Incidence of metastatic prostate cancer rates almost double - Dr. David B. Samadi

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Incidence of metastatic prostate cancer rates almost double

A new study from Northwestern University Feinberg School of Medicine sounds the alarm on finding almost double the rate of metastatic prostate cancer – cancer that has spread beyond the place it started - in men aged 55 to 69 since 2004. Between the years 2004 to 2013 the number of new cases of prostate cancer that had metastasized rose by a steep 72 percent within that age group while all other age groups showed a statistically significant increased incidence of metastatic prostate cancer.

“This is exactly what we don’t want to see occur – rising numbers of men diagnosed with advanced prostate cancer that could have been caught much earlier before it had spread,” said Dr. David Samadi. “I’m a firm believer of starting prostate cancer screenings at age 40 to help prevent this sort of thing from happening.”

While metastatic prostate cancer is rare, the rise shown in this study does cause some concern. Since 2012 when the U.S. Preventive Services Task Force (USPSTF) advocated against the prostate specific antigen (PSA) blood test to screen healthy men for prostate cancer, there have been declines in the overall incidence of the disease. The USPSTF reasoning for waiting to screen men until age 50 instead of age 40 was based on too many PSA tests resulting in the detection of many cases of asymptomatic prostate cancer that are slow growing and didn’t need aggressive treatment. It was believed there was more harm from potential side effects such as impotence to incontinence than from small potential benefits.

The researchers wanted to determine if the relaxed screenings had led to changes in the numbers of advanced and metastatic prostate cancer at the time of diagnosis. This was done by identifying all men diagnosed with prostate cancer (767,550) in the National Cancer Data Base (2004-2013) at 1,089 different healthcare facilities in the United States.

It was found that out of the 767,550 men only 3 percent had metastases at diagnosis which was some good news out of the study.

The American Cancer Society released a statement questioning the manner in which the study was conducted. One factor they attributed for the change in the rising numbers of metastatic cancer cases was due to a growing and aging population.

Each year in the United States, around 240,000 men are diagnosed with prostate cancer with 30,000 who will succumb to the disease. Prostate cancer that has spread from the prostate into other areas of the body is much harder to treat and usually is not curable.

“My concern has always been that starting PSA screenings at age 50, like the task force now recommends, will result in younger men who have the disease will not get a diagnosis until they are older and the cancer has advanced and possibly spread,” added Dr. Samadi. “Once cancer has spread and is no longer localized within the prostate gland, it becomes a different story for these men. Why take that chance? It is better to be more cautious by getting PSA screenings starting at age 40 along with rectal exams saving more lives over time.”

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