Can I Survive Advanced Prostate Cancer Whats The Prognosis
Prostate cancer is the second leading cause of death from cancer in men, according to the National Cancer Institute. While theres no cure, men can live with it for years if they get the right treatment. Each man with advanced prostate cancer is different, of course. You and your cancer have unique qualities that your doctor takes into consideration when planning the best treatment strategy for you.
According to Harvard Medical School, the prognosis for men with advanced prostate cancer is improving because of newer medications that help them get past a resistance to androgen-deprivation therapy that typically develops after a few years of treatment. With these medications, many men are living longer, and a number of men diagnosed with advanced prostate cancer are dying with the cancer, not from it.
Promptly treating prostate cancer bone metastases with the newest medication can help change a mans prognosis dramatically, Tagawa says. There are men who do well for decades, he says. Some men can even stop treatment, go on to live many years, and actually die of something unrelated.
Tagawa says that cancer specialists who use sophisticated imaging technologies, like positron-emission tomography scans, have gotten very good at finding even tiny bone metastases, which is valuable in diagnosing and removing early stage metastases.
If Treatment Does Not Work
Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for many people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
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What Is Prostate Cancer
Cancer can start any place in the body. Prostate cancer starts in the prostate gland. It starts when cells in the prostate grow out of control.
Cancer cells can spread to other parts of the body. Cancer cells in the prostate can sometimes travel to the bones or other organs and grow there. When cancer cells do this, its called metastasis. To doctors, the cancer cells in the new place look just like the ones from the prostate.
Cancer is always named for the place where it starts. So when prostate cancer spreads to the bones , its still called prostate cancer. Its not called bone cancer unless it starts from cells in the bone.
Ask your doctor to use this picture to show you where your cancer is.
The prostate
The prostate is a gland found only in men, so only men can get prostate cancer.
The prostate is just below the bladder and in front of the rectum . The tube that carries pee goes through the prostate. The prostate makes some of the fluid that helps keep the sperm alive and healthy.
There are a few types of prostate cancer. Some are very rare. Most prostate cancers are a type called adenocarcinoma. This cancer starts from gland cells. Your doctor can tell you more about the type you have.
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How Serious Is My Cancer
If you have prostate cancer, the doctor will want to find out how far it has spread. This is called the stage of the cancer. You may have heard other people say that their cancer was stage 1 or stage 2. Your doctor will want to find out the stage of your cancer to help decide what types of treatment might be best for you.
The stage is based on the growth or spread of the cancer through the prostate, and if it has spread to other parts of your body. It also includes your blood PSA level and the grade of the cancer. The prostate cancer cells are given a grade, based on how they look under a microscope. Those that look very different from normal cells are given a higher grade and are likely to grow faster. The grade of your cancer might be given as a Gleason score or a Grade Group . Ask your doctor to explain the grade of your cancer. The grade also can helpdecide which treatments might be best for you.
Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread outside the prostate.
If your cancer hasn’t spread to other parts of the body, it might also be given a risk group. The risk group is based on the extent of the cancer in the prostate, your PSA level, and the results of the prostate biopsy. The risk group can help tell if other tests should be done, and what the best treatment options might be.
About The Prostate And Prostate Cancer
The prostate gland is part of the male reproductive system and produces fluid that mixes with semen during ejaculation to help sperm travel. The prostate is a walnut-sized, rubbery organ that surrounds the urethrathe urinary duct that carries urine from the bladder out of the bodyand sits directly below the bladder.
The prostate gland, which grows during puberty, is considered an organ and is made up of several dozen lobules or saclike glands, held together with connective prostate tissue and muscle between them. The glands are called exocrine glands, because they secrete liquid to outside the body.
An enlarged prostate, called benign prostatic hyperplasia , is common in men over the age of 40 and may obstruct the urinary tract. The abnormal prostate cell growth in BPH is not cancerous and doesnt increase your risk of getting prostate cancer. However, symptoms for BPH and prostate cancer can be similar.
A condition called prostatic intraepithelial neoplasia , where prostate gland cells look abnormal when examined under a microscope, may be connected to an increased risk of prostate cancer. Prostate cancer is often caught by a doctor performing a digital rectal exam , through a prostate-specific antigen blood test, through a prostate biopsy or with a CT scan.
