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.
Hormonal Therapy And Its Complications
Several different hormonal approaches are used in the management of various stages of prostate cancer.
These approaches include the following:
- Abiraterone acetate .
- Aminoglutethimide.
Abiraterone acetate
Abiraterone acetate has been shown to improve OS when added to ADT in men with advanced prostate cancer who have castration-sensitive disease. Abiraterone acetate is generally well-tolerated however, it is associated with an increase in the mineralocorticoid effects of grade 3 or 4 hypertension and hypokalemia compared with ADT alone. It may also be associated with a small increase in respiratory disorders.
Bilateral orchiectomy
Benefits of bilateral orchiectomy include the following:
- Ease of the procedure.
- Immediacy in lowering testosterone levels.
- Low cost relative to the other forms of ADT.
Disadvantages of bilateral orchiectomy include the following:
- Psychological effects.
Bilateral orchiectomy has also been associated with an elevated risk of coronary heart disease and myocardial infarction.
Estrogen therapy
Estrogens at a dose of 3 mg qd ofdiethylstilbestrol will achieve castrate levels of testosterone. Likeorchiectomy, estrogens may cause loss of libido and impotence. Estrogens also cause gynecomastia, and prophylactic low-dose radiation therapy to the breasts is given to prevent this complication.
Luteinizing hormone-releasing hormone agonist therapy
Evidence :
Antiandrogen therapy
ADT
Evidence :
Antiadrenal therapy
Stage 3 Cancer Survival Rate
The life expectancy of a patient diagnosed with cancer depends upon various factors like age, overall health of the patient, type of cancer, when it is detected, available treatment options, and response of the patient to the treatment. Read on to know about the survival rates for various cancers..
The life expectancy of a patient diagnosed with cancer depends upon various factors like age, overall health of the patient, type of cancer, when it is detected, available treatment options, and response of the patient to the treatment. Read on to know about the survival rates for various cancers..
Development of cancer is divided into stages. Staging helps design proper treatment for the patient. Each year, millions of people are diagnosed with cancer worldwide. Detection of the condition in early stages helps increase the life expectancy of the patient. Usually, it is easier to remove cancer when it is in the initial stage. Thus, the growth of cancerous cells can be controlled. It is comparatively difficult to treat it, if it has reached the third or fourth stage.
Staging
First Stage: Growth of cancerous cells in the form of very small tumors is termed as stage one. There exist several types of cancers, and experts have determined the sizes of tumors for each stage for each type. During the first stage, cancer is confined to the local area .
Survival Rate
| Type of Cancer |
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Nomogram Predicting Model And Validation
The predicting model of nomograms was built with the factors in the multivariate Cox analysis . The C-index of this nomogram was 0.773, indicating a good discrimination ability of this model. Five- and 10-year calibration curves also revealed good agreement between the actual observation and the nomogram prediction.
Figure 3Figure 4
What Is The Survival Rate For Prostate Cancer
The average five-year survival rate for prostate cancer is very optimistic: 98%. This means it is relatively unlikely that a man diagnosed with prostate cancer will die from the disease.
This high survival rate is largely attributable to the fact that most prostate cancers are detected before the prostate cancer spreads to other organsin other words, when it is localized. Prostate cancer is detected at these earlier stages with regular screenings, which is why its so important for men to begin screening for prostate cancer at age 50.
That being said, there are aggressive prostate cancers that may decrease the chance of survival. The chances of survival dramatically decrease if the cancer has the opportunity to spread to further areas of the body.
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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.
Proactive Steps You Can Take
Diet and Exercise
According to the Prostate Cancer Foundation, a few minor changes to eating habits can be helpful for those dealing with the effects of prostate cancer. The organization recommends incorporating vegetables into many of your meals and minimizing fat intake from red meat and dairy products. The group also recommends getting vitamins from food sources like whole grains and vegetables as opposed to vitamin supplements. It is particularly important to get calcium from food sources, namely dark green leafy vegetables and low-fat dairy foods.
Coping and support
If you or a loved one has prostate cancer, it’s important to remember that you are not alone: More than 150,000 men are diagnosed with prostate cancer every year, according to the Prostate Cancer Foundation.
