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.
Do Some Groups Experience Higher Rates Than Others
Cancer death rates differed by cancer type, sex, racial and ethnic group, and residence in an urban or rural county. Healthy People 2030 objectives include reducing death rates for lung cancerexternal icon to 25.1 deaths per 100,000 population, colorectal cancerexternal icon to 8.9 deaths per 100,000 population, female breast cancerexternal icon to 15.3 deaths per 100,000 female population, and prostate cancerexternal icon to 16.9 deaths per 100,000 male population.
NOTES: Deaths were classified using the International Classification of Diseases, 10th Revision. Cancer deaths were identified using underlying cause-of-death codes C00-C97 . Rates were age-adjusted to the 2000 US standard population. Urban/rural status was based on county of residence, classified using the 2013 NCHS Urban-Rural Classification Scheme for Counties.Healthy People objectivesexternal icon are available.
National Center for Health Statistics, National Vital Statistics System, Mortality Data.
- 1,153 children younger than 15 years old died of cancer.
- 8,863 adolescents and young adults between 15 and 39 years old died of cancer.
- 151,578 adults between 40 and 64 years old died of cancer.
- 338,340 adults between 65 and 84 years old died of cancer.
- 102,413 adults who were 85 years old or older died of cancer.
Note: Age was not recorded for 3 cancer deaths.
Incidence Drops For Cervical Cancer But Rises For Prostate Cancer
Latest data shows improvements for cervical cancer are linked to HPV vaccine and downturns in prostate cancer are driven by advanced-stage disease.
Significant changes in cancer prevention and screening in the United States in recent years helped lead to both promising and worrisome 2023 cancer statistics reported by the American Cancer Society . In good news, data from women ages 20 to 24 who were first to receive the human papillomavirus vaccine showed a 65% reduction in cervical cancer incidence rates from 2012 through 2019. In contrast, data after several years of shifts in screening guidelines about the use of prostate specific antigen testing showed a 3% increase in prostate cancer incidence rate each year from 2014 through 2019, about 99,000 new cases. This is the first increase in about 20 years.
In general, though, incidence rates improved less for women than for men during these years. Lung cancer decreased about half as fast in women as in men. Liver cancer and melanoma incidence rates both increased in women, while they declined in men younger than 50 and stabilized in older men. Women also saw increases in the incidence of breast cancer and endometrial cancer.
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Myth: If You Have A Low Psa You Don’t Have Prostate Cancer
Fact: PSA levels can be useful in diagnosing prostate cancer, but theyre really only one piece of the larger puzzle. The PSA test is far from perfect, Sartor says. He draws a parallel between low PSA readings and negative mammograms in women. If you have a negative mammogram, it’s not 100 in terms of excluding cancer. The probability is less, but likewise just because your PSA is relatively low, you cant interpret that to mean that there is no cancer present.
However, the opposite can also occur: Sartor described a different scenario in which one of his patients a very bright and accomplished attorney had a biopsy after getting an elevated PSA, and the biopsy came back negative. After this negative result he figured he didnt have cancer, and waited three to four years before having his PSA tested again, Sartor says. Now he has prostate cancer that has spread to other parts of his body. In other words: metastatic disease. He took the negative biopsy as literally meaning he doesn’t have cancer, and it turned out badly for him.
To get the most complete picture of your prostate health, you need to get other diagnostic tests as well. This may mean getting a biopsy. But that standard is changing, says Sartor, citing major studies published in The New England Journal of Medicine in March 2018 and The Lancet in February 2017 that point to the value of a special type of MRI imaging called multiparametric magnetic resonance imaging.
Myth: Prostate Cancer Treatment Always Causes Impotence
Fact: According to research published in the December 2014 issue of the International Journal of Urology, theres been progress in developing models to predict erectile dysfunction after localized treatment for prostate cancer. Sartor says avoiding impotence depends on many factors, including the skill of the surgeon who is operating on you. But as surgical techniques are improving, people are recovering faster and having fewer side effects.
According to Sartor, one year after surgery, approximately 25 percent of patients will say their function is fine, 25 percent will have mild dysfunction, 25 percent will have moderate dysfunction, and 25 percent say they have severe dysfunction.
Age can also be a complicating factor, adds Wei: As men get into their sixties and seventies, a lot of them already have some compromise of sexual function. Prostatecancer treatment certainly wont correct this problem, but it also isnt likely to make it significantly worse for most men.
