Prognosis And Survival For Bladder Cancer
If you have bladder cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for bladder cancer.
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How Prostate Cancer Spreads
- The cells escape into the bloodstream, initially by invading small blood vessels around the tumor, then traveling to larger blood vessels that enable the cells to circulate around the body .
- The cells are filtered through the bodys lymph system although some are captured in lymph nodes, others may travel elsewhere in the body.
- The cells migrate along the length of a nerve, escaping from the prostate into adjacent soft tissue .
Staging And Grading For Stage 3 Cancer
Grade 3 and stage 3 cancer are not the same. Staging and grading cancer use different criteria to evaluate treatment options.
Staging is an important factor in determining cancer treatment options, since it establishes the tumors size and spread within the body. Staging is used for most cancers, but not all. Cancers in and near the brain, for example, dont use a defined staging system because their likelihood of spreading is low.
In general, cancer falls within stages 1 through 4. Some types may be stage 0, meaning there are cancerous cells in a layer of tissue, but they havent grown or spread.
Most cancers are staged using some form of the TNM system. Doctors may also use the TNM system to help determine the extent of certain cancers in each stage. The TNM system stands for:
- T , for the size of the original tumor
- N , whether the cancer is present in the lymph nodes
- M , whether the cancer has spread to other parts of the body
Some cancers, especially liquid cancers, are staged using different established protocols. The Binet and Rai systems, for example, are used to stage certain types of leukemia. Cancers of the female reproductive system, such as cervical cancer and ovarian cancer, are staged using the FIGO staging system, designed by the International Federation of Gynecology and Obstetrics .
When it comes to grading, tumors generally may be referenced in the following ways.
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What Are The Damico Risk Categories
The DAmico system provides an estimate of the risk of recurrence at five years after treatment. This system is one of the most widely used for risk assessment. It combines the PSA, Gleason score, and the clinical stage to create low, intermediate, and high risk categories. The higher the risk category, the higher the chance of recurrence is five years after treatment.
The DAmico risk categories are below. If one factor is putting you in a lower category but another is putting you in a higher category, then the higher category takes precedent.
Low Risk:
- PSA is less than 10 ng/mL AND
- Gleason score is equal to or less than 6 AND
- Clinical stage T1-T2a
- PSA is between 10 and 20 ng/mL OR
- Gleason score is 7 OR
- Clinical stage T2b
- Gleason score is 8-10 OR
- PSA is greater than 20 ng/mL OR
- Clinical stage T2c-T3
Life Expectancy And Survival Rates
Generally speaking, the earlier prostate cancer is detected, the more likely treatment will be successful. Once the cancer has begun to spread outside the prostate, treatment is likely to shift away from attempts to cure the disease and toward methods to help reduce the rate of spread, lengthen life and keep the symptoms under control, according to UCLA Health.
Unlike most prostate cancer diagnoses, for which the five-year survival rate is nearly 100 percent, the five-year survival rate for prostate cancer in the advanced stages may be less, depending on where the cancer has metastasized to. For instance, with regional metastasis , the five year survival rate is nearly 100 percent, but distant metastasis , has a five-year survival rate of just 30 percent, according to the National Cancer Institutes Surveillance, Epidemiology and End Results database.
The stage of the disease at diagnosis is a better predictor of survival than age is. Studies of age as a predictor of survivability have been inconsistent. An analysis of data, published in the journal Urology in December 2014, noted that some research has shown higher rates of survival among younger patients while other research has indicated that younger men typically develop prostate cancer that is aggressive, advanced and quickly fatal.
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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.
What Is Advanced Prostate Cancer
When prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer.
Prostate cancer is often grouped into four stages, with stages III and IV being more advanced prostate cancer.
- Early Stage | Stages I & II: The tumor has not spread beyond the prostate.
- Locally Advanced | Stage III: Cancer has spread outside the prostate but only to nearby tissues.
- Advanced | Stage IV: Cancer has spread outside the prostate to other parts such as the lymph nodes, bones, liver or lungs.
When an early stage prostate cancer is found, it may be treated or placed on surveillance . Advanced prostate cancer is not curable, but there are many ways to treat it. Treatment can help slow advanced prostate cancer progression.
