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 Are The Symptoms Of Prostate Cancer
If you have any symptoms that worry you, be sure to see your doctor right away. They may be caused by conditions other than prostate cancer.
Different people have different symptoms for prostate cancer. Some men do not have symptoms at all.
If you have any of the following symptoms, be sure to see your doctor right away
- Difficulty starting urination.
- Weak or interrupted flow of urine.
- Urinating often, especially at night.
- Trouble emptying the bladder completely.
- Pain or burning during urination.
- Pain in the back, hips, or pelvis that doesnt go away.
Keep in mind that these symptoms may be caused by conditions other than prostate cancer.
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What Are The Prostate Cancer Stages
The prostate is a gland about the size of a walnut that is a part of the male reproductive system. In the USA, roughly 13 out of every 100 men will develop prostate cancer sometime in their lives, making it one of the most common cancers in men. Most cases are diagnosed in the early stages when cancer affects only the prostate. As the disease progresses, prostate cancer can spread to lymph nodes, bones, liver, and other body parts. In the final stages, prostate cancer is often incurable, but some treatments can help lengthen and improve your quality of life.
Doctors often use the Gleason score and Grade Groups to evaluate prostate cancer as it develops. Cancer cells dont look the same as healthy cells. If cancer is suspected, your doctor will take a sample to study under a microscope. Cancer cells are then graded based on how similar or different they look compared to healthy cells. The grades typically range between 3 and 5. Low-scoring cancer cells that look more normal are often slow-growing, but higher scored cancer cells are much more likely to be aggressive and spread quickly .
The grades from the two most common cell patterns in your biopsy sample are added together. This number is usually between 6 and 10 and is called a Gleason Score. The cancer is then further broken down into Grade Groups 1 through 5 based on your Gleason score. A Gleason score of 6 would be put in Grade Group 1, and a Gleason score of 10 would be in Grade Group 5.
Stage 1 prostate cancer
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Metastatic Prostate Cancer Symptoms
With metastatic prostate cancer, the patient may notice different symptoms than those generally associated with other stages of the disease. Some of the most frequently occurring stage 4 prostate cancer symptoms include:
- Bone pain, particularly in the pelvis, ribs, skull and spine
- Unexplained weight loss
- General feeling of being unwell
- Changes in urinary habits, such as needing to go more often
- Cough, breathlessness or other changes involving the lungs and chest
Not everyone with metastatic prostate cancer will experience each of these symptoms, but patients should speak with their care teams if they notice any such changes.
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.
Surgery may be undertaken to treat bone fractures or to relieve the pressure on the spinal cord by bone metastases.
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Advanced Prostate Cancer Resources
At ZERO we are dedicated to helping you live your best life possible and we have resources and information to help you and your loved ones throughout the advanced prostate cancer journey. Our advanced prostate cancer resources include print materials, online educational programs and co-pay assistance. Check out some of our resources listed below.
Survival Statistics For Prostate Cancer
Survival statistics for prostate cancer are very generalestimates and must be interpreted very carefully. Because these statistics are based on the experience of groupsof people, they cannot be used to predict a particular persons chances ofsurvival. In general, most men diagnosed with prostate cancer do not die from thedisease itself and will die from other causes.
There are manydifferent ways to measure and report cancer survival statistics. Your doctorcan explain the statistics for prostate cancer and what they mean to you.
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What You Can Do
Its important that you learn all you can about advanced prostate cancer so you can make informed decisions. Be open with your doctors and others on your healthcare team. Express your concerns and feel free to advocate for yourself and your quality of life. Get another medical opinion if you feel its necessary.
Some complementary therapies may prove helpful in coping with advanced cancer. For example:
- tai chi, yoga, or other movement therapy
- meditation, breathing exercises, or other relaxation techniques
A variety of services can help you with everything from lodging while youre getting treatment to getting some help around the house. Communicating with online or in-person groups are a good way to share information and lend mutual support.
Loss Of Libido And Erectile Dysfunction
The hormones that are often used to treat advanced prostate cancer can decrease libido and cause erectile dysfunction , which occurs when a man isnt able to have or keep an erection to have sex, according to the University of Rochester Medical Center in Rochester, New York.
