you might offend, so "it is what it is."

But, I think you know what I meant. Choosing to approach prostate cancer deaths in terms of "mortality rates" rather than "deaths per annum" will definitely make prostate cancer look like a less significant cancer than it truly is.

Thirty thousand deaths per year. That's like 250 airline crashes. It's approaching the number of people who die annually on our highways. Imagine all the suffering and pain being endured by men with metastatic prostate cancer. Consider all the mental anguish these men and their loved ones live with every day as the disease worsens. But, hey, it's only number 22 in terms of mortality rate.

Yet, what is the main complaint here on HW? Having been hanging around here for six years now, it's clear to me that the main complaint is ED. The second most frequently heard complaint is incontinence. I certainly don't intend to minimize the effect ED issues and incontinence can have on a man's life. But isn't it odd that those on this forum who are truly suffering, often to the point of agony and approaching death, are the ones who complain the least?

So, why doesn't Prostate Cancer Awareness Month get the attention it really deserves? If we men took this male disease as seriously as women take breast cancer and other female cancers, things might be different. Maybe we've forgotten what it felt like to get that cancer diagnosis. How our wives cried, even though it may have been "just" a Gleason 6 diagnosis. Fact is, our disease doesn't even get the respect it deserves from some who frequent this forum, so why should we expect better from society in general?

I don't think "overtreatment" has given prostate cancer a bad name. Rather, it's the failure of men to become advocates for our gender and a failure to educate boys beginning in adolescence about male health issues, unlike women, who teach their daughters early about breast cancer and the other cancers that affect women.

The only people I hear worrying about "overtreatment" are guys who've been through the mill and are now lamenting the fact that cancer came with a cost. So, if that's causing the problem, we have no one to blame but ourselves, because the man on the street would tend to look at us as if we've lost our minds.

Post Edited (clocknut) : 9/8/2016 3:04:38 PM (GMT-6)