Docetaxel Prostate Cancer Life Expectancy

An Evolving Standard Of Care

Hormone-sensitive prostate cancer means a patients tumors are still largely being fueled by male sex hormones called androgens. For many years, metastatic hormone-sensitive prostate cancer was treated with ADT alone, which blocks the production of androgens by the testicles.

In 2014, a large clinical trial showed that adding the chemotherapy drug docetaxel to ADT improved survival in men with metastatic hormone-sensitive prostate cancer. Since then, this combination has become the standard of care for this group of patients.

More recently, studies have shown that adding other drugs that block the production or binding of androgensincluding abiraterone , enzalutamide , and apalutamide to ADT also helps people with metastatic hormone-sensitive prostate cancer live longer. In a trial combining apalutamide with ADT, for example, approximately 82% of men were still alive after 2 years compared with 74% of men treated with ADT alone.

Several clinical trials were then launched to see if combining any of these drugs with ADT and docetaxel could build on those survival gains. Results of those studies, however, have been mixed, with one showing an improvement in survival without the disease progressing and another finding no increase in overall survival.

Types Of Cancers That Are More Likely To Go Undetected

Some cancers are more easily detected than others. For example, certain types of skin cancer can be diagnosed initially just by visual inspection though a biopsy is necessary to confirm the diagnosis.

But other cancers can form and grow undetected for 10 years or more, as one study found, making diagnosis and treatment that much more difficult.

This table provides an overview of common cancers that often display little or no symptoms early on, and how theyre typically detected and diagnosed:

Type of cancer

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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.

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How Often You Have Hormone Therapy

You usually have hormone therapy that you take all the time . Or you may have a few months of treatment and then a break . Its thought that having intermittent therapy might reduce the side effects you get, but more research needs to be done to look into this.

You might have:

• one hormone therapy drug on its own
• two hormone therapies together
• hormone therapy with chemotherapy, such as docetaxel

Your doctor will talk to you about which hormone therapy they recommend and for how long you might have take it for.

Staging And Grading Of Advanced Prostate Cancer

The stage of a cancer describes its size and how far it has spread, based on your test results. Doctors often use the TNM staging system or a number staging system.

A doctor decides the grade by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread. You and your doctors can then talk about the best treatment choices for you.

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Abiraterone Improves Survival In Metastatic Prostate Cancer

A multinational phase III trial found that the drug abiraterone acetate prolonged the median survival time of patients with metastatic castration-resistant prostate cancer by 4 months compared with patients who received a placebo. The preliminary results from the study were presented October 11, 2010, at the 35th Congress of the European Society for Medical Oncology in Milan, Italy, and subsequently published in the New England Journal of Medicine on May 26, 2011 .

Standard prostate cancer treatments reduce blood levels of testosterone, the hormone that fuels the cancers growth. However, most prostate cancers eventually become resistant to these treatments. Such cancers are called castration-resistant prostate cancers. Abiraterone acetate is designed to treat these tumors by inhibiting the production of androgen in the testes, adrenal glands, and prostate cancer tumors themselves.

The clinical trial included 1,195 patients from 13 countries whose metastatic prostate cancer had previously been treated with one of two chemotherapy regimens that included docetaxel. Among the 797 patients randomly assigned to receive abiraterone acetate plus the corticosteroid prednisone, median overall survival was 14.8 months. Among the 398 who received prednisone plus placebo, median survival was 10.9 months.

• December 31, 2012

Improved Survival At 4 Years

In the ARASENS trial, nearly 1,300 participants were randomly assigned to receive darolutamide or a placebo . All participants received ADT within 12 weeks before randomization and six cycles of docetaxel starting within 6 weeks after randomization.

After 4 years, about 63% of patients who received darolutamide were still alive compared with about 50% of patients who received placebo. The group that received darolutamide lived longer even though most participants in the placebo group received other commonly used treatments, including abiraterone and enzalutamide, during follow-up.

Darolutamide resulted in other improvements as well. For example, among those treated with darolutamide, the time for their cancers to become resistant to hormone-suppressing therapies was longer, as was the time until the pain caused by their cancer got worse.

The frequency of serious side effectswhich included fatigue, falls, fractures, and cardiac issueswas similar in the two groups. Roughly two-thirds of the patients in both groups experienced serious side effects, most of which occurred when darolutamide were given at the same time as docetaxel.

