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 Prostate Cancer Is Treated
In cancer care, different types of doctorsincluding medical oncologists, surgeons, and radiation oncologistsoften work together to create an overall treatment plan that may combine different types of treatments to treat the cancer. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as palliative care experts, physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, physical therapists, and others.
The common types of treatments used for prostate cancer are described below. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.
Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patients preferences and overall health.
Cancer treatment can affect older adults in different ways. More information on the specific effects of surgery, chemotherapy, and radiation therapy on older patients can be found another section of this website.
Because most prostate cancers are found in the early stages when they are growing slowly, you usually do not have to rush to make treatment decisions. During this time, it is important to talk with your doctor about the risks and benefits of all your treatment options and when treatment should begin. This discussion should also address the current state of the cancer:
What Is A 5
A relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of prostate cancer is 90%, it means that men who have that cancer are, on average, about 90% as likely as men who dont have that cancer to live for at least 5 years after being diagnosed.
Dont Miss: Prostate Cancer 4th Stage Treatment
Also Check: Natural Remedies For Prostatitis Treatment
Bone Metastases And Mortality In Prostate Cancer Can We Be Doing More
Variable Migratory Pathways of Bone Metastases.Bone metastases are associated with higher mortality.Impact of Bone Metastases on Quality of Life
- Difficulty sleeping as a result of pain: 42%
- Difficulty performing normal activities: 40%
- Anxiety or distress as a result of pain: 40%
- Vomiting: 25%18
- Loss of appetite18
Economic Burden of Bone MetastasesIs Earlier Detection of Bone Metastatic Disease of Value?Use of ALP and PSA to Predict Risk of Bone Metastatic Disease
Dont Miss: Digital Examination Of The Prostate
Side Effects Of Chemotherapy
Side effects of chemotherapy are common and may include:
- Digestive issues such as nausea, vomiting and diarrhea
While on chemotherapy, patients are also susceptible to infections because their white blood cell counts are lower. Other common side effects include bruising or bleeding due to fewer blood platelets and fatigue due to the lowered red blood cell count.
Its also possible to experience a severe allergic reaction to some of the drugs used to treat prostate cancer, especially Taxotere® and Jevtana® . The patients care team may recommend medicines before each session to help prevent a reaction.
The prostate chemotherapy drug mitoxantrone may cause leukemia later in life, but this is rare. The prostate chemotherapy drug Emcyt® may increase the risk for blood clots.
During chemotherapy, doctors may also offer supportive care services to help ease side effects. For example, naturopathic providers may suggest supplements to reduce nausea. Also, a mind-body therapist may recommend techniques to help the patient relax and feel less anxious during prostate cancer chemotherapy treatments.
You May Like: Can Prostate Cancer Metastasis To The Colon
What Lies Ahead: Leading The Way With Alpha Therapies
The coming years will see even more powerful forms of radioactive therapy. The MSK laboratory of radiochemist Jason Lewis and other researchers are investigating the use of alpha particles, which have a much higher energy hundreds of times more potent than the photons used in conventional radiation or beta particles. Not only do alpha particles cause more damage when they slam into cancer cells but their path of destruction is more tightly focused, sparing normal cells.
MSK is building one of the nations first dedicated alpha particle GMP labs at a U.S. academic institution.
These radiopharmaceuticals that we are creating translate very well from bench to bedside, says Dr. Lewis, Chief of the Radiochemistry and Imaging Sciences Service and Director of the Radiochemistry and Molecular Imaging Probe Core Facility. When you see these striking responses to treatment, it brings real hope for the future and our patients.
Advances in radiotheranostics are supported by The Tow Foundation, long-time contributors to MSKs mission.
- A new FDA-approved drug could be an effective treatment against prostate cancer that has spread.
- The treatment uses a molecule that seeks out and attaches to a specific protein on the cancer cell surface called PSMA
- The technology delivers radiation that damages DNA and destroys the cancer cell..
Choosing To Stop Treatment Or Choosing No Treatment At All
For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.
Some people, especially if the cancer is advanced, might not want to be treated at all. There are many reasons you might decide not to get cancer treatment, but its important to talk to your doctors and you make that decision. Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms.
