Life After Treatment: Alan Weiners Story
When Alan Weiner found out he had prostate cancer, it was a huge and frightening emotional bomb blast.
The New York native was diagnosed in February 2014 at age 69. After seeking out opinions from various doctors, Weiner underwent robotic prostatectomy in April at Mount Sinai Hospital in New York.
Because of the emotional toll his diagnosis took, Weiner says he found a support group that helped him through that uncertain time in his life. I joined Gildas Club after surgery, but if I had known about it, I would have attended sessions prior to deciding treatment, he says. I found a friend who went through the process and was understanding of my anxieties, fears, and projections.
I never thought that the emotional aspects of this would be so difficult to deal with, Weiner adds. I never believed that the mortality rate of prostate cancer was very low, and I believed that I would be the one who would not make it. I now know that my fears and negative thinking were things most men go through, however.
Today, Weiner goes for routine checkups, and two years after his initial diagnosis, his PSA level is undetectable. He deals with persistent sexual dysfunction, but the bladder control issues he first experienced after his surgery have resolved.
Where Prostate Cancer Spreads In The Body Affects Survival Time
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DURHAM, N.C. â 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.
How Does Radiotherapy Treatment Work
Radiation therapy works by use of high doses of radiation to kill or slow down its growth rate. In prostate cancer treatment it is used to kill the cancerous cells or slow the growth rate. It also kills the nearby healthy cells as it kills the cancerous cells.
Where curing the cancer is impossible, radiotherapy is used to reduce the symptoms such as pain caused by cancer tumor. It can also be used to prevent the problems that result from cancer tumor such as loss of bowel and bladder control, blindness etc.
*All individuals are unique. Your results can and will vary.
Here are different types of radiations and how they work:
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What Is Radiation Therapy
Radiation therapy is a form of cancer therapy that employs high-intensity wave energy to destroy cancer cells. Over 50% of cancer patients receive radiation therapy as part of their treatment protocol. X-rays are the most common type of energy used during treatment, but gamma rays, protons, or electron beams can also be utilized. Radiation therapy refers typically to external beam radiation, meaning the source of energy comes from a device outside the patients body, targeting the beams at a specific location on the body.
However, radiation therapy can also be administered in other ways. Internal radiation therapy, known as brachytherapy, refers to the placement of a radioactive implant inside the body near the tumor location. The implant capsule can carry a higher dose of radiation to treat a smaller area than would be possible with external beam radiation.
Another form of radiation treatment, known as systemic radiation therapy, uses radioactive materials administered orally or through a vein. Although the radiation does pass through the body, the vast majority will be released at the tumor site, posing minimal risk to the rest of the body.
Get Regular Physical Activity
Some research has suggested that men who exercise regularly after treatment might be less likely to die from their prostate cancer than those who dont. Its not clear exactly how much activity might be needed, but more seems to be better. More vigorous activity might also be more helpful than less vigorous activity. Further studies are needed to follow up on these findings.
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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.
Is Prostate Cancer Curable
Prostate cancer is the most common type of cancer among men, second only to skin cancer. Learning that one has any type of cancer isnt easy, but the first question on most patients minds after diagnosis is, is prostate cancer curable?
The short answer is yes, prostate cancer can be cured, when detected and treated early. The vast majority of prostate cancer cases are discovered in the early stages, making the tumors more likely to respond to treatment. Treatment doesnt always have to mean surgery or chemotherapy, either. Non-invasive radiation therapy can effectively treat prostate cancer in the case of Pasadena CyberKnife, radiosurgery treatment generally takes less than a week, and you can typically resume your normal activities the same day you receive treatment.
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What Is Advanced Cancer
Advanced cancer is most often used to describe cancers that cannot be cured. This means cancers that wont totally go away and stay away completely with treatment. However, some types of advanced cancer can be controlled over a long period of time and are thought of as an ongoing illness.
Even if advanced cancer cant be cured, treatment can sometimes:
- Shrink the cancer
- Help relieve symptoms
- Help you live longer
For some people, the cancer may already be advanced when they first learn they have the disease. For others, the cancer may not become advanced until years after it was first diagnosed.
Advanced cancers can be locally advanced or metastatic.
Locally advanced means that cancer has grown outside the body part it started in but has not yet spread to other parts of the body. For example, some cancers that start in the brain may be considered advanced because of their large size or closeness to important organs or blood vessels. This can make them life-threatening even though they havent spread to other parts of the body. But other locally advanced cancers, such as some prostate cancers, may be cured.
Metastatic cancers have spread from where they started to other parts of the body. Cancers that have spread are often thought of as advanced when they cant be cured or controlled with treatment. Not all metastatic cancers are advanced cancers. Some cancers, such as testicular cancer, can spread to other parts of the body and still be very curable.
Death From Other Causes
The mean age at metastatic prostate cancer diagnosis in the study was roughly 71 years. Most of the cohort was White and had a diagnosis of stage M1b metastatic prostate cancer , which means the cancer had spread to the bones.
Among men in the cohort, the rates of death from septicemia, suicide, accidents, COPD, and cerebrovascular diseases were significantly increased compared with the general US male population, the team observes.
Thus, the study authors were concerned with not only with death from metastatic prostate cancer, but death from other causes.