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Prostate Cancer Survival Rates Are Favorable Overall
Thinking about survival rates for prostate cancer takes a little mental stretching. Keep in mind that most men are around 70 when diagnosed with prostate cancer. Over, say, five years, many of these men will die from other medical problems unrelated to prostate cancer.
To determine the prostate cancer survival rate, these men are subtracted out of the calculations. Counting only the men who are left provides what’s called the relative survival rate for prostate cancer.
Taking that into consideration, the relative survival rates for most kinds of prostate cancer are actually pretty good. Remember, we’re not counting men with prostate cancer who die of other causes:
- 92% of all prostate cancers are found when they are in the early stage, called local or regional. Almost 100% of men who have local or regional prostate cancer will survive more than five years after diagnosis.
- Fewer men have more advanced prostate cancer at the time of diagnosis. Once prostate cancer has spread beyond the prostate, survival rates fall. For men with distant spread of prostate cancer, about one-third will survive for five years after diagnosis.
Many men with prostate cancer actually will live much longer than five years after diagnosis. What about longer-term survival rates? According to the American Society of Clinical Oncology, for men with local or regional prostate cancer:
- the relative 10-year survival rate is 98%
- the relative 15-year survival rate is 95%
Enhancing Healthcare Team Outcomes
Prostate cancer diagnosis and treatment can be complex and is often controversial. an interprofessional team of specialty-trained nurses, nurse practitioners, physician assistants, primary care providers, oncologists, radiation therapists, genetic counselors, and urologists must work together to manage:
These and many more issues continue to challenge clinicians who deal with prostate cancer patients and men at risk for this common, potentially lethal male malignancy.
The interprofessional team can optimize the treatment of these patients through communication and coordination of care. Primary care providers, urologists, oncologists, radiation oncologists, and nurse practitioners provide diagnoses and care plans. Specialty care urologic nurses should work with the team to coordinate care and be involved in patient education and monitoring compliance. The interprofessional team can thus improve outcomes for patients with prostate cancer.
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Trends Of Cause Of Death Among Pca Patients By Time After Cancer Diagnosis
Non-cancer deaths accounted for the highest proportion of deaths throughout the follow-up period. As the follow-up time increased, the proportion of deaths from PCa gradually decreased, and the proportion of non-cancer deaths gradually increased. Beginning in the second year after diagnosis, the gap in the proportion of PCa-specific deaths and non-cancer deaths continued to widen . After the 10th year, non-cancer deaths accounted for 67.1% of all deaths, which was four times that of PCa-specific deaths . The cumulative mortality rate of the index cancer and non-index cancer increased slowly by time after diagnosis. The 5-year and 10-year CMRs of index cancer were 8.1% and 13.5%, respectively. The 5-year and 10-year CMRs of non-index cancer were 3.2% and 7.7%, separately. In contrast, the CMR of non-cancer causes increased rapidly, and the 5-year and 10-year CMR were 10.7% and 23.9%, respectively .
Figure 4 Cumulative mortality rate by time after diagnosis.
The SMRs of non-cancer deaths increased with prolonged survival time, and it was highest more than 10 years after diagnosis, with an SMR of 2.98 . This increasing trend was observed for most causes of death and was highest for Alzheimers disease. However, the SMRs of suicide and gastroduodenal ulcer death were significantly higher in the first year after diagnosis than 15 years after diagnosis .
How Is Advanced Prostate Cancer Treated
Androgen deprivation therapy is usually the choice of treatment of metastatic prostate cancer. Also known as hormone therapy, it is also used for treating patients who are unfit or unwilling to undergo surgery or/and radiation therapy.
Examples of hormone therapies for advanced prostate cancer include
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Managing Bone Pain And Weakness
Symptoms like nausea, hot flashes, and pain can usually be relieved with medication. Some people find that complimentary treatments like acupuncture or massage help manage side effects.
Your doctor may also recommend orthopedic surgery to stabilize your bones, relieve pain, and help prevent bone fractures.
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.
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Trends Of Cause Of Death Among Pca Patients By Year Of Cancer Diagnosis
In patients diagnosed in the 1970s, the gap between the proportion of deaths from PCa and non-cancer causes was not very large. Among patients diagnosed in 1975, 45.0% and 46.4% died of PCa and non-cancer causes, respectively . However, the proportion of deaths caused by PCa showed a rapid downward trend with the year of diagnosis, whereas the proportion of non-cancer deaths showed a clear upward trend. Among patients diagnosed in 2006, primary cancer accounted for only 17.6% of all deaths, compared with 56.4% of deaths from non-cancer causes .
