How Long Can I Live With Metastatic Prostate Cancer

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.

What Is Localized Prostate Cancer

Prostate cancer is the abnormal growth of cells in the prostate gland. Localized prostate cancer has not spread outside the gland. Early prostate cancer usually doesnât cause symptoms.

Prostate cancer is the most common cancer in men. Most men who get it are older than 65. If your father, brother, or son has had prostate cancer, your risk is higher than average.

Men of African descent have the highest rates of both prostate cancer and deaths from it.

About 21,000 men are diagnosed with prostate cancer in Canada every year.footnote 1 In the United States, about 12 out of 100 men in the U.S. will be diagnosed with prostate cancer sometime in their lifetime.footnote 2 But most men who are diagnosed with prostate cancer donât die from prostate cancer.

Unlike many other cancers, prostate cancer is usually slow-growing. When prostate cancer is found earlybefore it has spread outside the glandit may be cured with radiation or surgery.

Prostate cancer that has grown beyond the prostate is called advanced prostate cancer. Treatment choices are different for that stage of cancer.

How We Treat Prostate Cancer

The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.

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What Are Next Steps

Bone metastasis have a profound effect on the long-term outlook for prostate cancer. But its important to remember that the numbers are only statistics.

The good news is that life expectancy for advanced prostate cancer continues to increase. New treatments and therapies offer both longer life and better quality of life. Speak to your doctor about your treatment options and long-term outlook.

Everyones cancer experience is different. You may find support through sharing your treatment plan with friends and family. Or you can turn to local community groups or online forums like Male Care for advice and reassurance.

What Can Affect My Outlook

No one can tell you exactly what will happen. How prostate cancer affects you will depend on many things.

• Your stage Whether your cancer is localised, locally advanced, or advanced.
• Your Gleason score or grade group The higher your Gleason score, the more aggressive the cancer, and the more likely it is to spread.
• Your treatment options You may be able to have treatment aimed at getting rid of the cancer. Or you may be able to have treatment to keep the cancer under control. Read more about choosing your treatment.
• Your health If you have other health problems, you may have fewer treatment options. And you may be more likely to die from another condition, such as heart disease.
• Your PSA level After youve been diagnosed, PSA tests are a good way of monitoring your prostate cancer and seeing how youre responding to treatment.
• How successful your treatment is Your treatment may be successful at getting rid of your cancer or keeping it under control. But for some men, treatment may not work as well as expected.

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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.

Know Your Priorities When Deciding On Prostate Cancer Treatment

While this one study showed that people who get a prostatectomy may live longer, it’s important to understand the risks involved with each and to know your priorities. You may be quick to want to remove your prostate or get radiation treatment to get rid of the cancer right away, however, there are many quality of life issues to take into account:

• With active surveillance, your cancer may grow and spread.
• Choosing not to treat your cancer right away could lead to anxiety.
• Men who undergo radiation are more likely to have bowel problems.
• There is a chance you may lose bladder control after surgery.
• You may lose your ability to have an erection after surgery.

The decision about how you will treat your prostate cancer is not one to be taken likely. Discussing the risks and complications with your healthcare provider and your family, and thoroughly considering your priorities, can help you make a decision that feels right for you.

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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.

Where Prostate Cancer Spreads In The Body Affects Survival Time

EMBARGOED FOR RELEASE until 4 p.m. on Monday, March 7, 2016

DURHAM, N.C. — Patients with lymph-only metastasis have the longest overall survival, while those with liver involvement fare worst. Lung and bone metastasis fall in the middle.

Smaller studies had given doctors and patients indications that the site of metastasis in prostate cancer affects survival, but prevalence rates in organ sites were small, so it was difficult to provide good guidance, said Susan Halabi, Ph.D., professor of biostatistics at Duke and lead author of the study published online March 7 in the Journal of Clinical Oncology.

With the large numbers we analyzed in our study, we were able to compare all of these different sites and provide information that could be helpful in conveying prognosis to patients, Halabi said. This information could also be used to help guide treatment approaches using either hormonal therapy or chemotherapy.

Halabi and colleagues from leading U.S. and international cancer research centers pulled data from nine large, phase III clinical trials to analyze outcomes of 8,736 men with metastatic prostate cancer. The patients had all undergone standard treatment with the chemotherapy drug docetaxel.

Site of metastases was categorized into four groups: lung, liver , lymph nodes only, bone with or without lymph nodes and no other organ metastases.

Halabi said more research is needed to understand how and why prostate cancer spreads to different organs.

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Coping With Prostate Cancer

The diagnosis of cancer can cause great anxiety to the individual and his family and friends. At times, one may have troubles coping with the diagnosis, the disease, and its treatment. Searching online for information may prove overwhelming also and may not be the best resource. Ask your physician or local hospital about local resources. Often, there are local prostate cancer support groups which may help you cope with your feelings and provide local resources for more knowledge.

You may consider contacting one or more of the following organizations:

• US Prostate Cancer Foundation,
• Centers for Disease Control and Prevention ,
• American Cancer Society, and
• Patient Advocates for Advanced Cancer Treatment.

