Prostate Cancer Stages 1 10

How Do Prostate Cancer Stages & Grades Affect Survival Rates

10 Warning Signs of Prostate Cancer

Overall, the prostate cancer survival rate is 97.5%most men will not die of prostate cancer, even if they have it until the end of life. However, if you look at survival rates by stage, it has been shown that the more advanced forms of prostate cancer have a lower survival rate .

The National Cancer Institutes Surveillance, Epidemiology, and End Results Program , which is the database that compiles the incidence and survival rates, sorts prostate cancer into localized, regional, and distant rather than using the TNM system :

LocalizedCancer has not spread outside of the prostate
RegionalCancer has spread outside of the prostate to adjacent structures and lymph nodes
DistantCancer has spread to remote parts of the body, such as bones, liver, or lungs

Here are the 5-year relative survival rates for men with prostate cancer based on the SEER database information :

Being diagnosed with cancer can be difficult for both you and your loved ones. There is a great deal of information available about staging, survival rates, treatments, etc. Talking to your healthcare providers about your cancer can help you translate the alphabet soup into an actionable plan.

It is important to remember that cancer affects each person differently doctors have guidelines to follow, but no single treatment plan works best for everyone. Work as a team with your healthcare provider to come up with the best strategy for you to manage your prostate cancer.

Prostate Cancer Survival Rate

In terms of how often doctors deliver a diagnosis, prostate cancer is second only to skin cancer in the US. When it comes to a worldwide view, prostate cancer is the second leading cause of cancer deaths when men are concerned.

During their lifetime, 1 in 8 American men is bound to receive a prostate cancer diagnosis. This prognosis is highly related to age. The more you advance in age, the greater your chances become of developing this type of cancer.

Since this is a widely spread disease among men, today were going to take a look at the survival rate patients with prostate cancer are expecting. This prognosis is usually calculated over the first 5 years after the prostate cancer diagnosis. These rates are not looking further than this period of time, and they compare the survival rate over the course of these 5 years of prostate cancer patients to healthy men.

Be mindful that these rates are based on how the majority of prostate cancer patients performed in the last 10 years. Therefore, these statistics cannot overwrite the particularities of individual cases. Their goal is to offer estimations in the absence of professional diagnosis and interpretations. Moreover, prostate cancer treatment plans have continued to improve and record better results, which means that the survival rates are actually higher at this time than the official estimates.

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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

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What Are The Stages Of Prostate Cancer

If you are diagnosed with prostate cancer, the first thing your doctors will do is assess if and how much the cancer has spread. This process is called staging.

Prostate cancer, like all cancers, will fall into one of four stages. In stage 1, the cancer has not spread. The succeeding stages define gradually advanced stages of cancer up to stage 4, which describes cancer that has spread to other areas of the body.

Staging cancer is an important part of diagnosis and treatment. It helps doctors determine your treatment plan, and it helps patients understand how they will move forward.

Learning more about staging will help you understand what to expect from these early days of your diagnosis and make decisions regarding treatment.

Contents

SERO and Your Prostate Cancer

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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Gleason Score For Grading Prostate Cancer

Prostate cancer is also given a grade called a Gleason score. This score is based on how much the cancer looks like healthy tissue when viewed under a microscope. Less aggressive tumors generally look more like healthy tissue. Tumors that are more aggressive are likely to grow and spread to other parts of the body. They look less like healthy tissue.

The Gleason scoring system is the most common prostate cancer grading system used. The pathologist looks at how the cancer cells are arranged in the prostate and assigns a score on a scale of 3 to 5 from 2 different locations. Cancer cells that look similar to healthy cells receive a low score. Cancer cells that look less like healthy cells or look more aggressive receive a higher score. To assign the numbers, the pathologist determines the main pattern of cell growth, which is the area where the cancer is most obvious, and then looks for another area of growth. The doctor then gives each area a score from 3 to 5. The scores are added together to come up with an overall score between 6 and 10.

Gleason scores of 5 or lower are not used. The lowest Gleason score is 6, which is a low-grade cancer. A Gleason score of 7 is a medium-grade cancer, and a score of 8, 9, or 10 is a high-grade cancer. A lower-grade cancer grows more slowly and is less likely to spread than a high-grade cancer.

