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Effect of Age, Tumor Risk, and Comorbidity on Prostate Cancer Survival FREE

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The full report is titled “Effect of Age, Tumor Risk, and Comorbidity on Competing Risks for Survival in a U.S. Population–Based Cohort of Men With Prostate Cancer.” It is in the 21 May 2013 issue of Annals of Internal Medicine (volume 158, pages 709-717). The authors are T.J. Daskivich, K.H. Fan, T. Koyama, P.C. Albertsen, M. Goodman, A.S. Hamilton, R.M. Hoffman, J.L. Stanford, A.M. Stroup, M.S. Litwin, and D.F. Penson.

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

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Ann Intern Med. 2013;158(10):I-11. doi:10.7326/0003-4819-158-10-201305210-00001
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What is the problem and what is known about it so far?

It can be difficult to decide whether men diagnosed with prostate cancer will benefit from treatment because many will ultimately die of other medical issues. Knowing more about the survival of men with prostate cancer and other medical issues might help.

Why did the researchers do this particular study?

To see whether the survival of men with prostate cancer differed according to the presence and number of other medical problems.

Who was studied?

3183 men with prostate cancer that had not spread when the study began.

How was the study done?

The researchers used information that had been collected in a large study of men with prostate cancer. Within 6 months of diagnosis, the men completed a survey on which they indicated whether they had other medical problems (such as lung or heart disease). Their medical records were also reviewed to find details about the prostate cancer and its treatment. The researchers followed the men in the study and evaluated relationships among other diseases that were present; what kind of treatment was given; and whether the men died and, if so, whether they died of prostate cancer or something else.

What did the researchers find?

The greater the number of other medical problems reported on the survey, the greater the chance that the men later died of something other than prostate cancer. The increase in the chance of dying of another medical problem became greater the older the men were. For example, the chance of dying of something other than prostate cancer within 10 years was 26% for men younger than 60 years with 3 or more of the other medical problems assessed and 71% for men older than 75 years with the same number of other medical problems. Men with no or few medical problems who received aggressive prostate cancer treatment (such as surgery or radiation) seemed less likely to die of the disease than those who received less aggressive treatment (such as antihormone treatment). This was not the case in men with a greater number of other medical problems.

What were the limitations of the study?

The researchers could not confirm whether the other medical problems were actually present. The treatments that the men received were probably influenced by personal preferences and other issues that could not be measured and factored into the researchers' analyses.

What are the implications of the study?

Men with prostate cancer should discuss with their physicians whether their other medical problems are important when deciding whether they will benefit from prostate cancer treatment.





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