Myth: Prostate Cancer Is For Older Men
Fact: While its true that the majority of men diagnosed with prostate cancer are older, it can strike younger men, too. About 40 percent of all cases occur in men younger than 65, according to the ACS. Its not uncommon at all for men in their fifties and some in their forties to have prostate cancer, says Sartor.
The exact age you should start getting regularly screened for prostate cancer is still an area of confusion and debate. At least start talking to your doctor about PSA testing once youre 50 years old, the ACS recommends. The exception to this is if the disease runs in your family, in which case its a good idea to start PSA screening earlier, at age 40 or 45.
Who Dies From This Cancer
Because we have screening for prostate cancer, most of the time it is caught before it spreads to other parts of the body. Men who have prostate cancer that is characterized as localized or regional are not as likely to die as men whose cancer is distant. In general prostate cancer has excellent survival rates, but death rates are higher in African American men, men who have advanced stage cancer, and men who are between the ages of 75 and 84. Prostate cancer is the fifth leading cause of cancer death in the United States. The death rate was 18.9 per 100,000 men per year based on 20152019, age-adjusted.
Death Rate per 100,000 Persons by Race/Ethnicity: Prostate Cancer
Males
Stage Iii Prostate Cancer Survival
The five-year survival rates for Stage III prostate cancer are, like Stage I and Stage II, 100 percent. Stage III prostate cancers have spread into nearby seminal vesicles, but have not entered the lymph system or spread anywhere else in the body. This type of cancer is called regional prostate cancer, and with proper treatment, the prognosis is good. Treatment may include a prostatectomy or radiation, and hormone therapy.
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Where Can I Get Support
You might find it helps to talk openly to your family about your cancer, and your death. This can be very hard especially if you feel that youre the one having to start difficult conversations. But it can help both you and them deal with difficult feelings.If you dont want to talk to those close to you, you might find it easier to talk to someone else. Talking to your medical team can help. Your local hospice may have services to help you deal with difficult feelings. They can also support your family.There are quite a few specialist organisations and websites that offer advice, information and support during this time, including: Macmillan Cancer Support, Hospice UK, , Carers UK, Compassion in Dying, Citizens Advice Bureau, Age UK and Disabled Living Foundation.You can also speak to our Specialist Nurses who have the time to listen and talk through any problems youre having either physically or emotionally.
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How Cancer Causes Death
Even though cancer can lead to death, its not necessarily cancer that causes someone to die. Causes of cancer deaths can include:
- Organ failure due to the size and stress of a tumor
- Complications during surgery
- Organ rupture due to tumor size
- Infection due to the immune systems ability to fight off illness while on cancer treatment
Since all the organs in our body connect one way or another, all it takes is for one to begin shutting down, and the rest may start to follow suit. In the end, the person with cancer passes away.
Depending on the type of cancer, the cause of death can vary. Here are some more details on how cancer can cause death.
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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
Males
SEER 21 20142018, All Races, Males
Are There Side Effects Of The Combination Approach
There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects, both of which are common with any radiation treatment given to the prostate. But at MSK, we routinely use sophisticated planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications.
In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation that the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and after a few months dissolves on its own within the body, causing no harm or long-term effects.
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Myth: Prostate Cancer Treatment Always Causes Incontinence
Fact: Next to sexual function, men worry most about urinary incontinence as a result of prostate cancer treatment. Sartor says sexual side effects are more common than the urinary side effects the year after surgery. The majority of people do not have significant urinary problems.
If you do have bladder problems, youre more likely to face minor leakage than major accidents and in most men, the situation is temporary or treatable.
To help ensure the best outcome after surgery, Sartor recommends looking for a surgeon who has performed the procedure many times surgeons who are on their 900th procedure, for example, not their 41st. Experience does matter, he says. Its important to consider.
What Are Some Ways To Provide Emotional Support To A Person Who Is Living With And Dying Of Cancer
Everyone has different needs, but some worries are common to most dying patients. Two of these concerns are fear of abandonment and fear of being a burden. People who are dying also have concerns about loss of dignity and loss of control. Some ways caregivers can provide comfort to a person with these worries are listed below:
- Keep the person company. Talk, watch movies, read, or just be with them.
