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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Impact On Everyday Activities
If you have no symptoms, prostate cancer should have little or no effect on your everyday activities. You should be able to work, care for your family, carry on your usual social and leisure activities, and look after yourself.
However, you may be understandably worried about your future. This may make you feel anxious or depressed and affect your sleep.
If your prostate cancer progresses, you may not feel well enough to do all the things you used to. After an operation or other treatment, such as radiotherapy or chemotherapy, you’ll probably feel tired and need time to recover.
If you have advanced prostate cancer that has spread to other parts of your body, you may have symptoms that slow you down and make it difficult to do things. You may have to reduce your working hours or stop working altogether.
Whatever stage your prostate cancer has reached, try to give yourself time to do the things you enjoy and spend time with those who care about you.
Life After Treatment: Alan Weiners Story
When Alan Weiner found out he had prostate cancer, it was a huge and frightening emotional bomb blast.
The New York native was diagnosed in February 2014 at age 69. After seeking out opinions from various doctors, Weiner underwent robotic prostatectomy in April at Mount Sinai Hospital in New York.
Because of the emotional toll his diagnosis took, Weiner says he found a support group that helped him through that uncertain time in his life. I joined Gildas Club after surgery, but if I had known about it, I would have attended sessions prior to deciding treatment, he says. I found a friend who went through the process and was understanding of my anxieties, fears, and projections.
I never thought that the emotional aspects of this would be so difficult to deal with, Weiner adds. I never believed that the mortality rate of prostate cancer was very low, and I believed that I would be the one who would not make it. I now know that my fears and negative thinking were things most men go through, however.
Today, Weiner goes for routine checkups, and two years after his initial diagnosis, his PSA level is undetectable. He deals with persistent sexual dysfunction, but the bladder control issues he first experienced after his surgery have resolved.
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Prostate Cancer Survival Rates: What They Mean
As cancer diagnoses go, prostate cancer is often a less serious one. Prostate cancer is frequently slow-growing and slow to spread. For many men, prostate cancer is less serious than their other medical conditions.
For these reasons, and possibly because of earlier detection of low-grade prostate cancers, prostate cancer has one of the highest survival rates of any type of cancer. WebMD takes a look at prostate cancer survival rates and what they mean to you.
Watchful Waiting And Active Surveillance
Watchful waiting is an adequate approach in patients who are at low risk of death from prostate cancer because of their limited life expectancy due to severe comorbidities.26,27 Watchful waiting resulted in similar overall survival when compared with radical prostatectomy, but disease-specific survival was better in patients who had undergone surgery.26 For some patients it turns out to be hard to persist on a watchful waiting policy, and many men drop out and seek active treatment within several years, mostly when PSA elevation is noted.
Active surveillance is a novel and fascinating approach to distinguish between patients who are at higher risk and need active therapy and patients who are at low risk for disease progression.27,28 This approach avoids the risks of therapy while allowing early detection of those patients who are prone to progress. In these high-risk individuals, delayed active treatment is offered. Periodic monitoring of the PSA serum level, digital rectal exam, and repeated prostate biopsies are performed in patients who are on active surveillance, and active therapy is started when predefined threshold values are reached. This concept makes it possible to offer curative treatment to individuals who are at high risk for disease progression as indicated by active surveillance parameters.
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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.
Stage 4 Prostate Cancer Clinical Trials
Clinical trials provide cancer patients with life-extending and curative new medicines. Clinical drug trials are critical in getting new medicines to patients who need them the most, as well as securing data so that regulatory clearances may be secured, and new drugs can enter broad clinical practice. Patients who take part in clinical trials benefit both treatment science and their fellow patients.
There are currently 100 Phase III drug trials and more than 500 Phase I/II trials related to prostate cancer treatment in progress in the United States alone. Those that are approved will join the 12 new drugs that have been approved for men with advanced/metastatic disease since 2010 and further improve outcomes for patients:
Using our AI-powered approach, Massive Bio leads patients through the most extensive clinical trial matching process available.
We can assist you if you have been diagnosed with any of the following prostate cancer subtypes:
- Transitional Cell Carcinoma
- Small Cell Carcinoma
If you do not know which type of prostate cancer you have, that is okay. Additional testing can help you determine your exact diagnosis.
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What Are Some Ways To Provide Emotional Support To A Person Who Is Living With And Dying Of Cancer
Everyone has different needs, but some worries are common to most dying patients. Two of these concerns are fear of abandonment and fear of being a burden. People who are dying also have concerns about loss of dignity and loss of control. Some ways caregivers can provide comfort to a person with these worries are listed below:
- Keep the person company. Talk, watch movies, read, or just be with them.
- Allow the person to express fears and concerns about dying, such as leaving family and friends behind. Be prepared to listen.
- Be willing to reminisce about the person’s life.
- Avoid withholding difficult information. Most patients prefer to be included in discussions about issues that concern them.
- Reassure the patient that you will honor advance directives, such as living wills.
- Ask if there is anything you can do.
- Respect the person’s need for privacy.
