News Release

Only a small proportion of low-risk prostate cancers will progress to life-threatening disease

Peer-Reviewed Publication

The Lancet_DELETED

The disparity between reported incidence and mortality rates leads to the probable conclusion that only a small proportion of diagnosed low-risk prostate cancers will progress to life-threatening disease during the lifetime of the patient. This and other issues are discussed in a Seminar in this week’s edition of The Lancet, written by Professor Jan-Erik Damber and Dr Gunnar Aus, Sahlgrenska University Hospital, Gothenburg, Sweden.

The authors say: “In developed countries, prostate cancer is the second most frequently diagnosed cancer, and the third most common cause of death from cancer in men.” Prostate cancer is clinically diagnosed as local or advanced, with treatments ranging from surveillance to radical local treatment or androgen-deprivation* treatment. Androgen deprivation reduces symptoms in about 70-80% of patients with advanced prostate cancer, but most tumours relapse within two years to an incurable androgen-independent state.

Recorded incidence of prostate cancer has substantially increased in the past two decades, probably because of the introduction of screening with prostate-specific antigen**, the use improved biopsy techniques for diagnosis, and increased public awareness. Trends in mortality from the disease are less clearcut. Mortality has not gone up as much as incidence, and in some countries mortality has been stable or even decreased – with this disparity leading to the conclusion that only a small proportion of diagnosed low-risk prostate cancers will progress to life-threatening disease during the lifetime of the patient.

The authors conclude: “The main difficulty that clinicians face is the large number of men diagnosed with early stage disease, of whom a small proportion will have disease progression and eventually die from prostate cancer if not treated. Such progression could be a result of future random mutations in the tumour; in that scenario, indolent tumours could not be distinguished from aggressive tumours at the time of diagnosis. Alternatively, as yet undiscovered markers of aggressiveness might be already present early in the course of the disease.”

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Notes to editors: *Androgen deprivation = Hormonal therapy for prostate cancer, can be referred to as ‘castrational therapy’

**prostate-specific antigen: A tumour ‘marker’ – that is, something which indicates the presence of a tumour

Professor Jan-Erik Damber, Sahlgrenska University Hospital, Gothenburg, Sweden T) +46 70 322 76 91 E) jan-erik.damber@urology.gu.se

http://multimedia.thelancet.com/pdf/press/prostatecancer.pdf


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