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Comment by not_the_fda | Hacker News Reader

You die with prostate cancer, not from it. It has a 95% survival rate.

About 40 years ago my father, an oncologist, told me there were two common types of prostate cancer, the fast growing type that kills you and the slow growing type that doesn't. We've learned a lot about it since then, but that description is still essentially true.

It causes 30,000 deaths a year in the US, which is not insignificant - in comparison breast cancer kills 40,000.

Yes, the absolute number of deaths is significant. There is a debate within the medical community over whether the slower growing type should be relabeled as not-cancer / pre-cancer, etc., as surveillance is the more typical treatment plan these days. This in turn will increase the death rate percentage of the remaining (fast growing) cases.

Also worth mentioning that it's not just about surviving it, there's also quality of life. The earlier you catch it the better the outcome.

Does the slow growing type cause any quality of life loss?

If it doesn't escape the prostate, a tumor could potentially impinge on the urethra causing urinary difficulty. There is a benign version of this called BPH and it may be treatable by medications like Flowmax.

But it's not like we can always know it will stay slow growing forever. Some cancers can suddenly become aggressive and metastasize, so careful monitoring is important.

Plus a large percentage of men (like 1 in 8 in the US) eventually get it, it’s just that men often keel over before that happens. If men live longer, percentage will naturally increase

IIRC there was also some news a while back (pre-covid era) on the massive funding discrepancy between research into the two. Hopefully not the case any more.

Let's say you undergo medical procedures to cure it, (chemo, surgery, etc.) and end up dying from a complication from it. Does that still count as a prostate cancer death (the 5%)?

This is so very rare that I doubt it would move that statistic.

100k a year doesn’t seem rare

https://ihpi.umich.edu/news/ihpi-briefs/FTR

That’s for all surgeries as a whole, not prostate cancer treatments.

Coroners will list immediate, intermediate, and underlying (proximate) cause of death. In that case the immediate cause of death would be say sepsis after surgery, but the proximate cause of death is the cancer. If you are looking at cause-specific mortality I think you do include proximate causes even if it isn't the immediate cause. But like the other commenter said, I think this is factor is so small as to not be impactful.

It depends on the specific flavor of prostate flavor one has. It can be aggressive, but it can also be one of the most passive cancers out there.

My grandfather lived 20 years after he was diagnosed for prostate cancer, eventually the cancer metastasized and took him away but he did live until early he was in his 80s at which point he survived my father. It is possible that having his son die within his lifetime had something to do with his demise and he could’ve lived more in other circumstances.

I wouldn’t be thrilled to fly in a plane if it had a 5% chance to kill me.

You should multiply this 5% with the probability you have prostate cancer.

But if random chance forced you to become a plane user against your will, you wouldn't treat it like it's half a death sentence.

And it's 5% spread across every trip you take for the rest of your life.

Its a matter of where we spend dollars. Given a finite number of dollars, do you spend it curing prostate cancer with a 95% survival rate, or do you spend it curing colon cancer with a 57% survival rate?

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