What Are The Symptoms Of Stage 4 Prostate Cancer
While prostate cancer has very recognizable symptoms, the big problem is that these symptoms are very similar to other conditions, such as benign prostatic hypertrophy , and many men brush them off as just getting older. While many of these symptoms can be attributed to aging, it is vital for men to understand that they should not be ignored or marginalized. These symptoms should always be taken seriously. According to the American Cancer Society and the Mayo Clinic, symptoms of prostate cancer, and more specifically, stage 4 prostate cancer may include:
- Painful urination
- Erectile dysfunction
- Bone pain, often in the hips, back, and upper legs
- Swelling in the legs
Experiencing these symptoms, especially a combination of these symptoms, is a sign that you need to see your physician without delay. As a wife, sister, and daughter, I have heard the men in my life, quite vociferously, explain how they dont want to go to the doctor especially for that exam. Please gentlemen, we beg you get it checked, and get it checked regularly a very quick exam could save your life. The American Cancer Society recommends the following screening times :
- Age 50 for men who are at average riskof prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high riskof developing prostate cancer. This includes African Americans and men who have a first-degree relative diagnosed with prostate cancer at an early age .
- Age 40 for men at even higher risk.
Survival Rate For Stage 4 Cancer Depends On Factors Like The Cancer Types Treatments Patients Health Condition Etc Work With Your Doctor For Best Results
When one is diagnosed to have Stage IV cancer, the immediate concern is if the person will be able to survive the disease. This concern, also medically known as the prognosis, depends on many factors, including availability of treatment and ones general health condition. Knowing what stage ones cancer is mostly determines his probability of surviving based on research. Cancer staging therefore helps the doctor to advise the patient about his condition and what forms of treatment are suitable, and to predict his survival rate in the next few years.
Cancer survival rate refers to the percentage of patients afflicted with a certain form of cancer who survive the disease for a specified amount of time. Statistics often refer to a five-year period where scientific surveys on these patients are based, although these data do not specify whether the patients are still undergoing treatment or are completely cancer-free after five years. An over-all five-year survival rate of 80% would mean that for every 100 patients with the disease, 80 would probably live for at least another five years, and 20 would probably not survive this period of time.
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Staging Spread And Survival Rates
As with all cancers, doctors use the term stage to describe the characteristics of the primary tumor itself, such as its size and how far prostate cancer has spread when it is found.
Staging systems are complicated. The staging system for most cancers, including prostate cancer, uses three different aspects of tumor growth and spread. Its called the TNM system, for tumor, nodes, and metastasis:
- T, for tumor describes the size of the main area of prostate cancer.
- N, for nodes, describes whether prostate cancer has spread to any lymph nodes, and how many and in what locations.
- M, for metastasis, means distant spread of prostate cancer, for example, to the bones or liver.
Using the TNM system, each mans prostate cancer can be described in detail and compared to other mens prostate cancer. Doctors use this information for studies and to decide on treatments.
As far as survival rates for prostate cancer go, however, the staging system is pretty simple. As weve mentioned, in terms of survival rates, men with prostate cancer can be divided into two groups:
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What Is The Most Effective Treatment For Prostate Cancer
The choice of treatment for prostate cancer depends on many factors such as the patients prostate cancer risk as calculated from prostate-specific antigen levels, Gleason score, and tumor staging. Patients can discuss the significance of these factors in the choice of treatment with their doctor.
The standard effective treatment choices for men with early-stage prostate cancer are as follows
- Active surveillance: Monitoring the progression/status of the low-risk or early-stage cancer with regular testing and not treating it right away.
- Prostatectomy: Surgical removal of the prostate.
- Radiation therapy: Use of high-energy waves to destroy cancer cells.
Radiation therapy is one of the most effective treatments for many men with early-stage prostate cancer. It is also the best prostate cancer therapy for older men or those with other co-existing diseases. It can be delivered to the patient in any of the two ways
- External beam radiation: Sending/focusing high-energy waves from an external machine into the tumor.
- Brachytherapy: Placing a radioactive dye in the tumor through an implant or hollow tubes.
For metastatic prostate cancer, androgen deprivation therapy is usually the choice of treatment. ADT is also the only option in patients with prostate cancer who are unfit or unwilling to undergo surgery or/and radiation therapy.
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Your Cancer Care Team
People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.
The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.
Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
- whether the cancer has spread to other parts of your body
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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.
Types Of Cancers That Are More Likely To Go Undetected
Some cancers are more easily detected than others. For example, certain types of skin cancer can be diagnosed initially just by visual inspection though a biopsy is necessary to confirm the diagnosis.