Baus Radical Prostatectomy Audit

The British Association of Urological Surgeons now publishes the results of radical prostatectomy for surgery performed in the UK. Details of the operations performed by each surgeon and centre are given, with information about the technique used, transfusion rates, postoperative complications and length of stay for individual surgeons and units. The responsibility of entering the data, however, lies with the individual surgeons and is not always complete.

For more information and guidance on treatment for prostate cancer as well as radical prostatectomies visit Mr Neil Haldars Top Doctors profile today.

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What Is Prostate Cancer

Prostate cancer is cancer that affects the prostate glands present in men. Prostate cancer is the second-leading cause of cancer deaths for men in the United States.

Growth in the prostate can be of two types:

Benign growths: These are noncancerous growths and are rarely a threat to life .
Malignant growths: These are cancerous growths that are potentially life-threatening.

Psa Levels In Metastatic Prostate Cancer

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As part of patients’ ongoing treatment, the care team will regularly test PSA levels. PSA stands for prostate-specific antigen, which can be high in men who have prostate cancer. PSA tests are used not only for the initial cancer diagnosis but also to observe the advancement of the disease over time.

Generally, PSA levels are higher in men with metastatic prostate cancer. However, in rare cases, its possible to have a low PSA even if a patient has metastatic disease. For these patients, disease progression is better measured in other ways, such as through imaging tests and biomarker tools.

Metastatic Prostate Cancer Symptoms

With metastatic prostate cancer, the patient may notice different symptoms than those generally associated with other stages of the disease. Some of the most frequently occurring stage 4 prostate cancer symptoms include:

Bone pain, particularly in the pelvis, ribs, skull and spine
Unexplained weight loss
General feeling of being unwell
Changes in urinary habits, such as needing to go more often
Cough, breathlessness or other changes involving the lungs and chest

Not everyone with metastatic prostate cancer will experience each of these symptoms, but patients should speak with their care teams if they notice any such changes.

Figure 2 Why Understaging May Occur

When the prostate is removed, a pathologist examines slices of the gland for evidence of cancer. A. Under a microscope, the pathologist can distinguish tiny tumors, consisting of clumps of visibly abnormal cells. B. With current imaging technology, it is not yet possible for a pathologist to identify micrometastases individual cancer cells shed from the primary tumor that have gone on to seed adjacent tissue. In this image, for example, cancer cells have already penetrated the capsule and migrated to adjacent tissue, even beyond the margin of tissue removed during surgery.

Individual prostate cancer cells can spread to more remote areas of the body in three ways . Whats more, they can do so without being detected with our current technology, essentially escaping under the radar. So its always possible even if you are diagnosed with early-stage prostate cancer that the cancer has already spread and will manifest in the coming years. How likely is it that an early-stage prostate cancer will become active without treatment? A small study provides some clues .

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Risk Groups For Prostate Cancer

Prostate cancer is divided into risk groups.

Before planning your treatment, your cancer doctor will look closely at your risk group. This helps you and your doctors to decide on the best treatment for you. The treatment options for each risk group can be different.

Prostate cancer was previously grouped into low, intermediate or high risk groups. Doctors now use a more detailed system to work out your risk group. This is called the Cambridge Prognostic Group . It divides prostate cancer risk into 5 different groups. Your doctor may still describe your risk as low, moderate or high.

To work out your CPG risk group, your doctors look at:

the stage of the cancer
your Gleason score.

Treatments May Have Side Effects

The treatment options for early-stage prostate cancer fall into three broad categories: surgery, radiation therapy, and active surveillance. Your doctor will make a treatment recommendation based on your numbers as well as a mathematical tool known as a nomogram, which can help you and your doctor better assess how extensive your cancer is likely to be and whether it is likely to become active in the future.

Yet clinical studies have not provided any evidence that one treatment is better than another or that any treatment at all actually prolongs life: The average 5-, 10-, and 15-year survival rates are virtually the same for all treatment options in early-stage prostate cancer, including active surveillance. Its also important to understand that no mathematical model is foolproof, and some men diagnosed with early-stage, locally confined disease will later find out that their cancer was more extensive than originally believed.

If you are diagnosed with early-stage prostate cancer, you have a number of treatments to choose from. A brief comparison is listed in Table 2.

