Stage Iv Prostate Cancer Prognosis
Prostate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate. This average survival rate represents stage IV prostate cancers that have metastasized beyond nearby areas to lymph nodes, organs or bones in other parts of the body.
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.
Is Prostate Cancer An Aggressive Cancer
High-risk prostate cancer is aggressive, meaning it is likely to spread quickly outside the prostate. Understanding the risk level of your cancer will help your doctor advise you about possible treatments. Your doctor will look at key markers for aggressive cancer, as well as the stage of your specific cancer.
What Foods Kill Prostate Cancer
These include broccoli, cauliflower, cabbage, Brussels sprouts, bok choy, spinach and kale. Some studies suggest that cruciferous vegetables may help slow down the growth of prostate cancer and reduce the risk of advanced prostate cancer.
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How Long Can You Live With Prostate Cancer With No Treatment
Studies have shown that between 86% and 98% of men with LPC do not die from their cancer in all age groups, the researchers wrote. In fact, more than 95% of patients with LPC live at least 10 years after their diagnosis, whereas only 25% of patients in this study expected to live more than 10 years.
Questions To Ask Your Doctor
To help understand the progression of prostate cancer, discuss these questions with your doctors:
- What is my Gleason score?
- Has the cancer spread outside my prostate?
- Whats my prostate cancer stage?
- Are other tests needed to determine my cancer stage?
- What are the treatment options for my stage of cancer?
- Can I avoid treatment right now and go on active surveillance?
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Is Stage 3 Prostate Cancer Bad
The malignant cells may have spread to tissue beyond the prostate, or the cancer may still affect the prostate only. With proper treatment, about 95 percent of individuals with stage 3 prostate cancer will survive for at least 5 years.
Changes To Your Sex Life
Sex will be a little different if you have surgery to remove your prostate gland. It means you wonât ejaculate, though you can still have an orgasm. Trouble getting erections or having orgasms is also a risk after an operation or if you have radiation therapy.
You can work with your doctor to cut those risks. Start by asking about “nerve-sparing” surgery and more precise radiation therapy. You can ask about the success they’ve had in protecting other men from these side effects.
If you do end up having problems after treatment, youâre not out of luck. Keep in mind that for many men, the problems go away on their own once the body has time to heal. Medications, devices, penile implants, and couples counseling also can make your sex life satisfying again. But most of all, be patient with yourself.
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Keeping Health Insurance And Copies Of Your Medical Records
Even after treatment, its very important to keep health insurance. Tests and doctor visits cost a lot, and although no one wants to think of their cancer coming back, this could happen.
At some point after your cancer treatment, you might find yourself seeing a new doctor who doesnt know your medical history. Its important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment.
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What Are The Signs That Death Is Approaching And What Can The Caregiver Do To Make The Person Comfortable During This Time
Certain signs and symptoms can help a caregiver anticipate when death is near. They are described below, along with suggestions for managing them. However, each persons experience at the end of life is different. What may happen to one person may not happen for another. Also, the presence of one or more of these symptoms doesnt necessarily mean that the patient is close to death. A member of the health care team can give family members and caregivers more information about what to expect.
Withdrawal from friends and family:
- People often focus inward during the last weeks of life. This doesnt necessarily mean that patients are angry or depressed or that they dont love their caregivers. It could be caused by decreased oxygen to the brain, decreased blood flow, or mental preparation for dying.
- They may lose interest in things they used to enjoy, such as favorite TV shows, friends, or pets.
- Caregivers can let the patient know they are there for support. The person may be aware and able to hear, even if they are unable to respond. Experts advise that giving them permission to let go may be helpful. If they do feel like talking, they may want to reminisce about joys and sorrows, or tie up loose ends.
The dying process:
Outlook For Men With Advanced Prostate Cancer
While it isnt possible to cure advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain.
Some men may not respond well to one treatment, but may respond better to another. And when your first treatment stops working, there are other treatments available to help keep the cancer under control for longer.
