What Is My Outlook
If youre diagnosed with advanced prostate cancer, you may want to know how well your treatment is likely to control your cancer and for how long it will control it. This is sometimes called your outlook or prognosis. But not all men will want to know this.
While it isnt possible to cure advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain.
No one can tell you exactly what your outlook will be, as it will depend on many things such as where the cancer has spread to, how quickly it has spread, and how well you respond to treatment. Some men may not respond well to one treatment, but may respond better to another. And when your first treatment stops working, there are other treatments available to help keep the cancer under control for longer. Speak to your doctor about your own situation and any questions or concerns you have.
What Factors Determine Life Expectancy For Metastatic Prostate Cancer
The life expectancy of someone with cancer depends on the extent of metastasis and which organs are involved. Metastatic prostate cancer is designated as stage IV:
- Stage IVA: Cancer has progressed to surrounding lymph nodes but not to distant locations.
- Stage IVB: Cancer has progressed to distant tissues and organs, such as the bones or smooth muscles.
Generally, prostate cancers do not spread rapidly to other areas of the body. Most prostate tumors grow slowly and may not cause symptoms or complications for years, if at all.
Even when prostate cancer has spread to other regions of the body, it is usually treatable for an extended period. As a result, even men with advanced prostate cancer can enjoy good health for many years. However, if not properly treated, prostate cancer can cause serious symptoms and even turn fatal.
Metastatic Prostate Cancer: Investigators Ponder New Path To Improve Survival
I am convinced that treating early and hard is better than late and less, said urologic oncologist Judd W. Moul, MD, the James H. Semans Distinguished Professor of Urologic Surgery at Duke University School of Medicine in Durham, North Carolina, who has been extensively involved with clinical trials of prostate cancer therapies. Some doctors still hold the good stuff in their back pocket and avoid or delay the most effective options up front.
Starting multiple therapies earlier in the disease course seems to provide the most benefit, said prostate cancer investigator Jonathan E. Shoag, MD, Associate Professor of Urology at University Hospitals Cleveland Medical Center and Case Western Reserve University, both in Cleveland, Ohio.
Despite all of the scientific advancements, metastatic prostate cancer is still a bad disease, Dr Shoag said. The goal should be preventing cancer from becoming metastatic in the first place. We can do this by screening, diagnosing, and intervening in the disease course earlier.
Advanced molecular imaging, such as positron emission tomography , should be used to identify metastasis as early as possible, before it spreads to distant anatomic sites, according to investigators. Potent treatments should be considered at this stage. Physicians also should try to delay development of both metastasis and castration-resistant prostate cancer , which clinical trial data suggest is possible.
The Expanding Armamentarium
Don’t Miss: Prostate Cancer Survival Rates Stage 4
How Will My Cancer Be Monitored
Your doctor will talk to you about how often you should have check-ups. At some hospitals, you may not have many appointments at the hospital itself. Instead, you may talk to your doctor or nurse over the telephone. You might hear this called self-management.
You will have regular PSA tests. This is often a useful way to check how well your treatment is working. Youll also have regular blood tests to see whether your cancer is affecting other parts of your body, such as your liver, kidneys or bones.
You might have more scans to see how your cancer is responding to treatment and whether your cancer is spreading.
Your doctor or nurse will also ask you how youre feeling and if you have any symptoms, such as pain or tiredness. This will help them understand how youre responding to treatment and how to manage any symptoms. Let them know if you have any side effects from your treatment. There are usually ways to manage these.
Survival Statistics For Prostate Cancer
Survival statistics for prostate cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival. In general, most men diagnosed with prostate cancer do not die from the disease itself and will die from other causes.
There are many different ways to measure and report cancer survival statistics. Your doctor can explain the statistics for prostate cancer and what they mean to you.
Also Check: Dr Samadi Prostate Cancer Center
What Is The Life Expectancy For Stage 4 Prostate Cancer
Prostate cancer life expectancy is determined using five-year survival rates. This is the percentage of people who may still be alive five years after being diagnosed.
