Staging And Survival Rates
Staging is a method of describing where the cancer is located, where it has spread, and whether it is affecting other parts of the body.
Prostate cancer staging is based on a number of different factors, including prostate cancer screening tests, such as the digital rectal exam and the prostate-specific antigen test.
Doctors use diagnostic tests to determine cancers stage. Staging may not be complete until these tests are finalized. Knowing the correct stage helps the doctor decide the best course of treatment and the possible outcomes.
Stage 2 Prostate Cancer
In stage 2, the tumor is still confined to your prostate and hasnt spread to lymph nodes or other parts of your body. A doctor may or may not be able to feel the tumor during a prostate exam, and it may appear on ultrasound imaging. The survival rate is still .
The PSA score for stage 2 is less than 20 ng/mL.
Stage 2 cancer is further divided into three phases depending on the grade group and Gleason scores:
- Grade group: 1
- Gleason score: 6 or less
Who Gets This Cancer
Prostate cancer occurs only in men, and it is more common in older men than younger men. It is more likely to occur in men with a family history of prostate cancer and men of African American descent. The rate of new cases of prostate cancer was 111.3 per 100,000 men per year based on 20142018 cases, age-adjusted.
Rate of New Cases per 100,000 Persons by Race/Ethnicity: Prostate Cancer
SEER 21 20142018, All Races, Males
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What Happens Without Treatment
Physicians will sometimes talk about a particular diseases natural history or typical progression if it is left untreated indefinitely.
With regard to prostate cancer, most cases of the disease are discovered while the cancer is still confined to the prostate itself. This is called local disease or localized disease.
The disease is easiest to treat while it is confined to the prostate. At this stage, surgery and radiation are most likely to be curative and completely kill or remove whatever cancer cells are present.
If left untreated, however, prostate cancer can proceed on a number of different paths.
The Frequency Of Bcr Cp Crd And Rates Of Bpfs Cpfs Css
Median time of follow-up after RP was 64 months. Over this time, 207 men experienced BCR. One hundred twenty-seven men had BCR in the following year after RP, 27 in the second year, 16 in the third, 14 in the fourth, 7 in the fifth, and 16 patients had BCR after 5 years . Of 207 men, 181 received salvage radiotherapy or hormone therapy or both sRT + HT due to BCR.
Figure 1. Risk of biochemical recurrence by the following year after radical prostatectomy .
CP was diagnosed in 49 cases. Median time from BCR to CP was 17 months. Twelve men had metastases in lymph nodes, 11 had metastases in bones, 19 had metastases in lymph nodes and bones, 1 had visceral metastases, and 6 had local recurrence in the surgical bed. During the follow-up, 72 patients died. In 24 cases PCa was the cause of death.
According to the DAmico risk classification, the 5-year BPFS rate after RP of patients with one risk factor was 57.7%, and that with two factors was 34.4%. All patients with three risk factors had BCR in the first 5 years after RP .
In all study cohorts, 5- and 10-year BPFS rate was 49.2 and 34.2%, respectively. CPFS rate was 89.2 and 81% and CSS rate was 95.6 and 90.1%, respectively.
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What Is Intermittent Adt
Researchers have investigated whether a technique called intermittent androgen deprivation can delay the development of hormone resistance. With intermittent androgen deprivation, hormone therapy is given in cycles with breaks between drug administrations, rather than continuously. An additional potential benefit of this approach is that the temporary break from the side effects of hormone therapy may improve a mans quality of life.
Randomized clinical trials have shown similar overall survival with continuous ADT or intermittent ADT among men with metastatic or recurrent prostate cancer, with a reduction in some side effects for intermittent ADT .
Stage 3 Prostate Cancer Survival Rate
When doctors deem a prostate tumor as a stage 3 prostate cancer case, then cancer cells may have left the confinements of the prostate gland. Stage 3 is also broken down into 3 subgroups.
- Stage IIIA: PSA reading is slightly over 20ng/mL, the Gleason score is 8 or less. The location of cancer cells is on both sides of the prostate gland or even outside of it
- Stage IIIB: PSA reading is any level, the Gleason score is 8 or less. The location of cancer cells is inside or outside the prostate gland, but they havent reached lymph nodes yet
- Stage IIIC: PSA reading is at any level, the Gleason score is 9 or 10. The location of cancer cells is inside or outside the prostate gland, and they may have even reached lymph nodes or other parts of the body near the prostate gland.
With the right treatment, 95% of patients diagnosed with prostate cancer are likely to survive for at least 5 years. While active surveillance is outside the question at this point, other treatments are likely to lead to satisfactory results. External beam radiation coupled with hormone therapy, radiation coupled with hormone therapy, and radical prostatectomy are viable plans of action at this point.
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Keeping Health Insurance And Copies Of Your Medical Records
Even after treatment, its very important to keep health insurance. Tests and doctor visits cost a lot, and although no one wants to think of their cancer coming back, this could happen.
At some point after your cancer treatment, you might find yourself seeing a new doctor who doesnt know your medical history. Its important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment.
