Background of the Prostate Cancer Outcomes Study

Prostate cancer is the single most common form of non-skin cancer in men in the United States. In the year 2002 alone, an estimated 189,000 men will be diagnosed with prostate cancer, and some 30,200 will die of the disease. Prostate cancer exacts a particularly high toll on African-American men: mortality rates in African-American men are more than twice as high as rates in White men.

One of the problems facing prostate cancer patients is the uncertainty of many issues surrounding the management of the disease. It is not known, for example, if the potential benefits of prostate cancer screening outweigh the risks, if surgery is better than radiation, or if treatment is better than no treatment in some cases.

Decisions about treatments for prostate cancer are difficult to make. One problem is that it is difficult for the physician to predict whether the tumor will grow slowly with no health consequences to the patient or will grow quickly and become life-threatening. Also, there are no randomized trials that compare the relative benefits of treating early-stage patients with radiation therapy, radical prostatectomy (surgical removal of the entire prostate gland along with nearby tissues), or watchful waiting (following the patient closely and postponing aggressive therapy unless symptoms of disease progress). About 80% of men diagnosed with prostate cancer have early-stage disease.

In spite of all these uncertainties, it is known that specific treatments (radiation therapy, radical prostatectomy, and hormonal therapies) can have detrimental effects on urinary, bowel, and sexual functions. By collecting comprehensive data on the health outcomes of various treatments for prostate cancer, the PCOS will help men, their families, and physicians make decisions about treatment options.