Read Also: Prostate Cancer Laparoscopic Radical Prostatectomy
The Role Of Inflammation
Acute inflammation is a biological response triggered by harmful stimuli such as infection, trauma, and tissue injury to eliminate the source of damage . The tumor microenvironment is unequivocally linked with inflammation, whether the infiltration of immune cells engages with tumor cells causing inflammation or chronic inflammation promotes the malignant transformation of cells and carcinogenesis .
In an experiment performed by Morrissey et al., it was found that IL-6 was highly expressed in prostate cancer bone metastases. PC-3 cells inhibited osteoblast activity and induced osteoblast to produce IL-6 that promoted osteoclastogenesis . In addition, a recent study by Roca et al. observed that macrophage-driven efferocytosis induced the expression of pro-inflammatory cytokines, such as C-X-C motif chemokine ligand 5 by activating the signal transducer and activator of transcription 3 and the nuclear factor kappa-light-chain-enhancer of activated B cells signaling. CXCL5-deficient mice had reduced tumor progression. These findings suggested that the myeloid phagocytic clearance of apoptotic cancer cells accelerated CXCL5-mediated inflammation and tumor growth in bone . In summary, findings from available evidence suggest the alleviation of chronic inflammation as a potential therapeutic approach for prostate cancer bone metastases.
You May Like: Famous People With Prostate Cancer
Untreated Prostate Cancer No Death Sentence
By Frederik Joelving, Reuters Health
4 Min Read
NEW YORK â Even without treatment, only a small minority of men diagnosed with early-stage prostate cancer die from the disease, Swedish researchers reported Friday.
Drawing from a national cancer register, they estimated that after 10 years prostate cancer would have killed less than three percent of these men.
What the data is showing is that for most patients with low-risk cancer, there is no need to panic, said Grace Lu-Yao, a cancer researcher who was not involved in the new study. Prostate cancer really is no longer a fatal disease.
With modern screening tests, said Lu-Yao, of the University of Medicine and Dentistry of New Jersey in New Brunswick, many prostate cancers are found that might never have developed into serious disease. In such cases, the slight reduction of risk by surgically removing the prostate or treating it with radiation may not outweigh the substantial side effects of these treatments.
In the Swedish study, published in the Journal of the National Cancer Institute, researchers compared deaths among more than 6,800 men with prostate cancer who underwent treatment â surgery or radiation â or were simply monitored regularly by their doctors, the so-called watchful waiting approach. With watchful waiting, patients are only treated if their cancer progresses.
The Swedish findings jibe with earlier results, including a large US study.
You May Like: Erleada For Metastatic Prostate Cancer
Recommended Reading: What Is The Prostate Blood Test Called
There Are Different Types Of Treatment For Patients With Prostate Cancer
Different types of treatment are available for patients withprostate cancer. Some treatments are standard , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Prostate Cancer Life Expectancy
Cancer life expectancy depends on the stage of the cancer and on the treatment that the patient undergoes. Early detection of cancer and prompt treatment help increase the life expectancy of the patient. Once prostate cancer is detected, prostatectomy , radiotherapy , watchful waiting , hormone therapy, and other types of treatments are recommended by doctors.
To undergo a prostatectomy, the cancer needs to be detected in the early stages. Once the cancer metastasizes, it is difficult to remove it, or it is difficult to control its growth. So, survival rate and life expectancy for stage 4 prostate cancer cannot be favorable.
You May Like: How Can I Lower My Prostate Psa Levels
Are There Side Effects Of The Combination Approach To Prostate Cancer Radiation Therapy
When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on the PSA level, Gleason score, extent of visible disease on magnetic resonance imaging we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence, including a large trial, suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best compared to standard dose external beam radiation therapy alone.
Read Also: Beginning Signs Of Prostate Cancer
What Types Of Testing Should I Expect For Monitoring My Condition
Since metastatic prostate cancer isnt curable, your doctor will most likely set up regular visits to check the cancers location, and to manage any long-term side effects from the cancer or any medication youre taking.