Another condition, prostatitis, is the inflammation of the prostate. While not cancerous, it may cause higher PSA levels in the blood.
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How Does The Doctor Know I Have Prostate Cancer
Prostate cancer tends to grow slowly over many years. Most men with early prostate cancer dont have changes that they notice. Signs of prostate cancer most often show up later, as the cancer grows.
Some signs of prostate cancer are trouble peeing, blood in the pee , trouble getting an erection, and pain in the back, hips, ribs, or other bones.
If signs are pointing to prostate cancer, tests will be done. Most men will not need all of them, but here are some of the tests you may need:
PSA blood test: PSA is a protein thats made by the prostate gland and can be found in the blood. Prostate cancer can make PSA levels go up. Blood tests will be done to see what your PSA level is and how it changes over time.
Transrectal ultrasound : For this test, a small wand is put into your rectum. It gives off sound waves and picks up the echoes as they bounce off the prostate gland. The echoes are made into a picture on a computer screen.
MRI: This test uses radio waves and strong magnets to make detailed pictures of the body. MRI scans can be used to look at the prostate and can show if the cancer has spread outside the prostate to nearby organs.
Prostate biopsy: For a prostate biopsy, the doctor uses a long, hollow needle to take out small pieces of the prostate where the cancer might be. This is often done while using TRUS or MRI to look at the prostate. The prostate pieces are then checked for cancer cells. Ask the doctor what kind of biopsy you need and how its done.
Where Can I Find Support
It can be very difficult to deal with a diagnosis of advanced prostate cancer. Its natural to wonder if youre doing all you can to fight the cancer and how to handle guilt, intimacy with a partner, and concerns about masculinity. And finding and paying for the best care can, of course, be a challenge.
But emotional and practical support can help you move forward. An important thing to remember is that youre not alone. There are many kinds of help available, and the right cancer resources can make a world of difference.
Ask your doctor for resources you can contact, including social workers and support systems in your community. The Patient Navigator Program of the ACS can be reached at 1-800-227-2345 youll be connected to a patient navigator at a cancer treatment center who can help you with practical and emotional issues.
The Prostate Cancer Foundation has links to in-person and online support groups around the country, and the ACS lists nationwide support programs as well. The PCF also offers resources ranging from help with housing during cancer treatment to finding ways you can look good and feel better while living with cancer.
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Are Prostate Problems Always A Sign Of Prostate Cancer
Not all growths in the prostate are cancerous, and not all prostate problems indicate cancer. Other conditions that cause similar prostate cancer symptoms include:
- Benign prostatic hyperplasia : At some point, almost every man will develop benign prostatic hyperplasia . This condition enlarges the prostate gland but doesnt increase cancer risk. The swollen gland squeezes the urethra and blocks the flow of semen and urine. Medications, and sometimes surgery, can help.
- Prostatitis: Men younger than 50 are more prone to prostatitis, inflammation and swelling of the prostate gland. Bacterial infections are often the cause. Treatments include antibiotics or other medications.
Cancer Lethality Set Early
The study looked for changes in cancer aggressiveness in men diagnosed with prostate cancer from 1982 to 2004. All of the men had their prostates removed after diagnosis, and biopsy samples were taken from the glands. The Harvard team reexamined the samples and graded them using a tool called the Gleason score, which assigns a number from 2 to 10 based on how abnormal the cells look under a microscope. High-scoring or high-grade cancers tend to be the most lethal.
Over the study period, fewer and fewer men were diagnosed with advanced, late-stage prostate cancers that had spread beyond the prostate gland. This reflected the growing use of prostate-specific antigen testing to diagnose prostate cancers earlier and earlier. In contrast, the proportion of high-grade cancers, as measured by the Gleason score, remained relatively stable rather than gradually becoming more aggressive. Previous studies have seen a similar pattern.
Its a very interesting study that confirms what previous studies have found, says Dr. Marc B. Garnick, a prostate cancer specialist at Harvard-affiliated Beth Israel Deaconess Medical Center who was not involved in the study. There may be rare exceptions, but in the vast majority the cancer is born with a particular Gleason score.
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Symptoms Of Advanced Prostate Cancer
The symptoms of advanced prostate cancer depend on where the cancer has spread to. Find out about the possible symptoms and when to see your doctor.