The Internet has provided access to a number of sites focusing on prostate cancer treatment and outcomes. The National Cancer Institute and the National Comprehensive Cancer Network have patient information, as well as the American Urological Association.

Is Metastatic Prostate Cancer A Death Sentence

Its bad news, but it isnt likely to be a death sentence. Thanks to widespread screening, nearly 90 percent of prostate cancers are detected before they spread beyond the gland. At this point, the disease is highly curable, meaning that after five years men who have undergone treatment remain cancer-free.

Can you recover from metastatic prostate cancer?

Currently, no treatments can cure advanced/metastatic prostate cancer. However, there are effective ways to help slow its spread, prolong life, and control its symptoms, including immunotherapy, hormone therapy, chemotherapy, precision medicine and clinical trials.

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How Long Can Someone Live With Stage 4 Cancer

Doctors usually describe a persons outlook using the 5-year survival rate. These are calculated based on data from thousands of other people with a similar cancer at a similar stage.

The original location of the cancer determines its type. Survival rates vary, depending on the type of cancer and how far it has spread within the body.

Below, we describe the survival rates for some of the most common forms of cancer in stage 4:

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.

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Death From Other Causes

The mean age at metastatic prostate cancer diagnosis in the study was roughly 71 years. Most of the cohort was White and had a diagnosis of stage M1b metastatic prostate cancer , which means the cancer had spread to the bones.

Among men in the cohort, the rates of death from septicemia, suicide, accidents, COPD, and cerebrovascular diseases were significantly increased compared with the general US male population, the team observes.

Thus, the study authors were concerned with not only with death from metastatic prostate cancer, but death from other causes.

That concern is rooted in the established fact that there is now improved survival among patients with prostate cancer in the US, including among men with advanced disease. âPatients tend to live long enough after a prostate cancer diagnosis for noncancer-related comorbidities to be associated with their overall survival,â they write.

The editorialists agree: prostate cancer âhas a high long-term survival rate compared with almost all other cancer types and signals the need for greater holistic care for patients.â

As noted above, cardiovascular diseases were the most common cause of non-prostate cancer-related deaths in the new study.

As in the management of other cancers, there is concern among clinicians and researchers about the cardiotoxic effects of prostate cancer treatments.

The study had no specific funding. The study authors and editorialists have disclosed no relevant financial relationships.

Stages Of Prostate Cancer

In order to determine the stage of a patients prostate cancer, most doctors start by using the TNM staging system, which helps describe different aspects of the cancers growth.

• T the T category measures the size and extent of the Tumor
• N the N category measures whether and how far the cancer has spread to the Lymph Nodes
• M the M category whether the cancer has spread to other organs in the body (a process called Metastasis

The score for each of these categories is determined based on a pre-determined set of criteria. Your doctor cannot feel or see the tumor with a score of T1. A score of T3 means that the tumor has begun to grow outside of the prostate.

After calculating the TNM categories, doctors will combine the TNM score with the patients Gleason score and PSA levels assigning of a specific stage to the patients cancer.

Prostate cancer prognosis and survival rates can help give patients an idea of their chances of surviving the disease based on the stage and time of diagnosis. While some patients may find this information helpful, others may not want to know.

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About Dr Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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Heres What The Results Showed

After a median follow-up of just over 10 years, 9.7% of men who were treated with radiation and leuporelin for 18 months had died from prostate cancer, compared to 13.3% of the men treated with radiation and leuporelin for six months. Adding zoledronic acid made no difference in either case.

The authors concluded that hormonal therapy is more effective at preventing prostate cancer death when its given for 18 months rather than six. And similar benefits were noted for other endpoints as well. For instance, prostate tumors were less likely to metastasize, or spread, among men in the longer duration treatment group, and it took longer for their cancers to become resistant to hormone therapy if it was reinitiated later.

In earlier clinical research, scientists discovered that hormonal therapy given for three years protects against prostate cancer death more effectively than a six-month treatment regimen. But three years of hormone therapy isnt easily tolerated, and evidence so far shows that 10-year survival rates after either 18 months or three years of hormonal therapy are similar, the authors of the new study claim.

About the Author

Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases

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Overall Survival And Second Primary Malignancies In Men With Metastatic Prostate Cancer

• Roles Conceptualization, Investigation, Methodology, Writing review & editing

  Affiliation Bayer LLC, Whippany, New Jersey, United States of America

• Roles Conceptualization, Investigation, Methodology, Writing review & editing

  Affiliation Bayer LLC, Whippany, New Jersey, United States of America

• Roles Conceptualization, Investigation, Methodology, Writing review & editing

  Affiliation Bayer AB, Stockholm, Sweden

• Roles Conceptualization, Investigation, Methodology, Writing review & editing

  Affiliation Bayer AG, Berlin, Germany

• Roles Resources, Writing review & editing

  Affiliation Department of Surgical Sciences, Uppsala University, Uppsala, Sweden

• Roles Data curation, Formal analysis, Software, Visualization, Writing original draft

  Affiliation EPID Research, Espoo, Finland

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:

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