There are several types of advanced prostate cancer, including:
Biochemical Recurrence
With biochemical recurrence, the prostate-specific antigen level has risen after treatment using surgery or radiation, with no other sign of cancer.
Castration-Resistant Prostate Cancer
Non-Metastatic Castration-Resistant Prostate Cancer
Prostate cancer that no longer responds to hormone treatment and is only found in the prostate. This is found by a rise in the PSA level, while the testosterone level stays low. Imaging tests do not show signs the cancer has spread.
Metastatic Prostate Cancer
- Lymph nodes outside the pelvis
- Other organs, such as liver or lungs
Metastatic Hormone-Sensitive Prostate Cancer
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How Do Doctors Identify Prostate Cancer Stages
After diagnosis, your doctor will do a biopsy to study the prostate cancer cells. Theyll also do some tests to check cancer cells and whether cancer has spread. Your doctor will use any of these screening tests to check the prostate cancer stage:
- Digital rectal exam . It is done to check if the prostate is hard or enlarged.
- Prostate-specific antigen . High levels of PSA protein indicate cancer.
- Imaging. Transrectal ultrasound and prostate MRI are imaging tests to check the growth and spread of prostate cancer.
Why Is There A Disparity Between Men And Women With Bladder Cancer
In many cases, there are significant delays in diagnosing bladder cancer in women. Many women ignore the most basic symptomblood in the urine. They may associate it with menstruation or menopause and delay reporting this symptom to their doctors. Even after reporting the problem to their doctors, blood in the urine may be initially misdiagnosed. It may be seen as a symptom of post-menopausal bleeding, simple cystitis or a urinary tract infection. As a result, a bladder cancer diagnosis can be overlooked for a year or more.
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What Is Stage 4 Prostate Cancer
The fourth stage of prostate cancerdefines a tumor that has progressed to other regions of the body, such as the lymph nodes, lungs, liver, bones, or bladder. The 5-year survival rate for these tumors is 29 percent.
Keep in mind that each case is unique, and figures like these are merely suggestions. As advances in prostate cancer treatment become more common, your odds of surviving this disease improve.
In general, prostate cancer has a very good survival rate one of the greatest of any cancer type. Because prostate cancer is frequently a slow-moving disease, the majority of men diagnosed with it will die from an unrelated reason.
Stage 4 prostate cancer means the cancer has spread to lymph nodes or to other parts of the body. It is further divided into two substages:
- Prostate Cancer Stage 4A Stage 4A: The cancer has spread to nearby lymph nodes but may or may not have spread to nearby tissues.
- Prostate Cancer Stage 4B Stage 4B: The cancer has spread to another area of the body, such as the bones or distant lymph nodes.
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Pathological Stage: A Look At The Actual Cancer Cells And Their Distribution Within The Pelvic Area
This system assesses how pervasive the cancer cells are within and around the prostate. These stages begin at T2.
T2: The tumor is located in the prostate only.T3: The tumor has breached the prostate border on 1 or more sides.T3b: The tumor has begun to grow in the seminal vesicles.T4: The tumor has grown into other neighboring structures, like the bladder, the rectum, or the pelvic wall.
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Stage 4 Prostate Cancer Clinical Trials
Clinical trials provide cancer patients with life-extending and curative new medicines. Clinical drug trials are critical in getting new medicines to patients who need them the most, as well as securing data so that regulatory clearances may be secured, and new drugs can enter broad clinical practice. Patients who take part in clinical trials benefit both treatment science and their fellow patients.
There are currently 100 Phase III drug trials and more than 500 Phase I/II trials related to prostate cancer treatment in progress in the United States alone. Those that are approved will join the 12 new drugs that have been approved for men with advanced/metastatic disease since 2010 and further improve outcomes for patients:
Using our AI-powered approach, Massive Bio leads patients through the most extensive clinical trial matching process available.
We can assist you if you have been diagnosed with any of the following prostate cancer subtypes:
- Transitional Cell Carcinoma
- Small Cell Carcinoma
If you do not know which type of prostate cancer you have, that is okay. Additional testing can help you determine your exact diagnosis.
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What Questions Should I Ask My Healthcare Provider
If you have prostate cancer, you may want to ask your healthcare provider:
- Why did I get prostate cancer?
