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Rare types of prostate cancer - some short survival, some long survival


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Jim Marshall (not a doctor) said ...

  • Looking at the genes in prostate cancer cells has revealed that there are several types of prostate cancer.
  • The rare types listed below are not found that way.
  • The rare types listed below are classified by where they happen, or what they look like under a microscope.
  • For example - ductal: found in ducts; mucinous: with a lot of mucus.

Just being rare does not make them rapid - some are (neuroendocrine - 10 months average survival with only 1 man in 8 alive after 5 years) some aren't (mucinous - 10 years average survival with 3 men out of 4 alive after 5 years).

Note: Tony Brown has brought to out attention the controversy about intraduct prostate cancer in the Australian Financial Review.

Click

Prostate cancer villain unmasked

Intraduct prostate cancer and ductal prostate cancer are not the same.

If you are keen to know the difference, click:

Biopsy diagnosis of intraductal carcinoma is prognostic in intermediate and high risk prostate cancer patients treated by radiotherapy, by Theo Van der Kwast, Najla Al Daoud, and Robert G. Bristow

To see this article on another site (UroToday) you may have to subscribe to that site. Subscribing is often free.

... end Jim

Prostate Cancer and Prostatic Diseases (2012) 15, 283–288; doi:10.1038/pcan.2012.4; published online 21 February 2012

A comprehensive review of incidence and survival in patients with rare histological variants of prostate cancer in the United States from 1973 to 2008

D M Marcus1,2, M Goodman3, A B Jani1,2,4, A O Osunkoya2,4,5 and P J Rossi1,2

1Departments of Radiation Oncology, Emory University, Atlanta, GA, USA

2Winship Cancer Institute, Emory University, Atlanta, GA, USA

3Department of Epidemiology at Rollins School of Public Health, Emory University, Atlanta, GA, USA

4Department of Urology, Emory University, Atlanta, GA, USA

5Department of Pathology, Emory University, Atlanta, GA, USA

Correspondence: Dr DM Marcus, Department of Radiation Oncology, Emory University, 1365 Clifton Rd. NE, Suite A1300, Atlanta, GA 30322, USA. E-mail: dmarcus@emory.edu

Received 6 December 2011; Revised 19 December 2011; Accepted 5 January 2012

Advance online publication 21 February 2012

Abstract

Background:

The American Joint Commission on Cancer (AJCC) identifies five rare variants of prostate adenocarcinoma: mucinous, ductal, signet ring cell, adenosquamous and neuroendocrine including small cell. No prior study has comprehensively detailed incidence and outcomes for all AJCC variants of prostate cancer.

Methods:

We used the Surveillance, Epidemiology and End Results (SEER) program to analyze prostate cancers diagnosed from 1973 to 2008. Cases of mucinous, ductal, signet ring cell, adenosquamous and neuroendocrine carcinoma were identified, along with cases of non-variant adenocarcinoma for comparison. Age-adjusted incidence rates (IRs) and overall survival (OS) were evaluated and stratified by race, age, stage and PSA. All IRs represent the number of cases per million people per year.

Results:

Each variant is rare, with IRs between 0.03 (adenosquamous) and 0.61 (mucinous). There was a significant difference in incidence between Caucasian and African American patients with mucinous adenocarcinoma. Median OS varied ranged from 10.0 months in neuroendocrine carcinoma to 125.0 months in mucinous adenocarcinoma. In all, 5-year OS ranged from 12.6% in neuroendocrine carcinoma to 75.1% in mucinous adenocarcinoma. There was a significant difference in survival between Caucasian and African American patients for mucinous adenocarcinoma (median survival 144.0 vs 99.0 months, P<0.01). African American patients with mucinous adenocarcinoma also presented with more advanced stage disease compared with Caucasian patients. Multivariate analysis demonstrated that African American race was not associated with worse survival when corrected for stage.

Conclusions:

There are differences in IRs and OS among rare variants of prostate cancer. For mucinous adenocarcinoma, there are significant differences in incidence and survival between Caucasian and African American patients. These differences should be considered in clinical decision making for patients with these malignancies.

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