- Allow the person to express fears and concerns about dying, such as leaving family and friends behind. Be prepared to listen.
- Be willing to reminisce about the persons life.
- Avoid withholding difficult information. Most patients prefer to be included in discussions about issues that concern them.
- Reassure the patient that you will honor advance directives, such as living wills.
- Ask if there is anything you can do.
- Respect the persons need for privacy.
- Support the persons spirituality. Let them talk about what has meaning for them, pray with them if theyd like, and arrange visits by spiritual leaders and church members, if appropriate. Keep objects that are meaningful to the person close at hand.
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Should I Make Any Lifestyle Changes Including In My Diet Or Physical Activity
Achieving and maintaining a healthy weight by eating a balanced diet with plenty of fruits, vegetables, and whole grains, and staying physically active, can help your overall health. These lifestyle changes can also have a positive effect for men with bone metastases, Tagawa says. Both diet and exercise, he says, are things that are under a mans direct control.
A healthy lifestyle can help you better manage side effects from treatment as well. Try setting small but realistic goals for yourself when it comes to eating a healthy diet and getting plenty of exercise.
While no single food is likely to have a benefit for prostate cancer, smart food choices may help you feel better day to day. Start by cutting out foods high in sugar, saturated fat, and added flavorings and preservatives.
If youre not sure which healthy foods to choose, ask your doctor for a referral to a dietitian. This specialist can help you develop a meal plan that includes foods that offer the best chance of slowing the cancers growth and keeping you as healthy as possible.
As an oncologist, Tagawa says he concentrates on treating the cancer itself, but hes aware that many of the men he sees with advanced prostate cancer are older and more likely than younger men to have health problems that can benefit from diet and exercise.
And if youre on hormone therapy, talk to your doctor about investing in some weights or elastic resistance bands to support your bone strength too.
Clues In Diet And Lifestyle
To clarify the prognosis for a tumor, HSPH researchers are homing in on other factors that might affect susceptibility to prostate cancer, especially the aggressive form of the disease. Edward Giovannucci, professor of nutrition and epidemiology, recently looked at nine diet and lifestyle factors. He found that smoking, obesity, and lack of physical activity raise the risk of developing a more virulent cancer. According to Giovannucci, The question is whether there are two types of prostate canceran aggressive and nonaggressive formor whether certain factors cause a nonaggressive form to become more aggressive. Evidence provided by HSPH researchers suggests that an increase in insulin in the bloodstream, caused by obesity and physical inactivity, may encourage tumor growth.
Other investigations have linked dietary factors to the disease. A 2011 study by HSPH research associate Kathryn Wilson, together with Mucci and Giovannucci, professor of nutrition and epidemiology Meir Stampfer, and other colleagues, found that men who drank coffee had a notably lower risk of aggressive prostate cancer. Those who consumed six cups or more a day were 20 percent less likely to develop any form of the disease, and 60 percent less likely to develop a lethal disease those who consumed one to three cups a day showed no difference in developing any form of the disease, but had a 30 percent lower risk of developing a lethal form.
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Not All Cancers Cause Death
Firstly, it’s important to remember that not all cancers cause death. Overall, 50 out of every 100 people diagnosed with cancer in England and Wales live for 10 years or more. Cancer survival is improving and has doubled in the last 40 years in the UK.
Cancer at an early stage doesn’t usually kill you. A lot of effort is put into early diagnosis when treatment is likely to work best.
Where Prostate Cancer Spreads
If left untreated, diagnosed prostate cancer can grow and possibly spread outside of the prostate to local tissues or distantly to other sites in the body. The first sites of spread are typically to the nearby tissues.
The cancer can spread down the blood vessels, lymphatic channels, or nerves that enter and exit the prostate, or cancer could erode directly through the capsule that surrounds the prostate.
The seminal vesicles are a site of particularly common early spread. More extensive local spread can occur with cancer invading the nearby bladder or rectum.
Further advancement of cancer can occur when cancer cells enter the blood vessels and lymphatic channels. Once cancer has entered into these vessels, prostate cancer cells can seed into virtually any other part of the body.
Prostate cancer is known to have a particular affinity for spreading or metastasizing to the bones especially the lower spine, pelvis, and femur. Other organs such as the liver, brain, or lungs can also be the sites of spread, but these are much rarer.
