A recent study of 300 men over 60 who had died of causes other than prostate cancer found that half of them had tumors in their prostate glands, a finding that doesn’t surprise Dr. David Samadi, vice chairman of the Department of Urology and chief of Robotics and Minimally Invasive Surgery at the Mount Sinai School of Medicine in New York City.
“If every 80-year-old man that walks into my office right now — if we biopsied every one of them — half of those guys are going to have prostate cancer, but it’s the type of prostate cancer that’s slow-growing cancer and not going to hurt them,” he tells “The Steve Malzberg Show” on Newsmax.com.
“Ten minutes ago I saw a gentleman — 42-year-old — with prostate cancer,” he continued. “He has 30 years ahead of him, so case by case, different patients, different type of prostate cancers have to be treated different. When you get to the age of 75 or 80, we’re not going to be very aggressive because you will die with that cancer but not from it.”
Doctors have long struggled with trying not to overtreat slow-growing prostate cancer, which can lead to incontinence and impotence, and undertreat more aggressive malignancies. Current screening methods — the prostate-specific antigen blood test, digital rectal exams, and prostate biopsies — cannot necessarily differentiate between those cancers that will kill and those that will be slow-growing and non-life-threatening.
According to Dr. Samadi, that is where age can play a role.
“The big message is not every prostate cancer is the same,” he says. “Some are slow-growing, some are more aggressive. So we got to take it patient by patient. But in general, once you pass over the age of 75 … you’re not going to die from this.”
In the United States, 230,000 men are expected to be diagnosed with prostate cancer this year, but fewer than 30,000 will die from it, according to the American Cancer Society.
Authors of the study of prostate cancer and older men, which was published this month in the Journal of the National Institute of Cancer, put overall lifetime risk of prostate cancer for men at 17 percent and risk of dying from the disease at 3.4 percent.
Dr. Samadi emphasized the need for men to have annual PSA tests and digital rectal exams and to have regular conversations with their doctors about their individual risk.
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