Men with prostate cancer are far more likely to die from other causes, according to new research that suggests treatment should emphasize healthy lifestyle changes and not aggressive therapy designed to “cure” patients.
The new study, out of the Harvard School of Public Health, found prostate cancer patients most often die from other largely preventable conditions such as heart disease.
The research, published in the Journal of the National Cancer Institute, is the largest study to date to examine causes of death among men with prostate cancer, and suggests that care aimed at improving and maintaining quality of life be a top priority in prostate cancer management.
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"Our results are relevant for several million men living with prostate cancer in the United States," said lead researcher Mara Epstein. "We hope this study will encourage physicians to use a prostate cancer diagnosis as a teachable moment to encourage a healthier lifestyle, which could improve the overall health of men with prostate cancer, increasing both the duration and quality of their life."
Prostate cancer is the most common form of cancer, affecting one in six men during their lifetime. While incidence of prostate cancer has greatly increased in the United States and other nations in recent decades, studies show the likelihood that a newly diagnosed man will die from the disease has declined. The researchers said this is due to the widespread use of the prostate-specific antigen (PSA) test resulting in a higher proportion of men diagnosed with lower-risk forms of the disease.
For the new study, researchers examined causes of death among more than 490,000 American prostate cancer patients between 1973 and 2008 and another 210,000 Swedish cancer cases since 1961.
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The findings indicated just 35 percent of Swedish men and 16 percent of U.S. men diagnosed with prostate cancer actually died from this disease. In both populations, the risk of prostate cancer-related death declined, while the risk of death from heart disease and non-prostate cancer remained constant.
The highest number of deaths from the disease was among men diagnosed at older ages and those diagnosed in the earlier years of the surveys (before PSA screening was available).
"Our study shows that lifestyle changes such as losing weight, increasing physical activity, and quitting smoking, may indeed have a greater impact on patients' survival than the treatment they receive for their prostate cancer," said researcher Hans-Olov Adami.