There Are 2 Types Of Staging For Prostate Cancer:

The Clinical Stage The clinical stage is based on the results of tests that can be done prior to the surgery. They include the DRE, biopsy, X-rays, CT and/or MRI scans and bone scans. X-rays, bone scans, CT scans and MRI scans may not always be needed. They are recommended based on the PSA level, the size of the cancer, which is determined by its grade and volume and the clinical stage of the cancer.

The Pathologic Stage The pathologic stage is based on information found during surgery, plus the laboratory results referred to as pathology, of the prostate tissue removed during surgery. The surgery often includes the removal of the entire prostate and some lymph nodes.One important part of the staging process is determining the grade of the cancer. The grading system is based on the microanalysis of the prostatic tissue. While the stage of the cancer is determined based on the macro appearance of the tumor, in connection with the nearby organs and tissues, the grade of cancer is usually determined after a biopsy, when the cells are analyzed under a microscope.

Screening Indications And Controversies

Digital rectal examination and prostate-specific antigen measurement are the two components necessary for a modern screening program.

The indications for screening are controversial. Advocates of screening believe that early detection is crucial to finding organ-confined disease and to reducing the likelihood of mortality. When symptoms develop or when DRE results become positive, most cases have already advanced beyond organ-confined disease. Those who do not advocate screening note that screening can detect cancers that are not biologically significant , and subject patients to the risks of unnecessary intervention.

The American Cancer Society recommends that asymptomatic men with at least a 10-year life expectancy should be given an opportunity to make an informed decision with their health care provider after receiving information on the uncertainties, risks, and benefits of screening PSA evaluation. The recommended age at which men should receive this information varies by prostate cancer risk, as follows :

Age 50 for those at average risk of developing prostate cancer
Age 45 for those at high risk, including African Americans and men with a first-degree relative diagnosed with prostate cancer before age 65
Age 40 for those at higher risk

Men who decide to be screened should be tested with a PSA test. A DRE may also be done as a part of screening. If screening does not detect cancer, the time between subsequent screenings depends on the PSA results, as follows :

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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. This is common with prostate cancer radiation therapy because the radiation can damage cells in the tissues surrounding the prostate. But at MSK, we routinely use sophisticated computer-based 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. We have also found that, when treating with the combined approach, using the high-dose-rate brachytherapy compared to low-dose-rate brachytherapy may have less in the way of side effects.

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 the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and dissolves on its own within the body after a few months.

Stage Ii Prostate Cancer

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The tumor is more advanced or a higher grade than Stage I, but the tumor doesnt extend beyond the prostate. It may be felt during a digital rectal exam, or it may be seen on a sonogram.

Stage IIA: The tumor cannot be felt and involves half of 1 side of the prostate or even less than that. PSA levels are medium, and the cancer cells are well differentiated. This stage also includes larger tumors found only in the prostate, as long as the cancer cells are still well differentiated.

Stage IIB: The tumor may be large enough to be felt during DRE. The PSA level is medium. The cancer cells are moderately differentiated.
Stage IIC: The tumor may be large enough to be felt during DRE. The PSA level is medium. The cancer cells may be moderately or poorly differentiated.

Ct Scanning Mri And Bone Scanning

Men with PSA levels above 10 ng/mL, high-grade histology , or physical findings that suggest stage T3 disease should probably undergo a staging computed tomography scan and bone scan. CT scanning is the one modality with evidence-based guidelines. The CT scan can be used to evaluate extension into the bladder and lymph nodes to help stage the patient’s cancer or to consider lymph node sampling prior to treatment.

According to the National Comprehensive Cancer Network , technetium-99m-methyl diphosphonate bone scan is indicated in the initial evaluation of patients at high risk for skeletal metastases, as indicated by any of the following :

T1 disease, PSA 20
Symptoms suggestive of osseous metastasis

The NCCN recommends pelvic CT or magnetic resonance imaging in patients with any of the following:

T1-T2 disease and nomogram-indicated probability of lymph node involvement > 10%

Conventional endorectal MRI is helpful for localizing cancer within the prostate and seminal vesicles and for local staging. Dynamic, contrast-enhanced MRI and MR spectroscopic imaging are complementary in local staging, but their use is currently limited to a research setting.

Detection of large and poorly differentiated tumors
T staging: Detection of extracapsular extension, with high negative predictive values in low-risk men
N staging: MpMRI is equivalent to CT scan
M staging: MpMRI outperforms bone scan and targeted x-rays for M staging, with 98-100% sensitivity and specificity