New findings presented at The European Cancer Conference, show that US prostate cancer mortality rates, which had been increasing slowly during the 1970s and 1980s, suddenly started to fall rapidly during the 1990s. Between 1990 and 2000, US prostate cancer mortality fell by one third at ages 50-74, and it fell by one quarter at ages 75-84. Definite decreases are also beginning to be seen in the UK, France and some other European countries.
Early detection, prompt surgery and hormonal treatments are all contributing, according to Professor Sir Richard Peto, from the University of Oxford, UK.
He said: "Both in the US and in the UK, the mortality rates from prostate cancer are now falling fast: two of the main reasons are earlier diagnosis and wide use of hormonal treatments."
Otilia Dalesio, co-ordinator of the Prostate Cancer Trialists' Collaborative Group, commented: "For prostate cancer, as for breast cancer, early diagnosis and immediate hormonal treatment can improve 10-year survival."
Even after successful surgery, a few cancer cells may remain undetected nearby (where they can often be controlled by radiotherapy) or in distant parts of the body (where they cannot, and may eventually get out of control and cause death). One way of controlling distant fragments of prostate cancer is by hormonal therapy, which prevents the fragments from being stimulated into becoming more malignant and dangerous by the body's own sex hormones.
Randomised trials have shown that, following successful surgery, a few years of hormonal treatment substantially reduces the 10-year risk of death from prostate cancer.
The most widely used hormonal treatment for prostate cancer has been surgical castration (removing the testes, which produce the male sex hormone testosterone), but anti-hormonal drugs for prostate cancer are now available that can be used instead of castration.