Prostate Cancer Survival Rates: What They Mean
As cancer diagnoses go, prostate cancer is often a less serious one. Prostate cancer is frequently slow-growing and slow to spread. For many men, prostate cancer is less serious than their other medical conditions.
For these reasons, and possibly because of earlier detection of low-grade prostate cancers, prostate cancer has one of the highest survival rates of any type of cancer. WebMD takes a look at prostate cancer survival rates and what they mean to you.
What Is A 5
A relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of prostate cancer is 90%, it means that men who have that cancer are, on average, about 90% as likely as men who dont have that cancer to live for at least 5 years after being diagnosed.
Cancer Patients With Bone Metastasis
We included all adult residents of Denmark diagnosed with cancer in the Danish Cancer Registry from 1 January 1994 to 31 December 2010, and with a diagnosis of bone metastasis registered in the Danish National Patient Registry on or after the date of primary cancer diagnosis until 31 December 2012. DNRP holds discharge diagnoses from all inpatient admissions to Danish hospitals since 1977 and hospital outpatient clinic diagnoses since 1995. For each visit, the DNPR includes information on admission and discharge, procedures and up to 20 diagnoses. Since 1994, the diagnostic information has been coded according to the International Classification of Diseases, 10th Revision. All diagnostic codes are given in the online .
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What Is The Life Expectancy For Stage 4 Prostate Cancer
Prostate cancer life expectancy is determined using five-year survival rates. This is the percentage of people who may still be alive five years after being diagnosed.
The five-year survival rate for men with localized prostate cancer, where there is no evidence of cancer spreading outside the prostate, and regional prostate cancer, when cancer has migrated outside the prostate to adjacent structures or lymph nodes exclusively, is approximately 100 percent.
When prostate cancer reaches stage 4 and has spread to other organs such as the lungs, liver, or bones, the five-year survival rate falls below 30%. At stage 4, prostate cancer is unlikely to be cured, although with effective therapy, many people can live for several years. The patients life expectancy is determined by the precise characteristics of his cancer.
However, thanks to routine screening procedures, prostate cancer is often discovered early, before it has spread to other organs, and it is usually not fatal. When diagnosed early, there are several treatment options available, as well as a good likelihood of a cure.
How Will My Cancer Be Monitored
Your doctor will talk to you about how often you should have check-ups. At some hospitals, you may not have many appointments at the hospital itself. Instead, you may talk to your doctor or nurse over the telephone. You might hear this called self-management.
You will have regular PSA tests. This is often a useful way to check how well your treatment is working. Youll also have regular blood tests to see whether your cancer is affecting other parts of your body, such as your liver, kidneys or bones.
You might have more scans to see how your cancer is responding to treatment and whether your cancer is spreading.
Your doctor or nurse will also ask you how youre feeling and if you have any symptoms, such as pain or tiredness. This will help them understand how youre responding to treatment and how to manage any symptoms. Let them know if you have any side effects from your treatment. There are usually ways to manage these.
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What Treatments Are Available
If you have advanced prostate cancer, treatment wont cure your cancer. But it can help keep it under control and manage any symptoms.
If youve just been diagnosed with advanced prostate cancer, you may be offered the following treatments:
- chemotherapy with hormone therapy
- clinical trials.
Research has found that having radiotherapy together with one of the main treatments listed above can help some men with advanced prostate cancer to live longer. But radiotherapy isnt suitable for all men with advanced prostate cancer.
If you live in Scotland, you may also be offered a type of hormone therapy called abiraterone acetate together with standard hormone therapy. In the rest of the UK, abiraterone is currently only given to men with advanced prostate cancer that has stopped responding to other types of hormone therapy. The National Institute for Health and Care Excellence is currently deciding whether to make it available for men who have just been diagnosed with advanced prostate cancer.
Before you start treatment
Before you start any treatment, make sure you have all the information you need. Its important to think about how you would cope with the possible side effects. Speak to your doctor or nurse about this.
It can help to write down any questions you want to ask at your next appointment. It may also help to take someone with you, such as your partner, a family member or friend.
If you have any questions, speak to our Specialist Nurses.
What Are Bone Metastases With Prostate Cancer
The ACS describes bone metastases as areas of bone containing cancer cells that have spread from another place in the body. In the case of prostate cancer, the cells have spread beyond the prostate gland. Since the cancer cells originated in the prostate gland, the cancer is referred to as metastatic prostate cancer.
The cancer cells spread to the bones by breaking away from the prostate gland and escaping attack from your immune system as they travel to your bones.
These cancer cells then grow new tumors in your bones. Cancer can spread to any bone in the body, but the spine is most often affected. Other areas cancer cells commonly travel to, according to the ACS, include the pelvis, upper legs and arms, and the ribs.