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Psa And Gleason Score
Two other important factors that doctors and specialists use to assess cancer cells are the prostate specific antigen and the Gleason score.
PSA levels: PSA is a protein that appears in higher levels in the bloodstream when there is a problem with the prostate. Normally, PSA levels in the blood are very low, and a test cannot detect them. However, in some circumstance, such as prostate cancer, PSA levels start to rise.
Screening for prostate cancer uses a blood test for PSA. If PSA levels are high, the doctor may recommend further tests to see if prostate cancer is present.
There are various other reasons why PSA levels may rise, including sexual stimulation or an infection.
The grade and Gleason score: Different types of cancer cell act differently. Some types, or grades, are more aggressive and can spread more easily. The Gleason score and grade are different measures, but they both reflect how likely it is that a tumor will spread, and how quickly it will do so. Either a biopsy or surgery can determine the types of cancer cells present in the prostate tissues.
Nearly 50% of males have a condition known as prostatic intraepithelial neoplasia by the time they are 50 years old. PIN is when there are changes in the cells that line the prostate gland.
High grade PIN is not cancer, but the cells can become cancerous in the future. For this reason, a doctor may recommend treatment to remove the cells.
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Stage 1 Prostate Cancer Survival Rate
The first forms of prostate cancer take shape at stage 1. This is when abnormal cells start growing within the prostate gland.
A stage 1 prostate cancer is traced when the PSA reading detects 10ng/mL. Moreover, the Gleason score is 6.
The stage 1 prostate cancer survival rate for the first 5 years is 99%. In other words, men with this type of prostate tumor are almost 100% as likely as men who are cancer-free to live for at least 5 years after they receive the diagnosis.
A diagnosis that caught prostate tumor at stage 1 leads to the least intrusive forms of treatments. In most cases, doctors prescribe active surveillance. This entails continuous monitoring of the prostate tumor in order to observe the way it evolves and decide the optimal way to treat it.
Other treatment plans at this stage encompass radical prostatectomy or radiation therapy. Both of these recommendations can be prescribed at the same time.
Untreated Prostate Cancer No Death Sentence
By Frederik Joelving, Reuters Health
4 Min Read
NEW YORK â Even without treatment, only a small minority of men diagnosed with early-stage prostate cancer die from the disease, Swedish researchers reported Friday.
Drawing from a national cancer register, they estimated that after 10 years prostate cancer would have killed less than three percent of these men.
What the data is showing is that for most patients with low-risk cancer, there is no need to panic, said Grace Lu-Yao, a cancer researcher who was not involved in the new study. Prostate cancer really is no longer a fatal disease.
With modern screening tests, said Lu-Yao, of the University of Medicine and Dentistry of New Jersey in New Brunswick, many prostate cancers are found that might never have developed into serious disease. In such cases, the slight reduction of risk by surgically removing the prostate or treating it with radiation may not outweigh the substantial side effects of these treatments.
In the Swedish study, published in the Journal of the National Cancer Institute, researchers compared deaths among more than 6,800 men with prostate cancer who underwent treatment â surgery or radiation â or were simply monitored regularly by their doctors, the so-called watchful waiting approach. With watchful waiting, patients are only treated if their cancer progresses.
The Swedish findings jibe with earlier results, including a large US study.
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Prostate Cancer Survival Trends Over Time
As with most cancers, survival for prostate cancer is improving. However, interpretation of prostate cancer survival trends is difficult as the case-mix on which they are based is likely to have changed over time with earlier diagnoses following the advent of TURP and PSA testing. The detection of a greater proportion of latent, earlier, slow-growing tumours in more recent time periods will have the effect of raising survival rates due to lead-time bias . Lead-time bias for prostate cancer is estimated to be between five and 12 years, varying with a man’s age at screening. Data from the European Randomized Study of Prostate Cancer estimates that for a single screening test, mean lead times are 12 years at age 55 and six years at age 75. Some of the increase may also be attributed to genuine improvements in survival due to more effective treatment, for both early, aggressive prostate cancers and advanced cases.
One-year age-standardised net survival for prostate cancer has increased from 66% during 1971-1972 to 94% during 2010-2011 in England and Wales an absolute survival difference of 28 percentage points.
Prostate Cancer , Age-Standardised One-Year Net Survival, Men , England and Wales, 1971-2011
Prostate Cancer , Age-Standardised Five-Year Net Survival, Men , England and Wales, 1971-2011
Prostate Cancer , Age-Standardised Ten-Year Net Survival, Men , England and Wales, 1971-2011
What Does Survival Rate Mean
A survival rate indicates the percentage of those diagnosed with a type of cancer who survive over a certain period of time compared to their peers without the disease. Survival rates are usually measured across a five-year or ten-year span.
For example, if the five-year survival rate of a cancer in men is 80%, that means men diagnosed with that cancer are 80% as likely as other men their age without the cancer to survive five years after diagnosis.