But other cancers can form and grow undetected for 10 years or more, as one study found, making diagnosis and treatment that much more difficult.
This table provides an overview of common cancers that often display little or no symptoms early on, and how theyre typically detected and diagnosed:
|Type of cancer|
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Imaging Of Metastasis Status In Prostate Cancer Patients
The screening for PSA level in the serum of patients was introduced in the late 1980s and enabled a dramatic increase in early PCa detection . On the other hand, PSA is not solely a PCa-specific biomarker and, as such, leads to overdiagnosis and overtreatment of clinically insignificant cases, representing a significant burden for patients . Moreover, absolute PSA level does not always correlate with prognosis . Therefore, more specific and sensitive PSA-based values like PSA density , PSA velocity , free-to-total PSA , and PSA doubling time are seen as options with stronger predictive value. For example, PSADT is defined as the length of time for two-fold PSA level increase. A PSADT < 6 months is strongly associated with metastatic disease, increased PCa mortality , and relapse . Nonetheless, the reported benefit of PSADT in PCa management did not enter clinical routine and some studies even reported discrepant results indicating that further studies are required to determine the reliability of PSADT and other available biomarkers .
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.
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Stage 4 Patients Can Live For Years
The 5 year survival rates listed in the chart above are NOT intended to scare you, but rather to inform you of the average, approximate ratesfor each type of cancer we have explored in this article. The fact is, Stage 4 cancer patients can live for YEARS, and these statistics are just that, statistics. They do not define your experience and do not mean that you cannot beat cancer and thrive!
Do You See A Urologist For Prostate Cancer
Often, if a physician suspects their patient has prostate cancer, they will refer them to a urologist for further evaluation. Urologists specialize in diagnosing and treating diseases of the urinary system, including prostate cancer. A urologist can conduct a biopsy to confirm a prostate cancer diagnosis. During the biopsy, a thin, hollow needle will be inserted into the prostate to collect a sample of prostate tissue. The needle may be inserted multiple times to collect several samples.
Within a few days, the urologist should have the diagnosis. If the biopsy is positive for prostate cancer, he or she will then stage the cancer and discuss the patients treatment options. Some patients with early-stage prostate cancer may be eligible for an active surveillance approach in which their condition will be monitored regularly. Treatment may be considered if the cancer begins to spread or cause symptoms.
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Enzalutamide Improves Survival In Patients With Metastatic Prostate Cancer
In an international randomizedphase III clinical trial, the hormone therapy enzalutamide extended survival in men with metastatic prostate cancer that had progressed during treatment with androgen deprivation therapy. Participants in the trial had not received chemotherapy.
New England Journal of Medicine, June 1, 2014.
Early in their development, prostate cancers need relatively high levels of male sex hormones to grow. The testes are the main source of androgens, and treatments that stop the testes from producing male sex hormonesknown as hormone therapy or androgen deprivation therapy are therefore a common treatment for androgen-sensitive prostate cancer. However, most prostate cancers eventually become castrate resistantthat is, they can grow even when androgen levels in the blood are very low. ADT does not block production of the small amount of androgen that is made by the adrenal glands and by prostate cancer cells themselves, and this low level is sufficient to fuel the growth of castrate-resistant prostate cancers.
Enzalutamide is among several hormone therapies that have been developed to prevent the androgen-fueled growth of castrate-resistant prostate cancers. This drug works by keeping androgens from binding to the androgen receptors on prostate cancer cells.
Men in the trial were randomly assigned to receive 160 mg of enzalutamide or a placebo taken orally once daily.
- Posted:June 27, 2014
Stage 4 Prostate Cancer: Survival Rates Treatment And Support
Prostate cancer is in stage 4 when the cancer spreads beyond the lymph nodes and into other areas of the body. While the vast majority of prostate cancer cases are caught before this happens, when the cancer is treatable, stage 4 is far more difficult to treat. Therefore, the survival rate among men with stage 4 prostate cancer is much lower.
There are two types of stage 4 prostate cancer: 4A and 4B, according to the American Cancer Society. The type assigned to a persons diagnosis is based on whether the cancer has spread and to what degree, and the value assigned to two additional factors called the Grade Group and the prostate-specific antigen . The Grade Group is a measure of how likely the cancer is to spread quickly, and the PSA is a measure of a protein in the blood produced by cells in the prostate.
