Prostate Cancer Diagnosis May Bring Suicide, Heart Risks

Prostate Care Abroad

While men receiving a prostate cancer diagnosis abroad may react similarly to men in the United States, it's not clear how applicable this study would be, given differences in screening and treatments between the United States and Sweden.

For example, given that men in Sweden tend to be screened less, their disease is sometimes caught in later stages, making it more likely that hormonal therapy will be necessary, and the resultant side effects may create more anxiety.

"We're pursuing that actively, looking at the U.S. statistics," said Stampfer, although he said that data available for the United States is not as clear as that available in Sweden, and so doing a similar study would prove difficult. However, he said, "It looks like the overall, broad pattern would be similar in the U.S."

Stampfer said he was encouraged by the fact that men in later years of the study were less likely to suffer heart problems following a diagnosis of prostate cancer.

"In more recent times, the public has gotten more sophisticated, better information and realizes a cancer diagnosis is not a death sentence," he said. "It no longer carries as much of that horrible sense of doom that it used to."

Prostate Cancer Diagnosis: Finding Trouble

But the drop in heart risks may mean problems in the study.

Dr. Nortin Hadler, a professor of medicine and microbiology/immunology at the University of North Carolina said that given the lack of screening in Sweden, it's possible that the increase in heart disease is because that was why patients were coming to the doctor in the first place.

He explained that patients getting a prostate test were likely to be at the doctor's office for another reason, and in later years, with more awareness of prostate cancer, that effect was lessened.

"We don't know why these particular individuals who are diagnosed with prostate cancer decided to get the diagnosis," Hadler said. "The answer may be that something else brought them to the doctor, and as part of the doctor's approach ... they did a much more general exam."

But others said that possibility did not confound the study.

"The suicide portion of it verifies an American study that was done several years ago," said Dr. Otis Brawley of the American Cancer Society. Suicide and heart risks are part of what physicians need to discuss with patients before prostate screening, he said.

A Finding With Unclear Meanings

"Although it's an important cause of death, most men who get prostate cancer don't die of it, and I think that knowledge is becoming more and more widespread," Stampfer said. "That was the initial motivation for our study, to explore further what the potential impact a diagnosis of cancer might bring."

Of course, not all diagnoses of cancer are even correct.

While focusing on men with prostate cancer, the study also casts some light on the perils of false positives resulting from increased cancer screening.

The topic of screening's possible perils drew headlines last month when a government task force suggested that mammograms may be unnecessary for younger women at a lower risk of breast cancer. Similar discussions are taking place, albeit less publicly, about other forms of cancer.

"Most of the controversy relies on whether the screening advances the people who were screened," Hadler said.

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