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Additional Treatment After Surgery
Additional treatment can come with one of two approaches: treatment given as adjuvant therapy , or as salvage therapy . In the modern era, most additional treatment is given as salvage therapy because firstly this spares unnecessary treatment for men who would never experience recurrence, and secondly because the success rates of the two approaches appear to be the same.
Regardless of whether an adjuvant or salvage therapy approach is taken, the main treatment options following biochemical recurrence are:
- Radiotherapy this is the commonest approach. Because scans dont show metastatic deposits until the PSA is more than 0.5 ng/ml and because radiotherapy is more effective when given before this level is reached, the radiotherapy energy is delivered to the prostate bed. This is because we know that this is the commonest site of recurrence in most men, and that 80% of men treated in this way will be cured.
- Active surveillance this is appropriate for a very slowly-rising PSA in an elderly patient who has no symptoms.
- Hormonal therapy in many ways this is the least appealing option as it causes symptoms but does not cure anyone, although it does control the recurrence and lower the PSA.
What Is Prostate Cancer
The prostate is a walnut-shaped gland that lies below the bladder and in front of the rectum. In men, the size of the prostate increases with increasing age. Its primary function is to make fluid to nourish and lubricate the semen.
Growth in the prostate can be of two types:
- Benign growths: These are noncancerous growths and are rarely a threat to life .
- Malignant growths: These are cancerous growths that are potentially life-threatening.
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Cancer Staging May Miss Errant Cells
Once a pathologist confirms that cancer is present, the doctor will next determine how far the cancer extends a process known as cancer staging and discuss the implications with you. This is perhaps the most important information of all for you to obtain, as it determines whether the cancer is likely to be curable, or whether it has already spread to additional tissues, making prognosis much worse.
If you were my patient, I would ask you to consider two important points. First, cancer staging actually occurs in two phases: clinical and pathological . Of the two, pathological staging is more accurate.
A second point to understand, however, is that even pathological staging can be inaccurate . A cancer spreads, or metastasizes, once a primary tumor sheds cancer cells that travel elsewhere in the body and establish other tumor sites. Metastasis is a complex process that researchers do not fully understand. What is clear is that this process involves multiple genetic mutations and steps, and that each type of cancer spreads in a unique way.
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Prostate Cancer Survival Rate By Age
The age of the patient at the time he receives a diagnosis is a highly influential factor in the way the prostate tumor is going to evolve. Given that prostate tumors exhibit peculiar traits in younger men, the peak survival rate is attained in the middle age groups. From there, the survival starts dropping once more. Lets take a look at the numbers:
- 15-49 age group: 91% prostate cancer survival rate
- 50-59 age group: 92% prostate cancer survival rate
- 60-69 age group: 94% prostate cancer survival rate
- 70-79 age group: 89% prostate cancer survival rate
- 80-99 age group: 66% prostate cancer survival rate.
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Differences Among Risk Groups
Men with PCa have been classified into low-, intermediate- and high-risk Groups for tumor recurrence and disease specific mortality, based on PSA level, clinical or pathological staging and GS. High-risk patients have PSA level 20ng/mL or GS 8 or clinical/pathological stage T2c . Lymph-node positive and PSM have also been reported as poor prognosis factors.
Risk Group classification predicts biochemical and clinical progression as well as PCa specific mortality and overall survival. The risk of disease progression in these groups has been validated for patients submited to RP in many studies. In patients from Mayo Clinic, BCR rates were 2.3 and 3.3-fold greater in high and intermediate-risk in comparison with low-risk patients, respectively. In those patients, mortality rates in high and intermediate-risk patients were greater than 11 and 6-fold over low-risk men .
Therefore, it is crutial to understand the role of each clinical and pathologic feature in PCa BCR and disease progression.
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Nomogram Predicting Model And Validation
The predicting model of nomograms was built with the factors in the multivariate Cox analysis . The C-index of this nomogram was 0.773, indicating a good discrimination ability of this model. Five- and 10-year calibration curves also revealed good agreement between the actual observation and the nomogram prediction.
Figure 3Figure 4
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To Treat Or Not To Treat
Up until now, with a few notable exceptions, doctors have myopically focused on treating prostate cancer, says Adami. They are willing to spend tens of thousands of dollars on chemotherapy that has minimal effects on cancer mortality, often with substantial side effects. But we ignore entirely the fact that large groups of prostate cancer patients die from other causes that actually are preventable.
Among older patients especially, that activity can take the form of vigorous walking. Recently, Mucci has spearheaded an intervention with Adami and other colleagues in Sweden, Iceland, and Ireland in which men walk in groups with a nurse three times a week. In a pilot study, researchers found improvements in just 12 weeks in body weight, blood pressure, sleep, urinary function, and mental health.
Scientists at HSPH are also searching for genetic and lifestyle markers that help predict how aggressive a patients prostate cancer will be. For example, an ongoing project led by Mucci and Adami draws on detailed cancer registries in Nordic countries, including an analysis of 300,000 twins, to tease out the relative contribution of different genes to prostate cancer incidence and survival.
is a Boston-based journalist and author of The Coke Machine: The Dirty Truth Behind the Worlds Favorite Soft Drink.