Every year more than 200,000 men in the United States are diagnosed with prostate cancer. In 2010 it is estimated that there were 217,000 new cases but only 32,000 cancer-related deaths. Since most men who get this disease are elderly, many die with, rather than of, the disease. Coincidental with improvements in screening (primarily the PSA blood test) and treatment the death rate is somewhat lower than it was twenty years ago.
However, for many if not most men, it may not matter whether their cancer gets diagnosed and treated when it is in a very early stage because it grows so slowly. Why then do most men who develop prostate cancer get aggressive treatment such as radical surgery or high-dose radiation if the death rate is so low? Until now the answer has been that we do not know who will die if untreated and who will live. All that is about to change.