What Is The Difference Between Prostate Cancer And Advanced Prostate Cancer
Prostate cancer occurs when cells in the prostate gland begin to grow out of control. In the early stages of prostate cancer, the cancer cells are only present in the prostate and have not spread to nearby tissues.
Advanced prostate cancer, also known as stage 4 prostate cancer, occurs when cancer cells have spread to other areas of the body.
What Does It Mean For Prostate Cancer To Spread
Cancer cells can spread to other parts of the body. Doctors say the cancer has âmetastasizedâ or spread if this occurs.
Prostate cancer can spread to:
- pale skin due to anemia
These symptoms can also occur with aging and an enlarged prostate. As a result, some people may ignore them instead of seeking medical attention.
According to the Prostate Cancer Foundation, age is the biggest contributing factor to prostate cancer risk. Doctors diagnose an estimated 60% of all prostate cancers in males older than 65 years of age.
It states that additional risk factors for prostate cancer include:
- Family history: People with a close relative who has had prostate cancer may be twice as likely to get prostate cancer as those who do not.
- Race: Males of African descent are about 75% more likely to develop prostate cancer than white males and more than twice as likely to die from the condition.
- Smoking: A history of smoking is associated with a higher risk of aggressive prostate cancer.
Accessing Clinical Trials At Ucsf
UCSF is currently conducting research in four main areas:
- Identification of genetic and lifestyle factors that predispose men to clinically significant prostate cancer
- Discovering alterations in genes and proteins to improve current prostate cancer treatment
- Developing new therapies for men with recurrent widespread prostate cancer
- Preventing progression of early-stage untreated disease
To learn more, search for a trial or contact us, visit Cancer Clinical Trials at UCSF.
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What Is The Outlook
No cure is available for stage 4 prostate cancer. Your healthcare team will work with you to help control the cancer for as long as possible while maintaining a good quality of life.
Your outlook will depend on how fast the cancer is spreading and how well you respond to therapies.
With treatment, you can live for many years with metastatic prostate cancer.
How Prostate Cancer Is Diagnosed And Staged
Cancer staging helps you and your doctor understand how advanced your cancer is and how much it has spread at the time of diagnosis. Knowing your cancer stage also helps your doctor determine the best treatment options for you and estimate your chance of survival.
The most widely used staging system for cancer is the TNM system that classifies cancer from stage 1 to stage 4.
TNM stands for:
- Tumor: the size and extent of the tumor
- Nodes: the number or extent of nearby lymph node involvement
- Metastasis: whether cancer has spread to distant sites in the body
The TNM scale is used for many types of cancer. When a doctor uses it to determine your prostate cancer stage, theyll consider several other factors as well, including:
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What Is The Gleason Score For Prostate Cancer
Your Gleason score and Grade Group help your doctor gauge existing cancer spread. This information also helps determine the likelihood of the disease to metastasize to other parts of the body. To get this information, your doctor calculates:
Cancer grade: Using a scale of 1 to 5, a lab pathologist grades about a dozen biopsy samples. A grade of 3 indicates a slow-growing cancer, while a grade of 5 is an aggressive, fast-growing, or high-grade cancer. A biopsy sample that gets a 1 or 2 is considered to be normal tissue. These samples arent a factor in cancer staging.
Gleason score: Your doctor adds the most common cancer grade seen in all of the biopsy samples to the second most common grade. This total is the Gleason score.
How Do I Know How Long I Have Left To Live
You might want to know how long you have left to live. This can help you prepare and plan the time you have left. There might be things you want to do or people you want to see. But some men dont want to know how long they have left. Everyone is different.
You can ask your doctor how long you have left to live. They wont be able to give you an exact answer. This can be frustrating and it may feel like your doctor is trying to avoid your questions. But no-one can know for certain how long you have left because everyone’s body and everyone’s cancer is different. However, your doctor will be able to give you some idea based on where the cancer has spread to, how you are responding to treatment, how quickly the cancer has spread, and what problems it is causing.
It can be helpful to talk with your family about this. You may not want to upset them but they might have similar questions and thoughts to you.
If you have months or maybe years left to live, it can be difficult for your doctor to say exactly how long you have left. This is because they dont know how you will respond to different treatments. If your treatment stops working so well, there may be other treatments available. Some men may not respond well to one treatment, but may respond better to another. Read more about treatments for advanced prostate cancer.
Prostate Cancer Symptoms Explained As Joe Exotic Says He Has Aggressive Form Of Disease
Joseph Maldonado, better known as Joe Exotic, has been diagnosed with an aggressive form of prostate cancer, according to a letter written by the Tiger King figure.
A letter provided to CNN by his attorney John M. Phillips, Maldonadowho rose to fame in the 2020 Netflix documentary series Tiger King: Murder, Mayhem, and Madnesssaid a prostate biopsy had been returned with the diagnosis of aggressive cancer.