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Improvements In Life Expectancy

A decade ago, a man with metastatic prostate cancer would typically have a life expectancy of two to three years. Today, life expectancy for men with the same advanced disease is likely to be five to six years. In the UK the survival rate for men with stage 4 prostate cancer is approximately 50%, meaning that 50 out of every 100 men will survive their cancer for 5 years or more after they are diagnosed with stage 4 prostate cancer*. There is now a much broader range of chemotherapy drugs available for men with advanced disease with greater efficacy . We also have better treatments to control the symptoms of advanced prostate cancer, such as pain from metastases. In this section, we consider in more detail the different treatments that are available and evidence for their effectiveness.

How Third Stage Prostate Cancer Manifests Itself

At this stage the tumour has already grown outside the prostate gland. There are no distant metastases and no pain associated with them yet, but the patient may experience symptoms of obstruction, that is, compression of the urinary tract:

• frequent and difficult urination
• the need to push yourself when you go to the bathroom
• imperative, i.e. very intense, almost unbearable urges
• nighttime urge to pee, or nocturia
• a feeling of incomplete bladder emptying.

If the tumour has grown into the bladder neck, you may develop urinary incontinence or haematuria blood in the urine. Sometimes the patient experiences pain because the tumour is compressing the surrounding tissues. Due to the obstruction, some patients may develop renal failure or hydronephrosis enlargement of the renal pelvis.

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Prostate Cancer Survival Rates: What They Mean

• Staging, Spread, and Survival Rates

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.

Glencore Plc Annual Report 2019

Introduction: Current prostatecancer risk calculators are limited in impact because only a probability of having prostatecancer is provided. We developed the next generation of prostatecancer risk calculator that incorporates lifeexpectancy in order to better evaluate prostatecancer risk in context to a patient’s age and comorbidity..

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Nov 16, 2021 · The 5-year survival rate for most men with local or regional prostatecancer is 100%. Ninety-eight percent are alive at 10 years. For men diagnosed with prostatecancer that has spread to other parts of the body, the 5-year survival rate is 30%..

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Prostate Cancer Drug ‘extends Lives’

Early treatment with a chemotherapy drug extends the lives of patients with advanced prostate cancer by nearly two years, a major study shows.

Docetaxel is normally given after hormone treatment has failed.

But results, to be presented at the American Society of Clinical Oncology, will show earlier treatment can extend life expectancy from 43 to 65 months.

Experts said the findings from a trial in Britain and Switzerland were “potentially game-changing”.

More than 40,000 men are diagnosed with prostate cancer and nearly 11,000 die in the UK each year.

During the trial, being run across Britain and Switzerland, 2,962 men took part in the trial and some were given six doses of docetaxol at the start of their treatment.

Overall, patients who received the drug lived 10 months longer, but for patients where the cancer had already spread beyond the pelvis, the increase in life expectancy was 22 months.

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.

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What Factors Determine Life Expectancy For Metastatic Prostate Cancer

The life expectancy of someone with cancer depends on the extent of metastasis and which organs are involved. Metastatic prostate cancer is designated as stage IV:

• Stage IVA: Cancer has progressed to surrounding lymph nodes but not to distant locations.
• Stage IVB: Cancer has progressed to distant tissues and organs, such as the bones or smooth muscles.

Generally, prostate cancers do not spread rapidly to other areas of the body. Most prostate tumors grow slowly and may not cause symptoms or complications for years, if at all.

Even when prostate cancer has spread to other regions of the body, it is usually treatable for an extended period. As a result, even men with advanced prostate cancer can enjoy good health for many years. However, if not properly treated, prostate cancer can cause serious symptoms and even turn fatal.

Docetaxel With Adt Improves Survival For Metastatic Prostate Cancer Patients

Results from the phase III E3805 clinical trial show that adding docetaxel to standard hormone therapy extends survival for men with metastatic hormone-sensitive prostate cancer by 13.6 months.

Results from the phase III E3805 clinical trial show that adding docetaxel to standard hormone therapy extends survival for men with metastatic hormone-sensitive prostate cancer by 13.6 months. The extension of survival was greatest among men with extensive disease-a difference of 17 months. The trial was led by the Eastern Cooperative Oncology Group and funded by the National Cancer Institute. The results were presented at the plenary session by Christopher Sweeney, MBBS, a medical oncologist at Dana-Farber Cancer Institute in Boston, at a press briefing at the American Society of Clinical Oncology Annual Meeting, held May 30June 3 in Chicago.