With stage 4A, the tumor has already spread into the lymph nodes and may be spreading into tissues adjacent to the prostate, but has not spread to other areas of the body. The Grade Group can be of any value, as can the PSA.
With stage 4B, the tumor may have spread into the lymph nodes, may be spreading into nearby tissues and has spread to other areas of the body like the bones, certain organs and distant lymph nodes. The Grade Group and PSA can be of any value.
Stage 4 Lung Cancer And Treatments
Stage 4 lung cancer is diagnosed when it is determined that the cancer has spread either from one lung to the second lung, or from the lungs to another part of the body. The most common organs stage 4 lung cancer spreads to are the liver, brain, bones, or adrenal glands.
Stage 4 non-small cell lung cancer is usually inoperable, so the most common treatment methods tend to be targeted drug therapies, chemotherapy, radiation, and immunotherapy.
For stage 4 small cell lung cancer, chemotherapy and immunotherapy are most commonly used to treat symptoms, while shrinking the cancer.
Survival By Disease Progression
The extent prostate cancer has progressed can influence survival rates.
Prostate-specific antigen is a protein produced by cells of the prostate gland by normal and malignant cells. In men with prostate cancer, blood levels of PSA are often elevated.
Doctors can use PSA as a marker to better understand the progression of prostate cancer and the resulting prognosis.
One way doctors assess the progression of the disease is through PSA doubling time. This refers to the number of months it takes for PSA to double.
One study suggests a short doubling time means a poorer prognosis for patients with stage IV prostate cancer. Median survival was 16.5 months for those with a PSA doubling time lower than 45 days compared with 26 months for patients with a longer PSA doubling time.
Whether or not the cancer has metastasized and spread to other areas of the body outside the prostate can also influence survival. In distant or stage IV prostate cancer, when cancer has spread from the prostate to other organs like the liver or lungs, the five-year survival rate is 31% compared with localized cancer, which has a five-year survival rate of nearly 100%.
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Does Overdiagnosis Lead To Overtreatment Of Older Men
The widespread use of PSA screening has led to an increase in the diagnosis and treatment of early localized prostate cancer. Data from the US Cancer of the Prostate Strategic Urological Research Endeavor database suggest a significant decrease in risk in the last 2 decades in the United States, with more patients being identified with low-risk disease at diagnosis,29 but the role of active treatment of low- and intermediate-risk disease in elderly men remains controversial.
The median time from diagnosis to death from prostate cancer for men with nonpalpable disease is approximately 17 years.30,31 Considering that the US male life expectancy at the age of 65 years is 16 years, aggressive therapy will hardly extend life expectancy of older men with no palpable prostate cancer at the time of diagnosis.32 Twenty to 30% of prostate cancers detected by PSA screening programs show Gleason scores of 6 or lower and, thus, are not poorly differentiated and have volumes smaller than 0.5 cm3.3335
Histologic evaluation of radical prostatectomy specimens demonstrated that about 20% to 30% of cancers are small volume, show low Gleason scores, and are consequently clinically harmless.35,36 Many of these cancers pose little threat to life, especially for older men. Has PSA screening resulted in prostate cancer overdiagnosis?
How Long Can Someone Live With Stage 4 Cancer
Doctors usually describe a persons outlook using the 5-year survival rate. These are calculated based on data from thousands of other people with a similar cancer at a similar stage.
The original location of the cancer determines its type. Survival rates vary, depending on the type of cancer and how far it has spread within the body.
Below, we describe the survival rates for some of the most common forms of cancer in stage 4:
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How To Make The Right Treatment Decision
Current expert guidelines for treatment of localized prostate carcinoma recommend potentially curative therapy for patients whose life expectancy is at least 10 years., Patients with limited life expectancy are more likely to die from health conditions other than prostate cancer. Men with a life expectancy of more than 10 years are more likely to die from progressive prostate cancer. This 10-year rule enjoys broad acceptance among urologists and radiation oncologists.,
Conservative management proved to be an acceptable treatment option for men with low-grade Gleason scores, clinically localized disease, and life expectancies of less than 10 years. Increasing age was described as a risk factor for receiving inadequate treatment for prostate cancer. Thus, older men have been shown to receive potentially curative therapy less often than younger men., Radical prostatectomy is preferred treatment in men younger than 70 years, whereas radiation therapy is applied predominantly in patients older than 70 years. Conservative therapy such as watchful waiting or androgen deprivation by luteinizing hormone-releasing hormone analogs is preferentially applied in men older than 80 years. Watchful waiting or hormonal therapy is used to treat 82% of men older than 80 years.
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