The tiger enthusiast, convicted in 2019 on animal abuse charges and for his role in a plot to murder longstanding rival animal rights activist Carole Baskin, added: I am still waiting on the results from other tests as well. Right now, I dont want anyones pity.
His attorney told CNN: The PSA test is a blood test used primarily to screen for prostate cancer. It was high. He finally obtained biopsies. They revealed cancer. Medical care is different in a prison environment and fewer options are available.
According to the American Cancer Society, aside from skin cancer, prostate cancer is the second most common form of cancer in American men, 1 in 8 men will be diagnosed with the condition.
Prostate cancer is also the second-leading cause of death in American men after lung cancer, with estimates suggesting that 1 in 41 men in the U.S. will die as a result of the condition.
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Gleason Prostate Cancer Score
1960s as a way to measure how aggressive your prostate cancer may be.
A pathologist determines your Gleason score by looking at a biopsy of your prostate tissue under a microscope. They grade the cells in the biopsy on a scale of 1 to 5. Grade 1 cells are healthy prostate, whereas grade 5 cells are highly mutated and dont resemble healthy cells at all.
The pathologist will calculate your Gleason score by adding together the number of the most prevalent type of cell in the sample and the second most prevalent type of cell.
For example, if the most common cell grade in your sample is 4 and the second most common is 4, you would have a score of 8.
A Gleason score of 6 is considered low-grade cancer, 7 is intermediate, and 8 to 10 is high-grade cancer.
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Screening For Prostate Cancer
There are no tests available with sufficient accuracy to screen populations of men for early signs of prostate cancer. However, early detection and treatment can significantly improve prostate cancer survival.
The test most commonly used to aid early detection of prostate cancer is the prostate specific antigen blood test. This is not a diagnostic test as it can only indicate changes in the prostate. If you are concerned about prostate cancer you should talk to your doctor and make an informed choice about whether to have one of the tests designed to find early signs of prostate cancer, in view of the potential risks and benefits.
There are no proven measures to prevent prostate cancer.
Experimental Treatments For Advanced Prostate Cancer
Researchers are currently testing many new approaches and treatments for prostate cancer, including new medications. These include the following:
Immune checkpoint inhibitors
The immune system uses âcheckpointsâ to stop it from attacking the bodyâs healthy cells. These checkpoints are proteins on immune cells.
Cancer cells often use these checkpoints to keep the immune system from attacking them.
Immune checkpoint inhibitors are drugs that can these checkpoints on cancer cells. Inhibiting these checkpoints can allow a personâs immune system to attack the cancer cells.
Chimeric antigen receptor T cell therapy
This treatment involves taking immune cells from the personâs blood. A scientist then alters these cells in a lab to have receptors called chimeric antigen receptors on their surface.
These receptors help the cells attach to proteins on the surface of prostate cells. A scientist then multiplies these altered T cells in a lab before putting them back into the personâs blood.
Scientists hope these T cells can then find prostate cancer cells and launch a targeted immune attack.
However, this treatment is complicated and may have some serious side effects. This means it is currently only available as part of clinical trials.
Targeted drug therapies
Targeted drug therapies can act on specific parts of cancer cells and the environments surrounding them.
Two possible targeted therapy treatments are:
Treating prostate cancer that has spread to the bones
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Joining A Clinical Trial
Clinical trials are medically supervised, carefully controlled patient studies that attempt to determine whether a proposed new treatment is both safe and effective. Clinical trials also look at whether a new treatment can lead to better outcomes than existing treatments. These studies may involve researchers from a variety of disciplines, such as general medicine, medical specialties, genetics, biology, chemistry, engineering and psychology. Clinical trials are conducted at medical centers around the country, and participants are often actively recruited.
New treatments are continually being developed for prostate cancer. Many prostate cancer trials are designated for patients with a rising PSA after local treatment or for those with advanced, metastatic cancers. However, there are also many trials for men with less aggressive cancer, such as the active surveillance trials at UCSF. We also conduct trials of neoadjuvant treatment, which are medications given before surgery for higher-risk prostate cancer. Several new treatments and approaches show promise some as simple as lifestyle changes in diet and exercise.
Funding sources for clinical trials include the National Cancer Institute, Department of Defense, universities and medical centers, private research foundations, pharmaceutical and biotechnology companies, and various combinations of these groups.
Clinical trials usually occur in phases:
What If Results Arent Conclusive
If biopsy results are inconclusive, it means the cells dont look normal, but they dont look like cancer either. You may have a higher risk of developing prostate cancer in the future. Your doctor will want to monitor your health more closely, and perhaps conduct another biopsy later on.
Several conditions can cause these abnormal results.
Atypical small acinar proliferation : Also called glandular atypia or atypical glandular proliferation, these results indicate a high likelihood of cancer. However, there arent enough abnormal cells to make a diagnosis. Your doctor may recommend repeating the biopsy in a few months.
