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Background: As androgen deprivation therapy (ADT) becomes a standard of treatment for men with recurrent or metastatic prostate cancer, evaluation of adverse effects associated with this treatment is needed. In this study, the authors evaluated the effect of ADT administered as monotherapy and in combination with local treatment on physical well-being in a longitudinal sample of men with prostate cancer., Methods: Exposure to ADT was defined by 3 groups: local (local treatment only), combination (local treatment with adjuvant and/or neoadjuvant ADT), and primary ADT. Associations between exposure to ADT and physical well-being measured by self-reported health-related quality of life outcomes over time were evaluated by repeated measures analysis using mixed modeling. Estimates adjusted for various clinical and demographic variables are reported., Results: A total of 2922 men, who completed both pretreatment and follow-up health-related quality of life assessment, were identified from the CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) registry. During 24 months of follow-up, exposure to ADT was associated with worse physical well-being compared with local treatment at all time points (P < .001). Being exposed to ADT as primary therapy was associated with more severe declines compared with combination therapy., Conclusions: The potential consequence of decline in physical well-being in patients exposed to ADT has to be included in treatment decision making., (Copyright © 2011 American Cancer Society.)

Background: Prostate carcinoma is one of the leading causes of death in men. Although the mortality rate is high, it still may underestimate the number of deaths associated with the disease. This study was conducted to compare causes of death among men previously diagnosed with prostate carcinoma and to examine the extent to which differences in cause of death (death from prostate carcinoma vs. death from other causes) varied by age, race, clinical factors, and comorbid conditions., Methods: A review was conducted of the medical records of decedent members of the Kaiser Permanente Medical Care program who previously were diagnosed with prostate carcinoma between January 1980 and December 1984 (n=584). The review focused on demographic factors, symptoms, diagnostic tests, stage of disease, and treatment. Data on comorbidity were obtained from a computerized discharge summary. Logistic regression analysis was used to estimate odds ratios., Results: Approximately 54% of the decedent prostate carcinoma patients died of their prostate carcinoma. Decedents who were black, age < or = 65 years, diagnosed with more advanced disease stage, recipients of hormonal therapy, and whose death occurred > 6 months after diagnosis were more likely than others to die of prostate carcinoma. In contrast, the likelihood of dying of some other cause was associated with concurrent cardiovascular disease, after adjustment for the effects of race, age, and disease stage. There also were significant two-way age-race and age-time-to-death interactions., Conclusions: The prognostic significance of cardiovascular disease in prostate carcinoma patients should be investigated in subsequent survival studies. A number of questions need to be addressed delineating the complex relations between coexisting diseases and their treatment.

This population-based study presents trends in stage at diagnosis of invasive female breast cancer during the decade from 1978 to 1987 in the Detroit metropolitan area. Its purpose is to determine whether there has been an increase in early breast cancers: those that are smaller than 2 cm at diagnosis and have no axillary lymph node involvement. Trend analyses of tumor size, node status, year of diagnosis, age, and race were performed for 17,216 incident cases drawn from the Metropolitan Detroit Cancer Surveillance System (MDCSS). Although trends toward earlier diagnosis of breast cancer are observed, less improvement is seen for black women than white women in the presentation of breast cancer at smaller, node-free stages. Implications for breast cancer screening are discussed.

A representative community sample of 274 breast cancer (BC) patients from the Metropolitan Detroit Cancer-Surveillance System was studied longitudinally during the year after their BC diagnosis. The adjustment of these patients to their disease was examined in terms of (1) the changes in their physical and mental health functioning; and (2) the factors that predict or facilitate the recovery process, including the independent and interactive effects of age. Comparison of the outcomes at 4 and 10 months after diagnosis manifested a significant and consistent improvement in physical functioning. In contrast, there was an absence of any improvement in indicators of mental health and well-being. Whereas the cross-sectional analyses demonstrated that stage of disease had an impact on physical impairment, the longitudinal analyses revealed that physical impairment at time 1 was the significant predictor of deteriorating mental health at time 2. Furthermore, younger age was shown to exacerbate the impact of impairment on mental health. The more seriously impaired younger patients experienced significantly greater deterioration in their mental health and well-being than similarly impaired older patients. However, older age was found to exacerbate the impact of more extensive surgery on symptoms that produce limitations in activity.

Racial differences in cancer incidence between black and white populations are examined for leading cancer sites by age at diagnosis. The analysis was based on 116,858 incidents, invasive cancer cases occurring between 1973 and 1982 in black and white, male and female residents of the Detroit metropolitan area. Cases were drawn from the population-based Metropolitan Detroit Cancer Surveillance System. The results indicate that racial differences in age-specific incidence rates for many forms of cancer are more pronounced when cancer occurs in early adulthood and middle age (20 to 44 and 45 to 54 years) than in persons aged 65 and over. This is especially the case for male subjects. This may suggest that blacks and whites who survive to their senior years before developing cancer may be more alike in terms of behavior, exposures, or host susceptibility than blacks and whites for whom cancer occurs in early adulthood or middle age. The etiologic and public health implications of these race and age patterns must be considered in greater detail. Future case-control studies should include sufficient numbers of patients in both the youngest and oldest age groups to ensure that black and white differences can be adequately examined by age at diagnosis.