That concern is rooted in the established fact that there is now improved survival among patients with prostate cancer in the US, including among men with advanced disease. âPatients tend to live long enough after a prostate cancer diagnosis for noncancer-related comorbidities to be associated with their overall survival,â they write.
The editorialists agree: prostate cancer âhas a high long-term survival rate compared with almost all other cancer types and signals the need for greater holistic care for patients.â
As noted above, cardiovascular diseases were the most common cause of non-prostate cancer-related deaths in the new study.
As in the management of other cancers, there is concern among clinicians and researchers about the cardiotoxic effects of prostate cancer treatments.
The study had no specific funding. The study authors and editorialists have disclosed no relevant financial relationships.
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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:
- Gleason score: 6 or less
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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Coping With Prostate Cancer
The diagnosis of cancer can cause great anxiety to the individual and his family and friends. At times, one may have troubles coping with the diagnosis, the disease, and its treatment. Searching online for information may prove overwhelming also and may not be the best resource. Ask your physician or local hospital about local resources. Often, there are local prostate cancer support groups which may help you cope with your feelings and provide local resources for more knowledge.
You may consider contacting one or more of the following organizations:
- US Prostate Cancer Foundation,
- Centers for Disease Control and Prevention ,
- American Cancer Society, and
- Patient Advocates for Advanced Cancer Treatment.
The Internet has provided access to a number of sites focusing on prostate cancer treatment and outcomes. The National Cancer Institute and the National Comprehensive Cancer Network have patient information, as well as the American Urological Association.
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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In active monitoring, men with localized prostate cancer do not get surgery or radiation right after theyre diagnosed. Instead, they have regular biopsies, blood tests, and MRIs to see if their cancer is progressing. If it is, they can receive treatment.
Although some oncologists advise men with early, low-grade prostate cancer to choose active surveillance and professional groups such as the American Society of Clinical Oncology recommend it many patients recoil at what sounds like lets just wait for your cancer to become really advanced. A decade ago fewer than 10 percent of men diagnosed with prostate cancer chose monitoring, UCLA researchers found. But that is changing. Now at least half of men do.
That made sense to Garth Callaghan, author of the best-selling Napkin Notes, a book of missives he tucked into his daughters lunch box. Diagnosed with early prostate cancer in 2012, he said, none of the choices seemed particularly attractive to a 43-year-old man who dreaded the possibility of side effects of surgery or radiation, including incontinence and impotence. I was completely torn. My previous experience was, just get it out of my body. But after his doctor explained that prostate cancer is grossly overtreated in the United States, I did a complete 180 and chose active monitoring.
Most Patients Did Not Progress
With active surveillance, the patients had physical exams and PSA tests every six months, with biopsies recommended every one to two years.
Over an average of two and a half years of follow-up, 43 of the study participants showed evidence of cancer progression and received treatment.
In two patients, cancer spread beyond their prostate.
The study is published in the April issue of the Journal of Urology.
The findings support the idea that some men with prostate cancer may not need treatment, American Cancer Society Deputy Chief Medical Officer Len Lichtenfeld, MD, tells WebMD.
He says the addition of a second biopsy should help refine the search for men who are appropriate candidates for active surveillance, but he also agrees that the strategy of watchful waiting is not without its risks.
âThe real advance will be when we have tests that will tell us with a high degree of accuracy when treatment is needed and when it is not,â he says.
A great deal of research is being done to identify genetic tests or tumor markers that can do this, but Lichtenfeld says it will be years before these tests are validated.
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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.
Moffitt Cancer Centers Approach To Prostate Cancer Treatment
No matter the stage of your cancer, Moffitt Cancer Center can help you improve your prognosis and quality of life. Not only do we have a dedicated Genitourinary Oncology Program staffed by surgeons, medical oncologists, radiation oncologists and other support professionals who specialize in treating prostate cancer, but we also create individualized treatment plans for each of our patients. Our multispecialty team comes together in regular tumor board meetings to evaluate a number of different factors that can all affect a patients outcomeincluding the size, grade and location of tumors, along with any other treatments previously attemptedto develop the best possible plan for the patients unique situation.
At Moffitt, we welcome patients who have already received treatment elsewhere, as well as patients who are exploring their options for the very first time. Call , or submit a new patient registration form online a member of our team will tell you more about Moffitts prostate cancer survival rate and discuss your treatment options. We provide every new patient with rapid access to a cancer expert within a day, which is faster than any other cancer hospital in the nation.
Medically reviewed by Monica Chatwal, MD, medical oncologist, Genitourinary Oncology Program.
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Radiation Therapy For Prostate Cancer
Radiation therapy uses high-energy rays or particles to kill cancer cells. Depending on the stage of the prostate cancer and other factors, radiation therapy might be used:
- As the first treatment for cancer that is still just in the prostate gland and is low grade. Cure rates for men with these types of cancers are about the same as those for men treated with radical prostatectomy.
- As part of the first treatment for cancers that have grown outside the prostate gland and into nearby tissues.
- If the cancer is not removed completely or comes back in the area of the prostate after surgery.
- If the cancer is advanced, to help keep the cancer under control for as long as possible and to help prevent or relieve symptoms.
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