As a result, for couples, theres a real struggle to recover that sense of life together how to be intimate without having sex, says Michael J. Morris, MD, an oncologist at Memorial Sloan Kettering Cancer Center in New York City.
Depending on the type of treatment that caused the ED, the ability to have an erection may improve over time, according to the University of Rochester Medical Center. You and your partner may want to explore other ways to be intimate in your relationship. A sex therapist or couples counselor may be able to help. There are also treatments available for erectile dysfunction, such as medications and implants.
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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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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:
|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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What Else You Can Do For Your Loved One
Besides providing relief throughout the cancer end-of-life stages, a family caregiver can provide both emotional and practical support at the end of life. This usually involves speaking to the patient about their financial plan, but should also include things like speaking to the patient about how they would like to spend their final days. Perhaps there is something they wish they could have done or seen. And perhaps there is some way you can help them make this dream a reality. You can also help them with planning a funeral, as well as speak to them about when they feel it is time to begin hospice care.
Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.
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What Are Some Of The Problematic Aspects Of Prostate Cancer
Men who undergo prostate cancer may have enlarged prostate symptoms like frequent urination, especially at night, or leakage. Many men experience erectile dysfunction, which can impact their sex life. In addition, the disease and the treatment might cause fatigue and disrupt your life and motivation. Some cancer patients experience issues with mood, such as depression.
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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.
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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.
Signs Of Impending Death Identified In Cancer Patients
While many would rather not think about when someone might die, knowing how much longer a seriously ill person has left to live can be very useful for managing how they spend their final days. Researchers have now revealed eight signs in patients with advanced cancer associated with death within 3 days.
Diagnosis of an impending death can help clinicians, patients and their friends and family to make important decisions. Doctors can spare time and resources by stopping daily bloodwork and medication that will not make a short-term difference. Families will know if they still have time to visit their relatives.
This study shows that simple bedside observations can potentially help us to recognize if a patient has entered the final days of life, says study author Dr. David Hui.
Upon further confirmation of the usefulness of these tell-tale signs, we will be able to help doctors, nurses, and families to better recognize the dying process, and in turn, to provide better care for the patients in the final days of life.
The study, published in Cancer, follows on from the Investigating the Process of Dying Study a longitudinal observational study that documented the clinical signs of patients admitted to an acute palliative care unit . During the study, the researchers identified five signs that were highly predictive of an impending death within 3 days.
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How Prostate Cancer Is Diagnosed And Staged
Cancer staging helps you and your doctor understand how advanced your cancer is and how much it has spread at the time of diagnosis. Knowing your cancer stage also helps your doctor determine the best treatment options for you and estimate your chance of survival.
The most widely used staging system for cancer is the TNM system that classifies cancer from stage 1 to stage 4.
TNM stands for:
- Tumor: the size and extent of the tumor
- Nodes: the number or extent of nearby lymph node involvement
- Metastasis: whether cancer has spread to distant sites in the body
The TNM scale is used for many types of cancer. When a doctor uses it to determine your prostate cancer stage, theyll consider several other factors as well, including:
Health And Social Care Professionals You Might See
You might see a range of different professionals to help manage your symptoms and offer emotional and practical support. Some may have been treating you since your diagnosis. Others provide specific services or specialise in providing treatment to manage symptoms .
If you have questions or concerns at any time, speak to someone in your medical team. They can explain your diagnosis, treatment and side effects, listen to your concerns, and help you get support.
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Signs And Symptoms Of Prostate Cancer
Most prostate cancers are found early, through screening. Early prostate cancer usually causes no symptoms. More advanced prostate cancers can sometimes cause symptoms, such as:
- Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night
- Trouble getting an erection
- Pain in the hips, back , chest , or other areas from cancer that has spread to bones
- Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord
Most of these problems are more likely to be caused by something other than prostate cancer. For example, trouble urinating is much more often caused by benign prostatic hyperplasia , a non-cancerous growth of the prostate. Still, its important to tell your health care provider if you have any of these symptoms so that the cause can be found and treated, if needed. Some men might need more tests to check for prostate cancer.