Still, it is normal for men diagnosed with prostate cancer to feel alone, uncertain or fearful. Support groups are an excellent resource for men with prostate cancer, providing a community with whom to share encouragement, information and emotional support. These groups range from online communities with people who can help answer questions to groups of men diagnosed with prostate cancer or family members of those diagnosed. They are sometimes facilitated by mental health professionals and experts in the field of prostate cancer.
Palliative care
Palliative care can include any of the following:
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Treatments To Control And Prevent Symptoms Caused By The Spread Of Prostate Cancer To The Bones
Palliative External beam radiotherapy
Radiopharmaceuticals: Strontium-89 , samarium-153
Radium-223 dichloride is now licensed and called Xofigo. This is not widely available in the UK but BPC is one of a relatively small number of specialist centres using this treatment.
Zolidronic acid is a bisphosphonate given by a 15-minute intravenous infusion every 34 weeks. It reduces the risk of bone complications, including pain and fractures.
Xgeva : this is a newly licensed drug available at BPC.
Pain medications
Surgery may be undertaken to treat bone fractures or to relieve the pressure on the spinal cord by bone metastases.
*https://www.cancerresearchuk.org/about-cancer/prostate-cancer/survival
General Prostate Cancer Survival Rate
According to the American Cancer Society:
- The relative 5-year survival rate is nearly 100%
- The relative 10-year survival rate is 98%
- The 15-year relative survival rate is 91%
Note: Relative survival rate means the percentage of patients who live amount of years after their initial diagnosis.
Keep in mind, however, that because the compiled list figures are of cancers diagnosed up to 15 years ago, you may have an even greater chance of survival than these indicate due to advances in prostate cancer treatment technology
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Staging And Survival Rates
Staging is a method of describing where the cancer is located, where it has spread, and whether it is affecting other parts of the body.
Prostate cancer staging is based on a number of different factors, including prostate cancer screening tests, such as the digital rectal exam and the prostate-specific antigen test.
Doctors use diagnostic tests to determine cancers stage. Staging may not be complete until these tests are finalized. Knowing the correct stage helps the doctor decide the best course of treatment and the possible outcomes.
Survival By Tumor Grade
One way cancer is staged is by looking at the grade of cancer. Grade refers to how cancer cells look like under a microscope.
Traditionally for prostate cancer, this has been done using the Gleason Score, which was developed in the 1960s. Under this system, cancerous cells are categorized on a scale from 1 to 5. Grade 1 cells are considered normal prostate tissues, while cells in the grade 5 range have mutated to such an extent they no longer resemble normal cells.
In determining a Gleason score, a pathologist will examine a biopsy sample under a microscope and give a Gleason grade using the above scale to the most predominant pattern displayed, then a second grade to the pattern that is the second most predominant. Those two grades are then added to form the overall Gleason score .
In theory, Gleason scores could range from 2 to 10, but pathologists today rarely give a score between 2 and 5 and are more likely to be in the range of 6 to 10 with 6 being the lowest grade of prostate cancer.
Under the Gleason Score system, a 6 is considered low grade, 7 is intermediate and scores of 8, 9, or 10 are considered high-grade cancers.
The higher the Gleason score, the more likely it is the prostate cancer will grow and spread quickly.
However, there have been some issues with the Gleason system, and a new grading system, to act as an extension of the Gleason system, has been developed.
Under this system Gleason scores are now categorized into grade groups:
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Prognosis Of Men With High
Pan Song1#, Jiaxiang Wang2#, Mengxuan Shu2, Xiaoyu Di3, Yaxin Li3, Yuxin Qing3, Qiang Dong1
1 West China Hospital of Sichuan University , The First Clinical Medical College , The Second Clinical Medical College , , China
Contributions: Conception and design: Q Dong Administrative support: Q Dong Provision of study materials or patients: P Song, J Wang Collection and assembly of data: P Song, J Wang Data analysis and interpretation: P Song, J Wang, M Shu, X Di, Y Li, Y Qing Manuscript writing: All authors Final approval of manuscript: All authors.
#These authors contributed equally to this work.
Correspondence to:
Background: The aim was to evaluate the prognosis of men with all possible high-risk prostate cancers stratified by risk factors.
Methods: Within the Surveillance, Epidemiology and End Results database from 2004 to 2015, men with non-metastasis high-risk PCa were identified. Kaplan-Meier analysis and Cox regressions were adopted to evaluate the overall survival and prostate cancer-specific survival . Nomograms were conducted to build a predictive model. Concordance index and calibration curves were used to validate the model.
