Prognosis For Prostate Cancer
It is not possible for a doctor to predict the exact course of a disease, as it will depend on each person’s individual circumstances. However, your doctor may give you a prognosis, the likely outcome of the disease, based on the type of prostate cancer you have, the test results, the rate of tumour growth, as well as your age, fitness and medical history.
Prostate cancer often grows slowly and even more aggressive types tend to grow more slowly than other types of cancer. If diagnosed early, prostate cancer has one of the highest five year survival rates.
Tests To Identify Prostate Cancer Stage
After a prostate cancer diagnosis, your doctor will do tests to see how far the cancer has spread. Not all men need every test. It depends on the results of your biopsy, a test that checks tissue from your prostate gland for cancer. Tests that help your doctor figure out the stage of your prostate cancer include:
- CT scan of the abdomen and pelvis to see if the cancer has spread
- Nuclear medicine bone scan to see if the cancer has spread to your bones
- Surgery to check the lymph nodes in your pelvis for prostate cancer spread
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.
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Good Prostate Cancer Care
Your MDT will be able to recommend what they feel are the best treatment options, but ultimately the decision is yours.
You should be able to talk with a named specialist nurse about treatment options and possible side effects to help you make a decision.
You should also be told about any clinical trials you may be eligible for.
If you have side effects from treatment, you should be referred to specialist services to help stop or ease these side effects.
The 10 Deadliest Cancers And Why There’s No Cure
Any kind of cancer is awful, but these are the deadliest cancers of them all.
The dread and fear that can come with a cancer diagnosis have their roots in its killer nature: Cancer is the second most common cause of death in Americans after heart disease, according to theCenters for Disease Control and Prevention . Even when diagnosed early and attacked with the latest treatments, cancer still has the power to kill.
According to the World Health Organisation , the three cancers that killed the most people worldwide in 2020 were lung cancer , colorectal cancer and liver cancer . But those aren’t the deadliest cancers, according to Rebecca Siegel, MPH, senior scientific director of surveillance research at the American Cancer Society .
The number of people a cancer kills each year depends on two factors: how many people have it and what percentage of people diagnosed with the cancer survive it , Siegel explained. The deadliest cancers are those with the lowest survival.
Cancer researchers determine survival with a measure called the 5-year relative survival. This is the percentage of people who are expected to survive the effects of a given cancer, excluding risks from other possible causes of death, for five years past a diagnosis, according to the Surveillance, Epidemiology, and End Results Program , a National Cancer Institute initiative that collects, compiles, analyzes and reports data and statistics on cancer cases nationwide.
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Understanding Prostate Cancers Progression
To determine the appropriate treatment, doctors need to know how far the cancer has progressed, or its stage. A pathologist, the doctor trained in analyzing cells taken during a prostate biopsy, will provide two starting pointsthe cancers grade and Gleason score.
- Cancer grade: When the pathologist looks at prostate cancer cells, the most common type of cells will get a grade of 3 to 5. The area of cancer cells in the prostate will also be graded. The higher the grade, the more abnormal the cells.
- Gleason score: The two grades will be added together to get a Gleason score. This score tells doctors how likely the cancer is to grow and spread.
After a biopsy confirms prostate cancer, the patient may undergo additional tests to see whether it has spread through the blood or lymph nodes to other parts of the body. These tests are usually imaging studies and may include a bone scan, positron emission tomography scan or computed tomography scan.
Prostate cancer treatment: The care you need is one call away
Your multidisciplinary team will work with you to develop a personalized plan to treat your prostate cancer in a way that fits your individual needs and goals.
Gleason Score Vs Grade Groups
The International Society of Urological Pathology released a revised prostate cancer grading system in 2014. The grade group system seeks to simplify Gleason scores and give a more accurate diagnosis.
One of the major problems with the Gleason score is that some scores can be made up in different ways. For example, a score of 7 can mean:
- 3 + 4. The 3 pattern is the most common in the biopsy and 4 is the second most common. This pattern is considered favorable intermediate risk.
- 4 + 3. The 4 pattern is the most common in the biopsy and 3 is the second most common. This pattern is considered unfavorable and may mean local or metastatic spread.
So, although both situations give a Gleason score of 7, they actually have very different prognoses.
Heres an overview of how the two grading systems compare:
| Cancer grade | |
|---|---|
| grade group 5 | 910 |
Not all hospitals have switched to the grade group system. Many hospitals give both grade group and Gleason scores to avoid confusion until grade groups become more widely used.
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Certain Factors Affect Prognosis And Treatment Options
The prognosis and treatment options depend on the following:
- The stage of the cancer .
- The patients age.
- Whether the cancer has just been diagnosed or has recurred .
Treatment options also may depend on the following:
- Whether the patient has other health problems.
- The expected side effects of treatment.
- Past treatment for prostate cancer.
- The wishes of the patient.
Most men diagnosed with prostate cancer do not die of it.
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The Tnm System For Prostate Cancer Stages
As they do for most cancers, doctors use the TNM system to describe prostate cancer stages. The system uses three different aspects of tumor growth and spread:
- Tumor. Whatâs the size of the main area of prostate cancer?