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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Treatment Options For Localized Prostate Cancer
If you are diagnosed with low-risk prostate cancer, you may be presented with a number of different treatment options. The most common include:
- Active Surveillance: Your doctor may want to monitor your disease to see if treatment is necessary. With active surveillance, you will have regular check-ups with your doctors, and he or she may perform biopsies regularly. If your test results change, your doctor will discuss your options for starting treatment.
- Watchful Waiting: While some doctors use the terms active surveillance and watchful waiting interchangeably, watchful waiting usually means that fewer tests are done. You will still visit your doctor regularly, but your doctor will discuss changes in your health as they relate to managing your symptoms, not curing your disease.
- Prostatectomy: Removal of the prostate, called prostatectomy, is an option that has a strong likelihood of removing your cancer since you are removing the gland where it is located. However, this is an invasive procedure that can lead to other issues, which will be covered later.
- Radiation: Your doctor may suggest radiation as a means of therapy that targets tumors with radiation, usually through daily treatments in a hospital or clinic over multiple weeks.
How Is Prostate Cancer Diagnosed
Doctors describe the growth and spread of prostate cancer in stages. Doctors use these stages as guides when choosing treatment options or offering prognoses to their patients.
Prostate cancer staging is based on a number of different factors, including prostate cancer screening tests such as a digital rectal exam or prostate-specific antigen test and imaging studies like bones scans, MRIs, CT scans, and trans-rectal ultrasounds.
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What Happens When Prostate Cancer Is Left Untreated
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
While most men undergo some form of treatment for their prostate cancer, some men today choose to not be treated for their prostate cancer. Instead, they may choose to have their doctors monitor their cancer.
Known as active surveillance, it is common when the cancer is expected to grow slowly based on biopsy results, confined to the prostate, not causing any symptoms, and/or small. In active surveillance, doctors will initiate cancer treatment only if cancer starts growing.
Others men may choose to not undergo cancer treatment because of a short life expectancy or other serious medical problems. They may feel that the risks or side effects of cancer treatment outweigh their potential benefits.
This option is certainly OK and reasonable in the right circumstancesrequiring a careful and thoughtful discussion with your doctor and family.
Talking To Andrew’s Doctor
For fifteen months, Andrew responded really well to treatment and was feeling reasonably good. But then he developed a very bad spinal cord compression. He was unable to walk and at that point it was clear that things were very serious. He spent nearly a month in hospital and his consultant told us that the cancer was back with a vengeance and that they wanted to fast track him home.
Andrew didnt want to know how long he might have. I know that he knew what the score was but that he just didnt want to speak about it.
Andrew didnt want to know how long he might have.
I asked Andrews doctor how long he might live for. She told me that she could give me some indication of how long Andrew might live for if I wanted to know. I wasnt sure that I wanted to know if Andrew didnt it might have created a barrier between us.
I wanted to know what I should expect. But I wasnt sure that I wanted to know how long Andrew would live for if he didn’t know.
But I wanted to know what I should expect. I needed to plan what was going to happen when he came home, the arrangements that would need to be made and whether I needed to speak to other members of our family and friends. At this point I think I felt quite out of control, so speaking to the consultant was my way of regaining some of that control and it helped me to plan for his homecoming.
Its difficult to accept that cancer takes its own route at its own pace.
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Types Of Radical Prostatectomy
There are three main types of radical prostatectomy:
- Retropubic. In this procedure, the surgeon uses an incision in the lower abdomen to remove the prostate and the lymph nodes for examination. This procedure allows for a nerve-sparing approach, which can lower but not totally eliminate the risk of impotence following surgery. In the nerve-sparing approach, the surgeon tries to preserve one or both of the small nerve bundles needed for unassisted erections. However, if the cancer has spread to the nerves, this approach may not be advised.