Men with the combination of PSA > 20 ng/mL and GS 810 had the worst PCSS among all patients. PCa with three high-risk factors was not more aggressive than that with two high-risk factors of GS 810 and PSA > 20 ng/mL.
Keywords: Prostate cancer high-risk factors prognosis Surveillance, Epidemiology and End Results
Prostate Cancer Survival Trends Over Time
As with most cancers, survival for prostate cancer is improving. However, interpretation of prostate cancer survival trends is difficult as the case-mix on which they are based is likely to have changed over time with earlier diagnoses following the advent of TURP and PSA testing. The detection of a greater proportion of latent, earlier, slow-growing tumours in more recent time periods will have the effect of raising survival rates due to lead-time bias . Lead-time bias for prostate cancer is estimated to be between five and 12 years, varying with a mans age at screening. Data from the European Randomized Study of Prostate Cancer estimates that for a single screening test, mean lead times are 12 years at age 55 and six years at age 75. Some of the increase may also be attributed to genuine improvements in survival due to more effective treatment, for both early, aggressive prostate cancers and advanced cases.
One-year age-standardised net survival for prostate cancer has increased from 66% during 1971-1972 to 94% during 2010-2011 in England and Wales an absolute survival difference of 28 percentage points.
Prostate Cancer , Age-Standardised One-Year Net Survival, Men , England and Wales, 1971-2011
Prostate Cancer , Age-Standardised Five-Year Net Survival, Men , England and Wales, 1971-2011
Prostate Cancer , Age-Standardised Ten-Year Net Survival, Men , England and Wales, 1971-2011
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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.
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
Males
SEER 22 20152019, All Races, Males
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What Treatments Are Available
If you have advanced prostate cancer, treatment wont cure your cancer. But it can help keep it under control and manage any symptoms.
If youve just been diagnosed with advanced prostate cancer, you may be offered the following treatments:
- chemotherapy with hormone therapy
- clinical trials.
Research has found that having radiotherapy together with one of the main treatments listed above can help some men with advanced prostate cancer to live longer. But radiotherapy isnt suitable for all men with advanced prostate cancer.
If you live in Scotland, you may also be offered a type of hormone therapy called abiraterone acetate together with standard hormone therapy. In the rest of the UK, abiraterone is currently only given to men with advanced prostate cancer that has stopped responding to other types of hormone therapy. The National Institute for Health and Care Excellence is currently deciding whether to make it available for men who have just been diagnosed with advanced prostate cancer.
Before you start treatment
Before you start any treatment, make sure you have all the information you need. Its important to think about how you would cope with the possible side effects. Speak to your doctor or nurse about this.
It can help to write down any questions you want to ask at your next appointment. It may also help to take someone with you, such as your partner, a family member or friend.
If you have any questions, speak to our Specialist Nurses.
A Note About Sex And Gender
Sex and gender exist on spectrums. This article will use the terms male, female, or both to refer to sex assigned at birth. .
There are different ways of classifying cancer stages, including prostate cancer. Staging is when a doctor decides how far cancer cells have progressed and how much they may have spread.
Doctors determine the stage using the prostate-specific antigen and the Gleason score.
PSA is a protein that appears at higher levels in the bloodstream a problem with the prostate. The Gleason system can also help determine the stage by classifying cancer cells, which can act differently.
Some stages are more aggressive and can spread more easily. The Gleason score a calculation of how likely a tumor will spread and how quickly it will do so. This is called the grade.
Here is a brief overview of
| prostate, other parts of the body, and possibly surrounding tissues and lymph nodes |
A simpler way to stage cancer is to look at how far it has spread from its original site. These stages are:
- Localized cancer: Cancer cells remain in the area where they started. In this case, within the prostate gland.
- Regional cancer: Cancer has spread to nearby tissues and possibly nearby lymph glands, but not to other parts of the body.
- Distant cancer: Cancer has spread throughout the body and affects other organs, such as the lungs or liver.
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Inclusion And Exclusion Criteria
Patients were considered eligible if they met the following criteria: primary non-metastasis PCa . Patients met the definition of high-risk PCa: PSA > 20 ng/mL, or GS 8, or T3a. The survival status at the end of the follow-up were clearly known.
The following criteria were used for data exclusion: multiple tumors the information of age, PSA, TNM stage, GS or follow-up time were unclear or incomplete.