Men diagnosed with prostate cancer are less likely to die from the disease than from largely preventable conditions such as heart disease. A new study from Harvard School of Public Health which looks at causes of death among men with prostate cancer suggests that encouraging healthy lifestyle changes should play an important role in prostate cancer management.

Mara Epstein, a postdoctoral researcher at Harvard School of Public Health and colleagues hope that 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. The study was published July 25, 2012 in the Advance Access online Journal of the National Cancer Institute.

Prostate Cancer Incidence
Prostate cancer is the most frequently diagnosed form of cancer, affecting one in six men during their lifetime. While incidence of prostate cancer has greatly increased in Western countries in recent decades, the likelihood that a newly diagnosed man in these countries will die from the disease has declined. The researchers attribute this to the widespread use of the prostate-specific antigen (PSA) test, which has resulted in a higher proportion of men diagnosed with lower-risk forms of the disease.

Temporal trends
The researchers examined causes of death among prostate cancer cases recorded in the USA Surveillance, Epidemiology, and End Results Program (over 490,000 men from 1973 to 2008) and the nationwide Swedish Cancer and Cause of Death registries (over 210,000 men from 1961 to 2008).

The results showed that during the study period, prostate cancer accounted for 52% of all reported deaths in Sweden and 30% of reported deaths in the United States among men with prostate cancer; however, only 35% of Swedish men and 16% of USA men diagnosed with prostate cancer died from this disease. In both populations, the risk of prostate cancer-specific death declined, while the risk of death from heart disease and non-prostate cancer remained constant. The five-year cumulative incidence of death from prostate cancer was 29% in Sweden and 11% in the United States.

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Death rates from prostate cancer varied by age and calendar year of diagnosis, with the highest number of deaths from the disease among men diagnosed at older ages and those diagnosed in the earlier years of the surveys, especially in the years before the introduction of PSA screening.

Lifestyle changes
According to senior author Hans-Olov Adami, professor of epidemiology at Harvard School of Public Health, this study shows that lifestyle changes such as losing weight, increasing physical activity, and quitting smoking, may have a greater impact on patients’ survival than the treatment they receive for their prostate cancer.

For more information:
Epstein MM, Edgren G, Rider JR, Mucci LA, Adami HO. Temporal Trends in Cause of Death Among Swedish and US Men with Prostate Cancer. JNCI J Natl Cancer Inst(first published online July 25, 2012 doi:10.1093/jnci/djs299)

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