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Prostate cancer statistics can appear alarming, with projections estimating 34,250 deaths in the U.S. for 2024 and around 1.4 million new diagnoses globally in 2022.
Dr. Bruce Montgomery, an oncologist with UW Medicine, aims to shift the narrative surrounding these figures so that patients do not respond with fear or despair.
“Receiving a prostate cancer diagnosis does not equate to a definitive prognosis,” said Montgomery, the primary author of a recent literature review published in JAMA. He holds the positions of clinical director of Genitourinary Oncology at Fred Hutch Cancer Center and University of Washington Medical Center, along with being a professor of medicine and urology at the UW School of Medicine.
He urges patients to engage openly with their primary-care physicians regarding prostate cancer and for healthcare providers to proactively discuss screening options.
“Understanding the presence and aggressiveness of prostate cancer can be pivotal. Not all forms of cancer necessitate immediate treatment,” he stated. “In many cases, monitoring through active surveillance may be a viable option.”
A recent study from 2024, coauthored by Dr. Daniel Lin, a urologist at UW Medicine, highlighted the effectiveness of active surveillance, revealing that just 0.1% of men who chose this route succumbed to prostate cancer over a decade.
“It’s important to acknowledge that prostate cancer encompasses various forms,” Montgomery remarked. “As a healthcare provider, tailoring your approach to match the individual patient’s condition is essential.”
For instance, if a 50-year-old man is diagnosed with localized prostate cancer, more intensive treatment might be warranted. Conversely, if an 80-year-old develops a slow-progressing form of the disease, the therapeutic conversation would likely differ significantly.
“I have encountered older patients, in their 80s, who choose not to pursue therapy,” he observed. “They understand that treatments, like radiation, can severely affect their quality of life, leading them to decline such options.”
As their physician, he emphasized the need to honor their decision.
“However, for a 50-year-old confronted with the potential complications of prostate cancer, it’s generally advisable to consider treatment despite the associated side effects,” he noted.
Advancements in therapies for advanced prostate cancer have also seen substantial progress, significantly enhancing the survival rates for men whose cancer has metastasized.
“Treating metastatic prostate cancer is critical, and research from the last two decades has greatly improved outcomes,” he stated. “Determining the necessity and timing of treatment involves both expertise and careful judgment.”
The review addressed essential information that men and their healthcare providers should be aware of, such as:
- Globally, approximately 1.5 million new prostate cancer cases are diagnosed each year.
- About 75% of these cases are identified while the cancer remains localized within the prostate, with early detection linked to a five-year survival rate nearing 100%.
- Management strategies range from active surveillance to surgical removal of the prostate (prostatectomy) and radiation therapy, contingent on the risk of cancer progression.
- Approximately 10% of prostate cancer diagnoses occur after the disease has spread, associated with a five-year survival rate of 37%.
- Adenocarcinoma, originating in gland cells, is the most prevalent type of prostate cancer, with a median diagnosis age of 67 years.
- Over 50% of prostate cancer risk is attributed to genetic predispositions and advancing age.
Prostate cancer gained notable visibility in public discussions last year when well-known travel writer Rick Steves disclosed his diagnosis. Recently, he announced on his X account (formerly Twitter) that following treatment at UW Medicine and Fred Hutch, he is now cancer-free.
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