Last Updated: 2005-02-11 12:58:48 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In the PSA screening era, mortality rates
among most men diagnosed with prostate cancer in the United States are
no higher than those in the general population, a new analysis shows.
"The bottom line is that most men diagnosed with the disease today can
expect to live as long as, or longer than, men their age without the
disease," two editorialists comment.
The value of prostate specific antigen (PSA) screening in reducing
prostate cancer mortality is still in question, Dr. Hermann Brenner and
Dr. Volker Arndt of the German Center for Research on Aging in
Heidelberg write in the Journal of Clinical Oncology for January 20.
Widespread use of the PSA test in the US since the late 1980s means many
more men are living with a diagnosis of prostate cancer, the team points
out.
They used "the recently introduced period analysis methodology" to
evaluate 5- and 10-year survival rates for 183,484 men diagnosed with
prostate cancer between 1990 and 2000 included in the Surveillance,
Epidemiology and End Results Program (SEER) database.
Overall, relative 5-year survival rates for prostate cancer patients
were 99%, and 10-year survival rates were 95%, Drs. Brenner and Arndt
found. "That is, excess mortality compared with the general population
was as low as 1% and 5% within 5 and 10 years following diagnosis,
respectively," they explain.
For the two- thirds of men who had well or moderately differentiated
localized or regional prostate cancer, there was no excess mortality at
all.
The researchers note that it is possible that earlier diagnosis might
not in itself mean longer survival, but could indicate "mere
prolongation of the 'patient career' by advancement in diagnosis." The
question of whether PSA screening does in fact reduce mortality from
prostate cancer must be answered by large-scale clinical trials, which
are currently underway, they add.
In an accompanying editorial, Dr. George Wilding and Patrick Remington
of the Comprehensive Cancer Center at the University of Wisconsin in
Madison write: "Given the many uncertainties about this disease, this
information alone will be helpful for clinicians and their patients when
discussing treatment options and when considering what life will be like
living as a prostate cancer survivor."

J Clin Oncol 2005;23:441-447.

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc