Thursday, May 10, 2018

Talking prostates

In the last couple of years, there has been a sudden outbreak of people I know (including three that I am related to) who have had prostate problems - three cases of prostate cancer with surgical prostate removal, one case of some sort of prostate problem that still required surgery.  Admittedly, these are (with one exception) all in men who are about 6 - 7 years older than me, but it does tend to give one the gloomy feeling that such an unpleasant, and medically controversial, disease is likely looking to hit me too.   (I mean, the way every site assures us that virtually all men over 80 who haven't had it removed die with some form of prostate cancer cells helps give that impression too.)

But what are the figures for the number of men who do need to end up having the operation?

A review article from 2008 perhaps gives reason to feel a bit less foreboding:
The probability of developing prostate cancer increases from 0.005% in men younger than 39 years to 2.2% in men between 40 and 59 years and 13.7% in men between 60 and 79 years.57 The current lifetime risk of developing prostate cancer is 16.7% (1 in 6 men). The probability of developing histological evidence of prostate cancer is even higher. Carter and colleagues8 showed that 50% of men between 70 and 80 years of age showed histological evidence of malignancy. A lifetime risk of 42% for developing histological evidence of prostate cancer in 50-year-old men has been calculated.8,9 In men at this age, however, the risk of developing clinically significant disease is only 9.5%, and the risk of dying from prostate cancer is only 2.9%.9
Doesn't actually tell me how many have the operation, but still...

A more recent article notes:
Worldwide, more than 1 million men are diagnosed with prostate cancer each year and more than 300,000 die of the disease1. Current U.S. statistics show that either 1 in 5 or 1 in 6 men will be diagnosed with prostate cancer during their lifetime. With such a high incidence, should we be alarmed? What is a reasonable response to a risk of cancer as high as 1:5?
 One in five is pretty high, I guess - but the odds are still in favour of not ever getting a diagnosis.

But - yes, I have a brother who had it, so that makes things worse for me, risk wise:
  • Men with a brother who had prostate cancer had twice as high a risk of being diagnosed as the general population. They had about a 30% risk of being diagnosed before age 75, compared with about 13% among men with no family history.
  • Men with a brother who had prostate cancer had about a 9% risk of getting an aggressive type of prostate cancer by age 75, compared with about 5% among other men.
 Well, the odds are still in my favour of not getting it by 75.  

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