The five-year survival rate for men with localized prostate cancer, where there is no evidence of cancer spreading outside the prostate, and regional prostate cancer, when cancer has migrated outside the prostate to adjacent structures or lymph nodes exclusively, is approximately 100 percent.
When prostate cancer reaches stage 4 and has spread to other organs such as the lungs, liver, or bones, the five-year survival rate falls below 30%. At stage 4, prostate cancer is unlikely to be cured, although with effective therapy, many people can live for several years. The patients life expectancy is determined by the precise characteristics of his cancer.
However, thanks to routine screening procedures, prostate cancer is often discovered early, before it has spread to other organs, and it is usually not fatal. When diagnosed early, there are several treatment options available, as well as a good likelihood of a cure.
What Are The Treatment Options For Prostate Cancer
Treatment for prostate cancer is determined based on the size of the tumor and extent of metastasis and may include the following:
Hormone therapy
Hormone treatment deprives the body of the male hormones needed for prostate cancer growth. Orchiectomy or luteinizing hormone-releasing hormone analogs are used alone or in conjunction with an anti-androgen.
Newer hormonal drugs that decrease androgen production and block androgen receptor signaling have been approved by the FDA for the treatment of metastatic prostate cancer following chemotherapy, and they are being studied for early usage in the disease.
Abiraterone
Abiraterone is an oral targeted medication that inhibits androgen synthesis not only in the testes but also in the adrenal glands and the tumor itself. When used with prednisone, abiraterone has been demonstrated to improve quality of life and decrease pain progression in patients with hormone-refractory prostate cancer .
Although this drug is normally well tolerated, adverse effects such as tiredness, elevated blood pressure, and electrolyte or liver problems are possible, and patients must be checked on a regular basis.
Enzalutamide
Enzalutamide interferes with molecular processes that enable prostate cancer growth by targeting various stages in the androgen-receptor-signaling cascade. Furthermore, the medicine does not cause the typical adverse effects of chemotherapy, such as nausea and hair loss.
Chemotherapy
Targeted therapy
Immunotherapy
Sipuleucel-T
Don’t Miss: Screening For Prostate Cancer Icd 10
Managing Bone Pain And Weakness
Symptoms like nausea, hot flashes, and pain can usually be relieved with medication. Some people find that complimentary treatments like acupuncture or massage help manage side effects.
Your doctor may also recommend orthopedic surgery to stabilize your bones, relieve pain, and help prevent bone fractures.
An Evolving Standard Of Care
Hormone-sensitive prostate cancer means a patients tumors are still largely being fueled by male sex hormones called androgens. For many years, metastatic hormone-sensitive prostate cancer was treated with ADT alone, which blocks the production of androgens by the testicles.
In 2014, a large clinical trial showed that adding the chemotherapy drug docetaxel to ADT improved survival in men with metastatic hormone-sensitive prostate cancer. Since then, this combination has become the standard of care for this group of patients.
More recently, studies have shown that adding other drugs that block the production or binding of androgensincluding abiraterone , enzalutamide , and apalutamide to ADT also helps people with metastatic hormone-sensitive prostate cancer live longer. In a trial combining apalutamide with ADT, for example, approximately 82% of men were still alive after 2 years compared with 74% of men treated with ADT alone.
Several clinical trials were then launched to see if combining any of these drugs with ADT and docetaxel could build on those survival gains. Results of those studies, however, have been mixed, with one showing an improvement in survival without the disease progressing and another finding no increase in overall survival.
You May Like: Gnc Men’s Prostate Formula
Stage 4 Prostate Cancer Prognosis
Doctors need to know how far the cancer has advanced, or its stage, in order to choose the best treatment. A pathologist, a specialist who specializes in studying cells obtained from a prostate biopsy, will provide two starting points: the 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 reveals prostate cancer, the patient may be subjected to additional testing to determine whether the disease has spread to other regions of the body via the blood or lymph nodes. These are typically imaging examinations, such as a bone scan, positron emission tomography scan, or computed tomography scan.