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How Do I Know How Long I Have Left To Live
You might want to know how long you have left to live. This can help you prepare and plan the time you have left. There might be things you want to do or people you want to see. But some men dont want to know how long they have left. Everyone is different.
You can ask your doctor how long you have left to live. They wont be able to give you an exact answer. This can be frustrating and it may feel like your doctor is trying to avoid your questions. But no-one can know for certain how long you have left because everyone’s body and everyone’s cancer is different. However, your doctor will be able to give you some idea based on where the cancer has spread to, how you are responding to treatment, how quickly the cancer has spread, and what problems it is causing.
It can be helpful to talk with your family about this. You may not want to upset them but they might have similar questions and thoughts to you.
If you have months or maybe years left to live, it can be difficult for your doctor to say exactly how long you have left. This is because they dont know how you will respond to different treatments. If your treatment stops working so well, there may be other treatments available. Some men may not respond well to one treatment, but may respond better to another. Read more about treatments for advanced prostate cancer.
What Is The Treatment For The Final Stages Of Prostate Cancer
End stage prostate cancer means a person cannot be cured, and they will die from cancer. Palliative care, also called supportive care or comfort care, is used to help manage or relieve symptoms of end-stage prostate cancer.
The goal of palliative care is to improve a patients quality of life and relieve suffering. Palliative care can help patients cope with physical symptoms such as pain, fatigue, shortness of breath, loss of appetite, nausea, constipation, and difficulty sleeping , and mental/emotional symptoms such as depression and anxiety.
Hospice care may also be an option for terminally ill patients with a limited life expectancy and may begin if a patients condition is unable to be cured or managed. The only goal of hospice care is comfort and quality of life. Palliative care may occur in a hospice, in a patients home, in the hospital, or a long-term care facility.
Palliative care may include treatment to alleviate symptoms and keep a patient comfortable, such as:
- Help with medications
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Stage Ii Prostate Cancer Survival
Stage II cancer means the cancer is only in the prostate, and is only in a small percentage of the tissue. Like Stage I, Stage II prostate cancer is considered to be local prostate cancer and there is a 100 percent five-year survival rate. You are very unlikely to die as a result of being diagnosed with Stage II prostate cancer.
Many Men With Metastatic Prostate Cancer Die From Noncancer Causes
Approximately 1 in 6 deaths among men with metastatic prostate cancer are due to noncancer causes, according to a recent study.
Cardiovascular and cerebrovascular diseases and chronic obstructive pulmonary disease are among the most common noncancer causes of death.
These findings may provide insight into how men with metastatic should be counseled regarding future health risks and highlight the importance of multidisciplinary care for such patients, a team led by Omar Alhalabi, MD, of the University of Texas MD Anderson Cancer Center in Houston, reported in JAMA Network Open.
Using data from the Surveillance, Epidemiology, and End Results program database, the investigators studied 26,168 men diagnosed with metastatic prostate cancer from January 1, 2000, to December 31, 2016. Of these, 16,732 died during follow-up. Most deaths occurred within 2 years of diagnosis. The mean age at death was 74 years.
Of the total number of deaths following a diagnosis of metastatic prostate cancer, 13,011 were from prostate cancer, 924 were from other cancers, and 2797 were from noncancer causes, Dr Alhalabi and colleagues reported.
Men with metastatic prostate cancer had a significant 34%, 31%, and 19% higher mortality rate from cardiovascular disease, cerebrovascular disease, and COPD, respectively, compared with the age-matched US male population in adjusted analyses, according to the investigators.
References
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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.
Prostate Cancer Is Common With Aging
After skin cancer, prostate cancer is the most common cancer in men. About 1 in 7 men will be diagnosed with prostate cancer in their lifetime. And these are just the men who are diagnosed. Among very elderly men dying of other causes, a surprising two-thirds may have prostate cancer that was never diagnosed.
Only 1 in 36 men, though, actually dies from prostate cancer. Thats because most prostate cancers are diagnosed in older men in whom the disease is more likely to be slow-growing and non-aggressive. The majority of these men eventually pass away from heart disease, stroke, or other causes not their prostate cancer.
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