Fifteen Year Survival in Prostate Cancer

According to JAMA (Journal of American Medical Association) Feb 12, 1997

Patients

A group of 642 patients with prostate cancer of any stage, consecutively diagnosed between 1977 and 1984 at a mean age of 72 years with complete follow-up to 1994.

Main Outcome Measures

Proportion of patients who died from prostate cancer, and 15-year survival (with 95% confidence interval [CI]), corrected for causes of death other than prostate cancer.

Conclusion

Patients with localized prostate cancer have a favorable outlook while following watchful waiting, and the number of deaths potentially avoidable by radical initial treatment is limited. Without reliable prognostic indicators, an aggressive approach to all patients with early disease would entail substantial over treatment. In contrast, patients with locally advanced or metastatic disease need trials of aggressive therapy to improve their poor prognosis.

Study finds that Watchful Waiting is a viable option for Prostate Cancer Patients with low-risk tumors.

-Science Daily Article Aug 31, 2009

"These findings showed that men diagnosed with low-risk tumors who deferred treatment were still doing fine an average of eight years and up to 20 years following their diagnosis."

"Only half of these men wound up undergoing any treatment 10 to 15 years post-diagnosis," says Dr. Martin Sanda.

"This means that they were able to avoid the disruption in their quality of life which might have occurred had they undergone immediate treatment."

"If this approach was more broadly accepted as a standard care option for suitable low-risk prostate cancers, it might help us avoid throwing the baby out with the bathwater when it comes to the PSA test," he adds. "Instead of just abandoning the PSA test because it might be leading to an overdiagnosis of prostate cancer, we could conduct PSA screening in a way that allows more aggressive prostate cancers to be treated, and at the same time avoiding "overdiagnosis" of slow growing, while less aggressive, low risk tumors. Thus preserving the lifesaving benefits of treating aggressive cancers that have been detected through PSA testing."

Over diagnosis Since Introduction Of Prostate Cancer Screening

-Science Daily (Sep. 14, 2009)

"Given the considerable time that has passed since PSA screening began, most of this excess incidence must represent overdiagnosis," the authors write. "All overdiagnosed patients are needlessly exposed to the hassle factors of obtaining treatment, the financial implications of the diagnosis, and the anxieties associated with becoming a cancer patient…"

The increased diagnosis has been most dramatic among younger men: more than tripling since 1986 in men aged 50-59 (from 58.4 to 212.7 per 100, 000) and more than a sevenfold increase in men under age 50 (from 1.3 to 9.4 per 100,000).

Using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program, H. Gilbert Welch, M.D., MPH, of the White River Junction VA and The Dartmouth Institute for Health Policy & Clinical Practice., and Peter C. Albertsen, M.D., of the University of Connecticut, examined age-specific prostate cancer incidence rates to determine the excess (or deficit) in the number of American men diagnosed and treated in each year after 1986.

The following study findings are published in the September issue of the Journal of Urology.

PSA screening was introduced in 1987. A study by Dr. Dean Ornish and his colleagues found of 93 men studied, who had been diagnosed early with Prostate Cancer opted not to immediately seek a treatment decision. Rather they chose to closely monitor their tumors.

"Diet, exercise, and reduced stress, has shown to slow the growth of Prostate Cancer"

Half the men adopted a regimen that included a vegan diet, primarily fruits, vegetables, whole grains and legumes but no meat, eggs or dairy products supplemented with soy, vitamins and minerals. That same group of men also started moderate aerobic exercise, such as walking 30 minutes six days a week; participated in a one-hour support group meeting once a week; and began using stress-management techniques, such as yoga, breathing exercises and meditation for an hour a day .

After one year, the researchers found that psa levels (a protein marker for prostate  cancer) decreased in men in the group who made comprehensive lifestyle changes but increased in the comparison group. There was a direct correlation between the degree of lifestyle change and the changes in PSA. Also, they found that serum from the participants inhibited prostate tumor growth in vitro by 70 percent in the lifestyle-change group but only 9 percent in the comparison group. Again, there was a direct correlation between the degree of lifestyle change and the inhibition of prostate tumor growth.

Participants in the lifestyle-change group were placed on a vegan diet consisting primarily of fruits, vegetables, whole grains, and legumes supplemented with soy, vitamins and minerals. They participated in moderate aerobic exercise, yoga/meditation, and a weekly support group session. A registered dietitian was available for consultation, and a nurse case manager contacted the participants once a week for the first three months and weekly thereafter.