- What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
- Has the cancer spread outside of the prostate gland?
- What is the best treatment for the stage of prostate cancer I have?
- If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
- What are the treatment risks and side effects?
- Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
- Am I at risk for other types of cancer?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.
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Palliative Or Supportive Care
If your cancer is at an advanced stage and cant be cured, your medical team should discuss how the cancer will progress and which treatments are available to ease the symptoms.
You can be referred to a palliative care team, who can provide support and practical help, including pain relief.
Page last reviewed: 01 July 2021 Next review due: 01 July 2024
Prostate Cancer: What You Need To Know This Movember
Prostate cancer has the potential to grow and spread very quickly. It is important for patients to discuss their various testing options with HSP Group. The number of men being diagnosed with cancer is rising year on year. Men need to be pro-active and educated to recognise the warning signs of prostate cancer and other male cancers. Early detection can save your life. We encourage regular self-examinations and cancer screenings as symptoms dont always present until the cancer has spread.
What is a Prostate?
The prostate is a walnut sized gland that is part of the male reproductive system and located beneath the bladder in front of the rectum.
Why do men have a prostate?
How does the prostate grow and remain active?
The activity and growth of the prostate is stimulated by the male hormones called Androgens.
Risk Factors
Although the exact cause of prostate cancer is unknown, there are certain aspects of life that may increase your chance of having prostate cancer.
These include:
Having a risk factor does not mean that you will get Prostate cancer. Most men with any of the above risk factors never develop this disease.
How do I test for Prostate Cancer?
PSA testing can be done by means of a basic finger prick test and if a positive result is found, a PSA blood test will then be recommended to determine the actual level of the PSA.
- An enlarged prostate
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What Are The Four Stages Of Prostate Cancer
Prostate cancer stages range from 1 through 4.
- Stage 1 means the cancer is on one side of the prostate. …
- Stage 2 means the cancer remains confined to the prostate gland. …
- Stage 3 means the cancer is locally advanced. …
- Stage 4 means the cancer has spread to lymph nodes or to other parts of the body.
Treatment For Prostate Cancer At Moffitt Cancer Center
When a patient turns to Moffitt Cancer Center for diagnosis or treatment, we provide them with an individualized treatment plan that a multispecialty team of experts carefully assembles based on a comprehensive range of factors. We understand that prostate cancer stages are just a small part of the big picture our oncologists evaluate everything from the stage and cellular makeup of the cancer to the patients overall health and personal preferences, and then tailor a treatment plan to fit the patients unique situation.
Medically reviewed by Monica Chatwal, MD.
No referral is required to come to Moffitt. You can request an appointment online or call , and well set up a time for you to meet with one of our oncologists specializing in prostate cancer.
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Low Grade And High Grade Bladder Cancer
Bladder cancer starts in the lining of the bladder in about 90 percent of people diagnosed with this cancer. Bladder cancer is called low grade or high grade.
- Low-grade bladder cancer means the cancer has not invaded the muscles around the bladder . People rarely die from this type of bladder cancer, it often recurs after treatment.
- High-grade bladder cancer also often recurs and has a higher chance of spreading to other parts of the body. Almost all deaths from bladder cancer result this type so it is treated more aggressively.
General Prostate Cancer Survival Rate
According to the American Cancer Society:
- The relative 5-year survival rate is nearly 100%
- The relative 10-year survival rate is 98%
- The 15-year relative survival rate is 91%
Note: Relative survival rate means the percentage of patients who live amount of years after their initial diagnosis.
Keep in mind, however, that because the compiled list figures are of cancers diagnosed up to 15 years ago, you may have an even greater chance of survival than these indicate due to advances in prostate cancer treatment technology
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What Do Women Need To Know About Bladder Cancer
Bladder cancer can affect women at any age. Smoking is the greatest controllable risk factor. Smokers get bladder cancer twice as often as non-smokers. However, up to 50% of bladder cancer patients may have no history of smoking. Learn more about the risks associated with bladder cancer.
Bladder cancer symptoms may be identical to those of a bladder infection and the two problems may occur together. If symptoms do not disappear after treatment with antibiotics, insist upon further evaluation to determine whether bladder cancer is present. Bladder cancer has the highest recurrence rate of any form of cancerbetween 50-80 percent.