metastatic prostate cancer

Study finds the likely truth about men with metastatic prostate cancer

There’s an old saying many of us are familiar with that states, “Men may die with prostate cancer, but not from it.”  While this commonly repeated statement likely resonates well and is reassuring for any man diagnosed with the disease, it’s only applicable to men whose prostate cancer has been found at an early stage. Men diagnosed with late-stage prostate cancer which has already spread or metastasized to bones for instance are at a greater risk of actually dying from their prostate cancer and not just with it.

This finding is from a recent study published in August 2021 in the JAMA Network Open, which concluded that, unlike the familiar saying, the majority of men with metastatic prostate cancer die from it and not from other possible causes of death.

The research used data from the Surveillance, Epidemiology, and End Results Program (SEER) database from about 26,000 men who had been diagnosed with metastatic prostate cancer.  The data was gathered from these men from January 2000 to December 2016.  Then in 2020, the data was analyzed in which results showed that 64% of the men died during the follow-up period.

The interesting part of the research found that 77.8% of the men who died, the majority died from the disease of prostate cancer. Most of the prostate cancer deaths (59%) happened within 2 years with the 5-year survival rate in the study group was at 26%.

Of the remaining men who died during the follow-up period, 5.5% were from other cancers, and 16.7% succumbed to noncancer causes which included cardiovascular diseases, chronic obstructive pulmonary disease, and cerebrovascular diseases. The cause of death for these men came from each man’s death certificate and what was stated as the primary reason for their death. One caveat of this study was that using information from a death certificate has limited granularity in leaving out certain details that would have been valuable in knowing exactly what each man died from.

Lesson from this study

The majority of men diagnosed with prostate cancer have a nearly 100% survival rate if their cancer is caught still localized or regional.  That means the earlier it is found, the greater chance of beating it back, and most likely they will eventually die from something other than prostate cancer.

However, if prostate cancer is not found until it has already spread beyond the prostate gland and especially into the bones, survival rates plummet and a man’s chance of actually dying from the disease is likely.

The lesson learned from this study is that early intervention of prostate cancer screenings are immensely effective in catching the disease at a more treatable and sustainable stage. Even though prostate cancer is the second leading cancer diagnosed in men (second only to skin cancer) and the second leading cause of cancer death in men (second only to lung cancer), the good news is it has a long-term survival rate when compared to almost all other cancers, but only when found and diagnosed at an early stage.

This supports why men beginning at age 40, should have their first baseline prostate specific antigen (PSA) test and then depending on their personal risk factors, should work with their doctor on the frequency of the test going forward.

Another takeaway from the study was the need for a multidisciplinary team in preventing cardiovascular disease especially when men with prostate cancer are treated with androgen deprivation therapy (ADT). ADT is a common treatment when a man’s prostate cancer has returned and is used to reduce testosterone levels. However, men using ADT have been shown to have an association between cardiotoxic effects of ADT and myocardial infarction, even if they had no prior heart disease history.

It’s important for these men to be followed closely to help mitigate issues of cardiovascular disease increases over time. By helping men with reaching a healthy body weight, choose healthy foods, increase exercise to maintain or increase muscle mass, and treat hyperlipidemia, these lifestyle changes can be a literal lifesaver extending both lifespan and quality of life at the same time.

Dr. David Samadi | Robotic Prostate Surgeon

About is a resource created by Dr. David Samadi in order to raise awareness and get more men to receive prostate cancer treatment. The information is strictly general and you should always discuss with your doctor issues concerning your health.


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