What Are The Stages Of Prostate Cancer
Cancer staging is first described using what is called a TNM system. The “T” refers to a description of the size or extent of the primary, or original, tumor. “N” describes the presence or absence of, and extent of spread of cancer to lymph nodes that may be nearby or further from the original tumor. “M” describes the presence or absence of metastases — usually distant areas elsewhere in the body other than regional lymph nodes to which cancer has spread. Cancers with specific TNM characteristics are then grouped into stages, and the stages are then assigned Roman numerals with the numerals used in increasing order as the extent of the cancer being staged increases or the cancer prognosis worsens. Prognosis is finally reflected by considering the patient’s PSA score at presentation as well as their Gleason score in assigning a final stage designation.
The American Joint Commission on Cancer system for prostate cancer staging is as follows:
The primary tumor
Traditionally, advanced prostate cancer was defined as a disease that had widely metastasized beyond the prostate, the surrounding tissue, and the pelvic lymph nodes and was incurable. However, a more contemporary definition includes patients with the lower-grade disease with an increased risk of progression and/or death from prostate cancer in addition to those with widely metastatic disease.
CT scan is used for the initial staging in select patients including
The regional lymph nodes
The distant metastasis
Read Also: Radiation Oncology For Prostate Cancer
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.
Read Also: Can A Man Produce Sperm After Prostate Surgery
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
You May Like: Prostate Cancer Risk Calculator Uk
Treatments To Help Manage Symptoms
Advanced prostate cancer can cause symptoms, such as bone pain. Speak to your doctor or nurse if you have symptoms there are treatments available to help manage them. The treatments above may help to delay or relieve some symptoms. There are also specific treatments to help manage symptoms you may hear these called palliative treatments. They include:
This is the team of health professionals involved in your care. It is likely to include:
- a specialist nurse
- other health professionals, such as a dietitian or physiotherapist.
Your MDT will meet to discuss your diagnosis and treatment options. You might not meet all the health professionals straight away.
Your main point of contact might be called your key worker. This is usually your clinical nurse specialist , but might be someone else. The key worker will co-ordinate your care and help you get information and support. You may also have close contact with your GP and the practice nurses at your GP surgery.
Questions To Ask Your Doctor Or Nurse
- What type of hormone therapy are you offering me and why?
- Are there other treatments I can have?
- What are the advantages and disadvantages of my treatment?
- What treatments and support are available to help manage side effects?
- Are there any lifestyle changes that might help me manage my cancer, symptoms, or side effects?
- How often will I have check-ups and what will this involve?
- How will we know if my cancer starts to grow again?
- What other treatments are available if that happens?
- Can I join any clinical trials?
- If I have any questions or get any new symptoms, who should I contact?
Read Also: How Is A Prostate Biopsy Done
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.
Read Also: Prostate Cancer Ruined My Marriage
Definition Of Patient Outcomes And Evaluation Metrics
The relatively long survival time and low mortality rate of localized prostate cancer pose a great challenge in risk estimation. To get a more accurate disease prognosis evaluation over a shorter and practical timescale, we define a composite outcome as our event of interest:
-
Metastatic diseases
-
Prostate cancer mortality.
The event time is the earliest date of any of these three events. The censoring time is 1 year after the last PSA test. In cases where patients died of other causes before censoring, the censoring time instead is the time of death.
For better insight into the model performances over time, we calculate the time-dependent concordance-index \\):
Here, \\) is the cumulative distribution function at time t, given input feature \. To account for the high censoring ratio, we adjust \\) with the inverse probability of censoring weights. Additionally, we test our models against the more conventional outcome, namely, prostate cancer mortality. In this study, we set the truncation time t to be 2, 5, and 10 years after diagnosis.
Depending if the input \ is time-dependent, we employ two DL models, RDSM and Deep Survival Machine . As a benchmark, we also consider two popular machine learning models, Random Survival Forest and Gradient Boosting Machine , along with the classical Cox model,,,. All three benchmark models are implemented using the scikit-survival package.
Read Also: What Is The Main Cause Of Prostate Enlargement