I am not aware of any prostate cancer study that has offered this magnitude of improvement in survival, said current ASCO president Clifford Hudis, MD, chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center in New York City, at the press briefing. Across all the solid tumors, this is an almost unprecedented improvement in median survival.

What is particularly notable is that docetaxel is a relatively inexpensive agent compared with newer targeted therapies that are used to treat advanced prostate cancer.

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What Are The Treatment Options For Prostate Cancer

Treatment for prostate cancer is determined based on the size of the tumor and extent of metastasis and may include the following:

Hormone therapy

Hormone treatment deprives the body of the male hormones needed for prostate cancer growth. Orchiectomy or luteinizing hormone-releasing hormone analogs are used alone or in conjunction with an anti-androgen.

Newer hormonal drugs that decrease androgen production and block androgen receptor signaling have been approved by the FDA for the treatment of metastatic prostate cancer following chemotherapy, and they are being studied for early usage in the disease.

Abiraterone

Abiraterone is an oral targeted medication that inhibits androgen synthesis not only in the testes but also in the adrenal glands and the tumor itself. When used with prednisone, abiraterone has been demonstrated to improve quality of life and decrease pain progression in patients with hormone-refractory prostate cancer .

Although this drug is normally well tolerated, adverse effects such as tiredness, elevated blood pressure, and electrolyte or liver problems are possible, and patients must be checked on a regular basis.

Enzalutamide

Enzalutamide interferes with molecular processes that enable prostate cancer growth by targeting various stages in the androgen-receptor-signaling cascade. Furthermore, the medicine does not cause the typical adverse effects of chemotherapy, such as nausea and hair loss.

Chemotherapy

Targeted therapy

Immunotherapy

Sipuleucel-T

Outlook For Men With Localised Prostate Cancer

Most localised prostate cancer is slow-growing and may not need treatment or shorten a mans life. For many men who have treatment for localised prostate cancer, the treatment will get rid of the cancer. For others, treatment may be less successful and the cancer may come back. If this happens, you might need further treatment.

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How We Treat Prostate Cancer

The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.

The Future Of Hormone Therapy For Prostate Cancer

Some experts arent sure how much further we can improve hormone therapy for prostate cancer.

Im not saying that weve reached the end of what we can do with hormonal therapy, Thrasher tells WebMD, but there are only so many ways to shut down the hormonal effects. The cancer will still eventually escape.

Brooks argues that, overall, prostate cancer is only moderately affected by hormones. You can only do so much manipulating the levels of hormones, says Brooks. We have to find better ways to fight the basis of the cancer cells.

Thrasher and Brooks have more hope that the next breakthroughs will come with different approaches, like chemotherapy or vaccines.

But Holden remains optimistic about the future of hormone therapy for prostate cancer.

Cancer cells eventually figure out how to survive, how to overcome a specific hormone therapy, he says. But if we have enough types of drugs and can keep changing the hormone therapy, we might be able to keep the cancer cells in a state of confusion. We could change therapies before they have a chance to adapt.

Its like an endless chess game, he says. You may not ever win, but you might be able to prolong the game indefinitely. I think that hormone therapy still has a lot of promise. We just need to develop better anti-androgens, and more varieties of them.

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My Dad Has Advanced Prostate Cancer Metastatized To Bone

Hello,

Ive come here because Im not sure where else to go. Ive just found out in the past week that my Dad has prostate cancer, which has metasised to his pubic bone. His PSA levels were extrremely high, 164, and his Gleason score is 10. Hes 72, but you wouldnt think it. He is so fit and healthy and he only went to the doctors in the first place because he had a pain in his leg, which we now know is because it spread to his bone. I am an only child, Im 26, I live near my parents and have been staying over since we find out.

My Dad is mostly postive, he has started his hormone therapy and in July he will have 6 rounds of chemo. They can manage but they cant cure. They said its really agressive cancer, but they can keep him going, but for how long? I cant bear to watch my Dad go through this pain, hes the kindest, sweetest most generous man. And my Mum, my Dad is my mums world, she just keeps asking me how are we going to cope shes imagining herself all alone in this home they built together, and to be honest, so am I. I am trying to be strong and resume normality but this has changed everything. I thought my Dad would live to see me get married, go far in my career. I want him to be there, to watch me grow. I dont want him to leave Mum all alone. I dont have any siblings to share this with my friends are supportive and my boyfriend too but, I just feel so hopeless. Would be reassured to hear of anyone else in the same boat.

Thank you