And since treatments for advanced prostate cancer are changing so fast and need to be given in a certain sequence to be the most effective, youll probably have not only a prostate cancer doctor but other specialists taking care of you. Your care team should coordinate closely, say the authors of a major study of such teams published in August 2015 in the journal Annals of Oncology.
Along with regularly testing your prostate-specific antigen levels, your care team may request blood tests that measure such prostate cancer indicators as alkaline phosphatase and lactate dehydrogenase. Magnetic resonance imaging or PET scans of the spine or other bones can also help identify how your cancer responds to treatment.
If youve had radiation, youre at an increased risk for bladder and colorectal cancer and should get screened regularly for these as well.
The tests youll have and how often youll need them should be customized to you. Your care team will consider your overall health, medications that are safe for you to take, other health conditions you might have, and what stage your cancer was when you were diagnosed.
You May Like: Can You Reduce An Enlarged Prostate
Surgically Removing The Prostate Gland
A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.
Like any operation, this surgery carries some risks, such as urinary incontinence and erectile dysfunction.
In extremely rare cases, problems arising after surgery can be fatal.
It’s possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.
Studies have shown that radiotherapy after prostate removal surgery may increase the chances of a cure, although research is still being carried out into when it should be used after surgery.
You may want to ask your doctors about storing a sperm sample before the operation so it can be used later for in vitro fertilisation .
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someone’s risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA recurrence or biochemical recurrence.
Don’t Miss: Which Is Better For Prostate Cancer Radiation Or Surgery
Fast Facts On Prostate Cancer
- Prostate cancer rarely reaches an advanced stage.
- People with the condition normally have a very good outlook when they receive an early diagnosis and treatment.
- Hormone therapy is a treatment option for advanced prostate cancer, as are chemotherapy and immunotherapy.
- Prostate cancer can spread to the bones, brain, and lungs.
Prostate cancer occurs when cells in the prostate gland mutate and start to develop abnormally, multiplying at an uncontrolled rate. In some instances, the cancerous cells can spread to other body parts through tissue, the blood, or the lymphatic system.
After a doctor diagnoses prostate cancer, they will test to see if the cancer has spread to other areas of the body, or how much of the body is affected.
The doctor will assign a stage of prostate cancer from 1 to 4. Stage 4 is the most advanced form.
Stage 4 prostate cancer has spread to pelvic lymph nodes or is blocking the ureters. The ureters are the tubes that connect the kidneys to the bladder. Stage 4 prostate cancer may also have spread to the bladder, the rectum, the bones, or distant lymph nodes.
Doctors will test any cancerous cells in the body to determine if the additional cells came from the prostate. Even if they detect cancer in the bones, doctors still consider this prostate cancer if that is where the cancer originated.
There are two types of stage 4 prostate cancer:
Research Into Hormone Therapy
Prostate cancer depends on the male hormone testosterone for its growth. Hormone therapies block or lower the levels of testosterone. You might have it to lower the risk of your cancer coming back after treatment or to shrink or slow the growth of prostate cancer.
Researchers are looking into:
- the best time to have hormone therapy
- having hormone therapy in combination with other treatments
Also Check: Psa Levels In Metastatic Prostate Cancer Uk
Life After Treatment: Alan Weiners Story
When Alan Weiner found out he had prostate cancer, it was a huge and frightening emotional bomb blast.
The New York native was diagnosed in February 2014 at age 69. After seeking out opinions from various doctors, Weiner underwent robotic prostatectomy in April at Mount Sinai Hospital in New York.
Because of the emotional toll his diagnosis took, Weiner says he found a support group that helped him through that uncertain time in his life. I joined Gildas Club after surgery, but if I had known about it, I would have attended sessions prior to deciding treatment, he says. I found a friend who went through the process and was understanding of my anxieties, fears, and projections.
I never thought that the emotional aspects of this would be so difficult to deal with, Weiner adds. I never believed that the mortality rate of prostate cancer was very low, and I believed that I would be the one who would not make it. I now know that my fears and negative thinking were things most men go through, however.
Today, Weiner goes for routine checkups, and two years after his initial diagnosis, his PSA level is undetectable. He deals with persistent sexual dysfunction, but the bladder control issues he first experienced after his surgery have resolved.