Prostatic intraepithelial neoplasia : Prostate cells show changes in their appearance. In low-grade PIN, cells look almost normal. In high-grade PIN, cell patterns look abnormal. High-grade PIN increases your cancer risk.
Proliferative inflammatory atrophy : Prostate cells appear smaller than usual and show signs of inflammation. PIA may eventually lead to high-grade PIN or prostate cancer.
From the community:My story is that my PSA test climbed in one year over 0.75 which is the standard of care reason for an ultrasound guided transrectal biopsy . Had first a prostate MRI to localize where to do the biopsies and then 13 actual biopsy samples of which 3 came out positive. Had full body CT which did not show anywhere else and then within a month radical prostatectomy with lymph node removal. Today, 2 years later, PSA still undetectable. Inspire member
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Symptoms Of Prostate Cancer
When this happens, you may notice things like:
- an increased need to pee
- straining while you pee
- a feeling that your bladder has not fully emptied
These symptoms should not be ignored, but they do not mean you have prostate cancer.
It’s more likely they’re caused by something else, such as prostate enlargement.
The Top 7 Signs Of Advanced Prostate Cancer
In the early stages, you may not notice any symptoms related to prostate cancer. This is why screenings are important. Symptoms can sometimes be noticed for the first time when the cancer advances.
Advanced prostate cancer, also called metastatic cancer, means the cancer has spread to other areas of your body beyond your prostate gland. The most common areas for prostate cancer to spread are your bladder, rectum, and bones. It can also spread to your lymph nodes, liver, lungs, and other body tissues.
Whether youve just been diagnosed or youre in treatment, its also important to know the signs of advanced cancer. Cancer can behave differently depending on your genetics, so not every person will experience the same symptoms in the same way.
Read on to learn more about the seven top symptoms of advanced prostate cancer and how to spot them.
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What You Can Do
Its important that you learn all you can about advanced prostate cancer so you can make informed decisions. Be open with your doctors and others on your healthcare team. Express your concerns and feel free to advocate for yourself and your quality of life. Get another medical opinion if you feel its necessary.
Some complementary therapies may prove helpful in coping with advanced cancer. For example:
- tai chi, yoga, or other movement therapy
- meditation, breathing exercises, or other relaxation techniques
A variety of services can help you with everything from lodging while youre getting treatment to getting some help around the house. Communicating with online or in-person groups are a good way to share information and lend mutual support.
Signs And Symptoms Of Prostate Cancer
Most prostate cancers are found early, through screening. Early prostate cancer usually causes no symptoms. More advanced prostate cancers can sometimes cause symptoms, such as:
- Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night
- Trouble getting an erection
- Pain in the hips, back , chest , or other areas from cancer that has spread to bones
- Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord
Most of these problems are more likely to be caused by something other than prostate cancer. For example, trouble urinating is much more often caused by benign prostatic hyperplasia , a non-cancerous growth of the prostate. Still, its important to tell your health care provider if you have any of these symptoms so that the cause can be found and treated, if needed. Some men might need more tests to check for prostate cancer.
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Bladder And Urinary Troubles
A prostate tumor that has grown significantly in size may start to press on your bladder and urethra. The urethra is the passage the carries urine from your bladder out of your body. If the tumor is pressing on your urethra, you might have trouble passing urine.
One of the common areas for prostate cancer to spread to is the bladder, because the two organs are close. This can cause additional problems with urination and bladder function.
Some symptoms your bladder and urethra are being affected by cancer include:
- urinating more frequently
- getting up in the middle of the night to pee
- feeling like you have to urinate often and not actually passing anything
Its not as common, but prostate cancer can also spread to your bowel. The cancer first spreads to the rectum, which is the part of your bowel closest to the prostate gland.
Symptoms of cancer thats spread to the bowels include:
What Should I Expect As My Cancer Progresses
How does prostate cancer spread?
Prostate cancer cells can move from the prostate to other parts of the body through the blood stream. Or they can spread to the lymph nodes near the prostate and then travel through the lymph vessels to other parts of your body. Lymph nodes and lymph vessels are part of your lymphatic system and are found throughout your body.
Prostate cancer most commonly spreads to the bones and lymph nodes. It can also spread to, or press on, the tube you urinate through , the bladder, the tubes that carry urine from the kidneys to the bladder and part of the bowel . Prostate cancer may spread to other parts of the body, including the lungs and liver. But this is less common.
If tests and scans show that your cancer is spreading, ask your doctor what will happen next. This can help you and your family prepare for what to expect. Find out more about advanced prostate cancer and treatments.
Watch our video about advanced prostate cancer.
How does prostate cancer cause problems?
Prostate cancer can cause problems if it is pressing on your bones or nerves. It can also cause problems by stopping your normal cells from working properly.
What problems can advanced prostate cancer cause?
The symptoms and problems you have will depend on where the cancer has spread to. Even though your cancer is still growing, you will still be able to have treatment to help manage these problems.
Advanced prostate cancer problems may include:
What should I look out for?
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