When men are initially diagnosed with localized prostate cancer, they face numerous management options — including watchful waiting and active surveillance under appropriate circumstances. In general, physicians tend to recommend treatment if the patient’s reasonable life expectancy is 10 years or more. However, the accurate estimation of reasonable life expectancy can be problematic.
Mohan et al. have reported data from a pilot study of the usefulness of “self-rated health” (SRH) — a well-understood and robust predictor of mortality — in assessing the health-adjusted life expectancy (HALE) of men newly diagnosed with localized prostate cancer.
The authors gathered data from 144 patients with localized prostate cancer, all diagnosed at a large, private, urology practice in Norfolk, Virginia, before the men had chosen a treatment option. They were able to show that:
- HALE determined by SRH correlated well with objective health measures and was higher than age-based life expectancy by an average of 2 years.
- The observed difference in life expectancy due to SRH adjustment was higher among patients with a better socioeconomic and health profile.
They conclude that SRH is an easy-to-use indicator of HALE in patients with localized prostate cancer. Their paper contains a table for estimation of HALE by age and SRH is provided for men aged 70-80 years. They are clear that additional research with larger samples and prospective study designs would be essential before the SRH method could be incorporated into primary care and urology practice settings.