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for prostate cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead it groups cancers into localized, regional, and distant stages.
- Localized: There is no sign that the cancer has spread outside the prostate.
- Regional: The cancer has spread outside the prostate to nearby structures or lymph nodes.
- Distant: The cancer has spread to parts of the body farther from the prostate, such as the lungs, liver, or bones.
Towards A Meaningful Definition Of High
In the United States, approximately 238,590 men were expected to be diagnosed with prostate cancer in 2013, and 29,720 prostate cancer patients were anticipated to die of their disease in 2013.2 Many of the patients who die of prostate cancer present initially with tumours seemingly confined to the gland this arguably represents true high-risk disease and new approaches are needed for these patients. By current estimates, high-risk disease accounts for 15% of all prostate cancer diagnoses3. The limitations of determining risk based on the T, N, M classification, which does not include Gleason score or PSA, have long been recognized. An important first step toward a more reliable schema was first proposed by DAmico et al.,4 using an endpoint of PSA failure and defining high-risk as a clinical T stage cT2c, a Gleason score 8, or a PSA > 20 ng/mL this definition has been adopted by the American Urological Association .5 The Radiation Therapy Oncology Group developed the first classification which associated specific baseline factors with overall survival and cause-specific survival, arguably more relevant measures. High risk in the RTOG classification includes 1) Gleason 8, or 2) Gleason =7 plus either cT3 or node-positive PSA adds little to this model for the prediction of cause-specific survival or overall survival.6 When combining the RTOG model with the Kattan nomogram, the ability to predict prostate cancerspecific survival is improved.7
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Financial Assistance For Advanced Prostate Cancer Patients
There are resources available to help men pay for their medications for treatment and other related expenses. Treatments may include oral drugs, injections, supportive care drugs, or other medications and procedures. To help offset the cost of prescription drugs, patient assistance programs have been established. Other resources exist to help people navigate the ever-changing costs associated with cancer care today. Visit our Financial Resources section to learn about resources for support.
You can also contact ZERO360 for help finding financial assistance and other resources.
Where Prostate Cancer Spreads In The Body Affects Survival Time
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DURHAM, N.C. — Patients with lymph-only metastasis have the longest overall survival, while those with liver involvement fare worst. Lung and bone metastasis fall in the middle.
Smaller studies had given doctors and patients indications that the site of metastasis in prostate cancer affects survival, but prevalence rates in organ sites were small, so it was difficult to provide good guidance, said Susan Halabi, Ph.D., professor of biostatistics at Duke and lead author of the study published online March 7 in the Journal of Clinical Oncology.
With the large numbers we analyzed in our study, we were able to compare all of these different sites and provide information that could be helpful in conveying prognosis to patients, Halabi said. This information could also be used to help guide treatment approaches using either hormonal therapy or chemotherapy.
Halabi and colleagues from leading U.S. and international cancer research centers pulled data from nine large, phase III clinical trials to analyze outcomes of 8,736 men with metastatic prostate cancer. The patients had all undergone standard treatment with the chemotherapy drug docetaxel.
Site of metastases was categorized into four groups: lung, liver , lymph nodes only, bone with or without lymph nodes and no other organ metastases.
Halabi said more research is needed to understand how and why prostate cancer spreads to different organs.
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The Underlying Molecular Mechanisms In Prostate Cancer Bone Metastases
Various types of prostate cancer cell lines, including LuCaP 23.1, LNCaP, C4-2, and IGR-CaP1, were utilized as prostate cancer models. The LuCaP 23.1 and LNCaP cells are highly sensitive to androgen . The C4-2 cell lines showed features of reduced androgen sensitivity and increased metastatic capability . In the androgen-sensitive prostate cancer cell lines, the downregulation in androgen receptor expression reduced AR-mediated transcription and cell growth. Meanwhile, the knockdown of AR expression had a marked effect on AR-mediated transcription and cell growth in the androgen-insensitive prostate cancer cell lines . The expression of AR is an important regulator of prostate cancer cell growth and development at the early stage. However, prostate cancer progresses to castration-resistant prostate cancer at the later stage. Thus, possible correlation between AR expression and the signaling molecules involved in prostate cancer bone metastasis could be considered. On the other hand, the IGR-CaP1 cell line represents a unique model recapitulating widespread bone metastasis with mixed osteoblastic and osteolytic bone lesions that resemble the conditions observed in patients .
Treating Prostate Cancer That Doesnt Go Away Or Comes Back After Treatment
If your prostate-specific antigen blood level shows that your prostate cancer has not been cured or has come back after the initial treatment, further treatment can often still be helpful. Follow-up treatment will depend on where the cancer is thought to be and what treatment youve already had. Imaging tests such as CT, MRI, or bone scans may be done to get a better idea about where the cancer is.