Advanced prostate cancer means that a cancer that began in the prostate gland has spread to another part of the body. If your cancer has spread you might:
- have bone pain
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Stem Cell Or Bone Marrow Transplant
A stem cell transplant, sometimes called bone marrow transplant, replaces damaged blood-forming cells with healthy ones. The procedure takes place following large-dose chemotherapy or radiation therapy to kill cancer cells and to stop your stem cells from producing cancerous cells.
Stem cell transplants can be used for several types of cancer, including multiple myeloma and some kinds of leukemia.
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Can You Live 20 Years With Prostate Cancer
After 20 years, only 3 of 217 patients survived. Men with moderate-grade disease have intermediate cumulative risk of prostate cancer progression after 20 years of follow-up. These results are in line with earlier findings on the outcomes of prostate cancer patients depending on Gleason scores.
What Should I Expect As My Cancer Progresses
How does prostate cancer spread?
Prostate cancer cells can move from the prostate to other parts of the body through the blood stream. Or they can spread to the lymph nodes near the prostate and then travel through the lymph vessels to other parts of your body. Lymph nodes and lymph vessels are part of your lymphatic system and are found throughout your body.
Prostate cancer most commonly spreads to the bones and lymph nodes. It can also spread to, or press on, the tube you urinate through , the bladder, the tubes that carry urine from the kidneys to the bladder and part of the bowel . Prostate cancer may spread to other parts of the body, including the lungs and liver. But this is less common.
If tests and scans show that your cancer is spreading, ask your doctor what will happen next. This can help you and your family prepare for what to expect. Find out more about advanced prostate cancer and treatments.
Watch our video about advanced prostate cancer.
How does prostate cancer cause problems?
Prostate cancer can cause problems if it is pressing on your bones or nerves. It can also cause problems by stopping your normal cells from working properly.
What problems can advanced prostate cancer cause?
The symptoms and problems you have will depend on where the cancer has spread to. Even though your cancer is still growing, you will still be able to have treatment to help manage these problems.
Advanced prostate cancer problems may include:
What should I look out for?
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Should I Make Any Lifestyle Changes Including In My Diet Or Physical Activity
Achieving and maintaining a healthy weight by eating a balanced diet with plenty of fruits, vegetables, and whole grains, and staying physically active, can help your overall health. These lifestyle changes can also have a positive effect for men with bone metastases, Tagawa says. Both diet and exercise, he says, are things that are under a mans direct control.
A healthy lifestyle can help you better manage side effects from treatment as well. Try setting small but realistic goals for yourself when it comes to eating a healthy diet and getting plenty of exercise.
While no single food is likely to have a benefit for prostate cancer, smart food choices may help you feel better day to day. Start by cutting out foods high in sugar, saturated fat, and added flavorings and preservatives.
If youre not sure which healthy foods to choose, ask your doctor for a referral to a dietitian. This specialist can help you develop a meal plan that includes foods that offer the best chance of slowing the cancers growth and keeping you as healthy as possible.
As an oncologist, Tagawa says he concentrates on treating the cancer itself, but hes aware that many of the men he sees with advanced prostate cancer are older and more likely than younger men to have health problems that can benefit from diet and exercise.
And if youre on hormone therapy, talk to your doctor about investing in some weights or elastic resistance bands to support your bone strength too.
About Rare Prostate Cancers
Although prostate cancer is a common cancer in men, there are different types of prostate cancer, and some of these are rare. Because they are rare, we dont know as much about them. If you are diagnosed with one of the cancers mentioned here, speak to your doctor or nurse about what that means and what treatments are suitable for you.
Like most things in our body, the prostate is made up of different types of cells . The type of cancer that develops depends on the cell it starts in.
The most common type of prostate cancer starts in some of the cells that line the prostate, called glandular epithelial cells. There are two types of gland cells basal cells and luminal cells . Prostate cancer can develop in either of these cells.
When we talk about common prostate cancer here, we mean this type of prostate cancer. You may hear it called adenocarcinoma or acinar adenocarcinoma or see this written in your biopsy results .
Rarer types of cancer can also develop from gland cells, or from other types of cells in the prostate.
Some men have more than one type of prostate cancer. For example, they may have some common prostate cancer as well as a rare cancer.
Some of the rare cancers may be more aggressive than common prostate cancer. This means they may grow faster and are more likely to spread outside the prostate.
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