Figure 3 Cause of death by year of death and time after diagnosis. Cause of death by year of death. Cause of death by time after diagnosis.
Reduce The Prostate Cancer Death Rate C08
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18.5prostate cancer deaths per 100,000 males *
18.8prostate cancer deaths per 100,000 males occurred in 2018 *
* Age adjusted to the year 2000 standard population.
Reduce the prostate cancer death rate
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Myth: My Dad Had Prostate Cancer So I Will Too
Fact: If a man has one relative with prostate cancer, say a father or brother, his chances of getting it are two times higher than someone who doesnt have this history, says John Wei, MD, a urology professor at the University of Michigan in Ann Arbor. Two family members with prostate cancer hike the risk five-fold.
But not everyone with a family history of prostate cancer will get it themselves. If prostate cancer runs in your family, talk with your doctor about when to start regular PSA tests your healthcare provider might be more aggressive about recommending follow-up testing.
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.
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What Is Cdc Doing To Reduce Cancer Deaths
CDCs framework to reduce cancer deaths includes eliminating preventable cancers, ensuring that all people get the right screening at the right time, and helping cancer survivors live longer, healthier lives. CDC supports foundational programs that aim to reduce the cancer burden through multi-disciplinary collaboration and coordination. These programs include the National Breast and Cervical Cancer Early Detection Program, the Colorectal Cancer Control Program, the National Program of Cancer Registries, and the National Comprehensive Cancer Control Program. Visit CDCs Cancer Prevention and Control website for more information.
Risk Of Prostate Cancer
About 1 man in 8 will be diagnosed with prostate cancer during his lifetime.
Prostate cancer is more likely to develop in older men and in non-Hispanic Black men. About 6 cases in 10 are diagnosed in men who are 65 or older, and it is rare in men under 40. The average age of men at diagnosis is about 66.
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Cause Of Death Among Pca Patients
Among the 501,262 patients who died during follow-up, 27.4% died of PCa, 15.6% died of non-index cancers, and 57% died of non-cancer causes. Cardiovascular diseases caused the majority of non-cancer deaths, accounting for 30.2% of all deaths in patients with PCa, followed by respiratory diseases and infectious diseases .
Table 2 Cause of death for patients diagnosed with prostate cancers between 1975 and 2016 in SEER 18 registries.
Among patients who died of non-cancer causes, the mortality rate in patients with PCa was 1.45 times that of the general population . Patients diagnosed before the 1990s, those 6079 years old, those of non-black ethnicity, unmarried patients, patients with a PSA between 10 and 20 ng/ml, and patients with distant type were more likely to die from noncancer causes than the general population. Except for patients diagnosed between 2010 and 2016 and those with a PSA < 10 ng/ml, the SMRs of non-cancer deaths in all subgroups were > 1 and statistically significant .
The mortality of cardiovascular diseases was 36% higher in PCa patients than in the general population . The SMRs of infectious diseases and respiratory diseases in PCa patients were 1.52 , and 1.33 , respectively. We also examined more detailed causes of death and found that the risk were highest for Alzheimers disease and hypertension, which had SMRs of 3.92 and 2.23 , respectively .
Figure 2 Forest plot showing the SMRs of different non-cancer of death in ranked order.
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 112.7 per 100,000 men per year based on 20152019 cases, age-adjusted.
Rate of New Cases per 100,000 Persons by Race/Ethnicity: Prostate Cancer
SEER 22 20152019, All Races, Males
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Concerning Trend: Prostate Cancer Is On The Rise
Prostate cancer is the second leading cause of cancer death for men in the United States, and the progress made since 2014 toward reducing rates has recently reversed, the report said.
- Prostate cancer increased by 3% annually from 2014 through 2019.
- Health experts say deaths may be driven by the diagnosis of advance disease, which the report showed increased by 4% to 5% each year.
- Before, prostate cancer had dropped by about 40% from 2007 to 2014 due to early diagnosis through screening.
These findings have been exacerbated by the pandemic, when men were not getting health care regularly, Haywood said. Im seeing in our practice definitely more men with more aggressive and advanced stage cancer.
Genetic Testing For Prostate Cancer
You may hear a lot about genetics or genomics. Both terms are related to genes and cell DNA, but they are different. These tests are being used to learn more about the DNA of cancer cells, and link DNA mutations with treatments. In the future, genetic testing may be the first step doctors take when diagnosing prostate cancer.
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