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Epidemiology Of Advanced Prostate Cancer
Approximately 12.5% of men will develop prostate cancer in their lifetime, with the likelihood increasing with age prostate cancer is most often diagnosed in men age 65 to 74 years, and the median age at diagnosis is 67 years. Since the advent of prostate-specific antigen screening, prostate cancer is being detected and treated earlier.
Overall, incidence rates of prostate cancer began declining in 2000. Acceleration in the decline began in 2008, when organizations began recommending against routine PSA screening From 2011 to 2015, the rate decreased by about 7% per year.
A review of almost 800,000 cases of prostate cancer diagnosed from 20042013 found that although the incidence of low-risk prostate cancer decreased from 2007-2013 to 37% less than that of 2004, the annual incidence of metastatic prostate cancer during those years increased to 72% more than that of 2004. The increase in metastatic prostate cancer was greatest in men aged 5569 years.
At diagnosis, 77% of prostate cancer cases are localized in 13%, the cancer has spread to regional lymph nodes, and 6% have distant metastasis. The 5-year relative survival rate for localized and regional prostate cancer is 100%, compared with 30.5% for metastatic cases.
The mortality rate associated with prostate cancer continues to increase in Europe and in countries such as Australia, Japan, and Russia.
What Are Next Steps
Bone metastasis have a profound effect on the long-term outlook for prostate cancer. But its important to remember that the numbers are only statistics.
The good news is that life expectancy for advanced prostate cancer continues to increase. New treatments and therapies offer both longer life and better quality of life. Speak to your doctor about your treatment options and long-term outlook.
Everyones cancer experience is different. You may find support through sharing your treatment plan with friends and family. Or you can turn to local community groups or online forums like Male Care for advice and reassurance.
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What Are The Symptoms Of Advanced Prostate Cancer And Bone Metastases
When cancer cells spread to the bones, the condition weakens the very frame on which the body rests. The cells interfere with the strength and hardness of the bones structure, interrupting its normal cycle of building up and dissolving.
Theres no cure for advanced prostate cancer, but theres a lot that doctors can do to help with the symptoms that might develop. This includes managing pain. A common misconception is that if theres cancer in the bone, there must be pain, Tagawa says. Thats not true. Cancer can be in the bone without pain. However, if there is pain, he says, it can be controlled with anticancer therapies and pain medication, and good quality of life can be maintained.
In addition to pain, some men with bone metastases develop a condition called hypercalcemia, in which, because of the damage to bones from the cancer cells, too much calcium builds up in the blood. Hypercalcemia can make you feel constipated, thirsty, sleepy, or sluggish, and it can increase the urge to urinate, according to the ACS. Over time, hypercalcemia can cause muscle and joint achiness, as well as weakness in the muscles. In advanced stages, it can cause the kidneys to shut down.
There are treatments for hypercalcemia as well as for other complications from advanced prostate cancer, such as bones that become weak and break or fracture, and for growths in the spine that can press on the spinal cord and damage nerves.
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Stage 4 Prostate Cancer Prognosis
Doctors need to know how far the cancer has advanced, or its stage, in order to choose the best treatment. A pathologist, a specialist who specializes in studying cells obtained from a prostate biopsy, will provide two starting points: the cancers grade and Gleason score.
- Cancer grade: When the pathologist looks at prostate cancer cells, the most common type of cells will get a grade of 3 to 5. The area of cancer cells in the prostate will also be graded. The higher the grade, the more abnormal the cells.
- Gleason score: The two grades will be added together to get a Gleason score. This score tells doctors how likely the cancer is to grow and spread.
After a biopsy reveals prostate cancer, the patient may be subjected to additional testing to determine whether the disease has spread to other regions of the body via the blood or lymph nodes. These are typically imaging examinations, such as a bone scan, positron emission tomography scan, or computed tomography scan.
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Stages Of Prostate Cancer
In order to determine the stage of a patients prostate cancer, most doctors start by using the TNM staging system, which helps describe different aspects of the cancers growth.
- T the T category measures the size and extent of the Tumor
- N the N category measures whether and how far the cancer has spread to the Lymph Nodes
- M the M category whether the cancer has spread to other organs in the body (a process called Metastasis
The score for each of these categories is determined based on a pre-determined set of criteria. Your doctor cannot feel or see the tumor with a score of T1. A score of T3 means that the tumor has begun to grow outside of the prostate.
After calculating the TNM categories, doctors will combine the TNM score with the patients Gleason score and PSA levels assigning of a specific stage to the patients cancer.
Prostate cancer prognosis and survival rates can help give patients an idea of their chances of surviving the disease based on the stage and time of diagnosis. While some patients may find this information helpful, others may not want to know.