- Laparoscopic. In this recently developed procedure, the prostate is removed in a fashion similar to a retropubic prostatectomy, but the procedure is performed through five very small incisions using lighted, magnified scopes and cameras. The prostate specimen is then removed in a small bag through one of the incisions, which is expanded to 2 to 3 cm to allow specimen removal.Potential benefits of this procedure are less pain and earlier return to full activities. Nerve-sparing methods and lymph node dissections can be performed with this technique as well.
- Perineal. In this procedure, the prostate is removed through an incision in the skin between the scrotum and anus. The lymph nodes cant be removed through this incision. If the lymph nodes need to be examined, removal can be done through a small abdominal incision or by a laparoscopic procedure. A nerve-sparing approach can be performed perineally.
What Are Some Topics Patients And Family Members Can Talk About
For many people, its hard to know what to say to someone at the end of life. Its normal to want to be upbeat and positive, rather than talk about death. And yet, its important to be realistic about how sick the person may be. Caregivers can encourage their loved one without giving false hope. Although it can be a time for grieving and accepting loss, the end of life can also be a time for looking for meaning and rethinking whats important.
During this period, many people tend to look back and reflect on life, legacies created, and loved ones who will be left behind. Some questions to explore with a patient at the end of life are the following:
- What are the happiest and saddest times we have shared together?
- What are the defining or most important moments of our life together?
- What are we most proud of?
- What have we taught each other?
Patients with serious, life-threatening illness have stated that being positive or adding humor remains an important outlet for them. Even at this challenging moment, laughter may still be the best medicine.
Advanced Genomic Testing For Prostate Cancer
The most common lab test for prostate cancer is advanced genomic testing, which examines a tumor to look for DNA alterations that may be driving the growth of the cancer. By identifying the mutations that occur in a cancer cells genome, doctors may get a clearer picture of the tumors behavior and be able to tailor a patients treatment based on the findings.
How Fast Does Prostate Cancer Spread To The Bones
Early detection can catch prostate cancer even before there are any symptoms. Some types of prostate cancer grow very slowly.
There are four main stages of prostate cancer. Within each stage, the cancer is graded based on factors like the size of tumor, prostate-specific antigen level, and other clinical signs.
If the cancer has spread to the bones, its considered to be the most advanced, or stage 4.
Newer lab tests look at the genes inside cancer cells. This can provide more information on how quickly the prostate cancer may progress.
Theres also a grading system known as the Gleason system, which assigns the cancer into a grade group based on how closely it resembles normal tissue.
During the biopsy to diagnose prostate cancer, the cells are closely examined. The more abnormal cells that are in the biopsy sample, the higher the Gleason score and grade group.
When more abnormal cells are present, the cancer is more likely to spread quickly.
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Impact On Everyday Activities
If you have no symptoms, prostate cancer should have little or no effect on your everyday activities. You should be able to work, care for your family, carry on your usual social and leisure activities, and look after yourself.
If your prostate cancer progresses, you may not feel well enough to do all the things you used to. After an operation or other treatment, such as radiotherapy or chemotherapy, you’ll probably feel tired and need time to recover.
If you have advanced prostate cancer that has spread to other parts of your body, you may have symptoms that slow you down and make it difficult to do things. You may have to reduce your working hours or stop working altogether.
Whatever stage your prostate cancer has reached, try to give yourself time to do the things you enjoy and spend time with those who care about you.
How Does Cancer Cause Death
Every patient is different, and the way cancer causes death varies. The process can depend on the type of cancer, where it is in the body, and how fast its growing.
For some people, the cancer cant be controlled anymore and spreads to healthy tissues and organs. Cancer cells take up the needed space and nutrients that the healthy organs would use. As a result, the healthy organs can no longer function. For other people, complications from treatment can cause death.
During the final stages of cancer, problems may occur in several parts of the body.
In some cases, the exact cause cant be pinpointed and patients simply decline slowly, becoming weaker and weaker until they succumb to the cancer.
Again, every patient is different and all processes have different stages and rates in which they advance. And some conditions have treatments that can help slow the process or make the patient more comfortable. Its very important to keep having conversations with the patients health care team.
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