- Nodes. Has it spread to any lymph nodes? If so, how far and how many?
- Metastasis. How far has the prostate cancer spread?
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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.
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.
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Acute Myeloid Leukemia 5
Leukemias develop from stem cells in the bone marrow, which differentiate into different blood-cell precursors and eventually blood cells. Leukemia occurs when blood cell development is halted and the cells become cancerous, explained Romundstad. Leukemias are classified according to the stage at which blood cells and precursors halt their development and become cancerous, Romundstad said.
Acute myeloid leukemia refers to any cancer that develops in myeloid cells , which are blood precursor cells that have the potential to develop into red blood cells, some types of white blood cells, and platelets.
In AML, rather than developing into these blood cell types, stem cells get stuck at an immature stage and are called “blast cells,” according toLeukemia and Lymphoma Society . There are no or very few blast cells in healthy blood. Having too many blast cells and too few healthy blood cells causes many symptoms of AML, including frequent infections, bruising, and bleeding easily.
AML is more common in adults than in children, though it can occur at any age. For the most part, doctors don’t know what causes it, though smoking, previous chemotherapy or radiation treatments for other cancers, and exposure to the chemical benzene increase the risk of getting it. Treatment approaches may include chemotherapy, a stem cell transplant or targeted therapies. According to the NCI, AML is predicted to claim the lives of some 11,540 Americans in 2022.
Tnm Staging System The Most Widely Used Staging System For Prostate Cancer Isthe Ajcc Tnm System For Prostate Cancerthere Are 4 Stages Often The Stages 1 To 4 Are Written As The Roman Numeralsi Ii Iii And Iv Generally The Higher The Stage Number The More The Cancerhas Spread The Stages Can Be Further Divided Into A B Or C An Earlier Lettermeans A Lower Stage Talk To Your Doctor If You Have Questions About Staging Tnm Staging Is Based On The Following: T Describes Thetumour And Whether Doctors Can Feel It Or See It On Imaging Tests It Alsodescribes Whether The Tumour Has Grown Outside Of The Prostate To Thesurrounding Tissues T Is Usually Given As A Number From 1 To 4 A Highernumber Means That The Tumour Takes Up More Of The Prostate Or That The Tumourhas Grown Outside Of The Prostate Into Nearby Tissues Some Stages Are Alsodivided Further Into A B Or C An Earlier Letter Means A Lower Stage The Clinical T Is Your Doctor’s Best Estimate Of Theextent Of The Cancer Based On A Physical Exam A Digital Rectal Exam A Prostatebiopsy And Imaging Tests If You Have Surgery To Remove Your Prostate Apathological T Will Be Given Pt Is More Accurate Than Ct T The Tumour Has Grown Outside The Prostate And Into The Seminal Vesicles T4 The Tumour Has Grown Outside The Prostate And Into Nearby Structures Suchas The Bladder Rectum Pelvic Muscles And Pelvic Wall
N describeswhether the cancer has spread to lymph nodes near the prostate. N0 means that thecancer hasn’t spread to any nearby lymph nodes. N1 means that it has spread tonearby lymph nodes.
M describeswhether the cancer has spread to other parts of the body. M0 means that the cancerhas not spread to other parts of the body. M1 means that it has spread to otherparts of the body.
PSA level describes the amount of the prostate-specificantigen in the blood.
Grade Group is a measureof how likely the cancer is to grow and spread.
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Survival Rates For Prostate Cancer
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. These rates cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Ask your doctor, who is familiar with your situation, how these numbers may apply to you.
Survival For All Stages Of Prostate Cancer
Generally for men with prostate cancer in England:
- more than 95 out of 100 will survive their cancer for 1 year or more
- more than 85 out of 100 will survive their cancer for 5 years or more
- almost 80 out of 100 will survive their cancer for 10 years or more
Survival of prostate cancer is also reported in Scotland and Northern Ireland. But it is difficult to compare survival between these countries because of differences in the way the information is collected.
Cancer survival by stage at diagnosis for England, 2019Office for National Statistics
These statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account the background mortality that they would have experienced if they had not had cancer.
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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.
Stages Types And Grades Of Prostate Cancer
The tests and scans you have to diagnose prostate cancer give information about:
- the type of cell the cancer started in and where it began
- how abnormal the cells look under the microscope
- the size of the cancer and whether it has spread
In the UK, doctors use the Grade Groups or Gleason score to grade prostate cancer. Doctors now use the Grade Groups and other information to divide prostate cancer into 5 groups. This is called the Cambridge Prognostic Group .
You might also be told about the TNM stage, or you may see this on your pathology report. Another way doctors may describe your cancer is as localised, locally advanced and metastatic prostate cancer.
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How Prostate Cancer Spreads And Progresses
Prostate cancer grows within the prostate gland, often for many years. Over time, the cancer spreads outside the prostate. This happens in one of three ways:
- It grows into nearby tissues
- It spreads through your system of lymph nodes and lymph vessels
- It travels to distant tissues through your blood
Prostate cancer stages describe how far the cancer has spread.
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.
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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.
Researchers are also studying a link between diet and increased prostate cancer risk. Diets high in calcium or low in vegetables may cause an increased risk of aggressive prostate cancer.