- Support the persons spirituality. Let them talk about what has meaning for them, pray with them if theyd like, and arrange visits by spiritual leaders and church members, if appropriate. Keep objects that are meaningful to the person close at hand.
First Line Treatment For Advanced Prostate Cancer
The established first line approach is to control the progression of the disease by reducing levels of testosterone in the body. This is because testosterone increases the speed at which prostate cancer cells reproduce.
There are two different ways to lower testosterone levels. Hormone therapy lowers the levels of testosterone in the body by taking tablets or having injections. It is sometimes referred to as medical castration. The surgical option involves removing the testicles, known as surgical castration or orchidectomy, although this is now rarely used.
Another approach is called anti-androgen treatment. Androgens have to bind to a protein in the cell called an androgen receptor to work. Anti-androgens are drugs that bind to these receptors so the androgens cant, effectively blocking them. The main side-effects are gynaecomastia breast enlargement and breast pain, although a single radiotherapy dose to the breasts can help this side-effect.
Combining anti-androgens with testosterone reduction is known as Maximum Androgen Blockade and may be used if hormone treatment alone is not working sufficiently.
Treating with chemotherapy at the same time as the start of hormone deprivation was found to increase survival by 13 months in all patients and 17 months in men with high-volume disease.
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How Should Caregivers Talk To Children About A Family Member’s Advanced Cancer
Children deserve to be told the truth about a family members prognosis so they can be prepared if their loved one dies. Its important to answer all of their questions gently and honestly so they dont imagine things that are worse than reality. They need to be reassured that they will be taken care of no matter what happens.
Caregivers need to be prepared to answer tough questions. To do this, they should know what their own feelings and thoughts are about the situation. They need to be able to show children how to hope for the best while preparing for and accepting that their loved one may die.
Prostate Cancer Survival Rate
The prostate cancer survival rate is exceptionally high. Because this cancer grows very slowly and responds well to treatment, the majority of patients are able to lead long and healthy lives. According to the American Cancer Society, the five-year survival rate for both localized cancer and regional cancer is nearly 100%.
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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.
Pain medications
Surgery may be undertaken to treat bone fractures or to relieve the pressure on the spinal cord by bone metastases.
*https://www.cancerresearchuk.org/about-cancer/prostate-cancer/survival
Understand Treatment Options And Risks
Regardless of your Gleason score or prostate cancer stage, every patients situation is unique. Its important that you fully understand yours by discussing it with your physician.
If you accurately diagnose and treat your prostate cancer, you can have a better chance of preventing it from getting worse .
The three main types of prostate cancer treatment are active surveillance, radiation therapy, and surgical removal . There are benefits and drawbacks to each treatment type.
For example, if prostate cancer is already spreading but was misdiagnosed or missed altogether, active surveillance may not be the best course of action. Similarly, a prostatectomy could be unnecessary if your prostate cancer is confined to a single, small T-stage tumor that can be closely monitored.
This is why working closely with your medical team to accurately diagnose your prostate cancer is so important. Accurate and early diagnosis followed by active, consistent treatment is the best path to fighting prostate cancer and preventing a recurrence.
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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.
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.
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In The Last Days Of Life Patients And Family Members Are Faced With Making Decisions About Treatments To Keep The Patient Alive
Decisions about whether to use life-sustaining treatments that may extend life in the final weeks or days cause a great deal of confusion and anxiety. Some of these treatments are ventilator use, parenteral nutrition, and dialysis.
Patients may be guided by their oncologist, but have the right to make their own choices about life-sustaining treatments. The following are some of the questions to discuss:
- What are the patients goals of care?
- How would the possible benefits of life-sustaining treatments help reach the patient’s goals of care, and how likely would this be?
- How would the possible harms of life-sustaining treatments affect the patient’s goals of care? Is the possible benefit worth the possible harm?
- Besides possible benefits and harms of life-sustaining treatments, what else can affect the decision?
- Are there other resources, such as palliative care, a chaplain, or a medical ethicist, that could help the patient or family decide about life-sustaining treatments?
Prostate Cancer Is Common With Aging
After skin cancer, prostate cancer is the most common cancer in men. About 1 in 7 men will be diagnosed with prostate cancer in their lifetime. And these are just the men who are diagnosed. Among very elderly men dying of other causes, a surprising two-thirds may have prostate cancer that was never diagnosed.
Only 1 in 36 men, though, actually dies from prostate cancer. That’s because most prostate cancers are diagnosed in older men in whom the disease is more likely to be slow-growing and non-aggressive. The majority of these men eventually pass away from heart disease, stroke, or other causes — not their prostate cancer.
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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.
Life Expectancy And Localized Prostate Cancer
So how do these treatments affect life expectancy? In one study, researchers in Switzerland examined the treatment and outcomes of 844 men diagnosed with localized prostate cancer. They compared men who had been treated with prostatectomy, radiotherapy and watchful waiting and found that at five years from diagnosis, the type of treatment made little difference to survival. When the researchers went to 10 years from diagnosis, they did find a difference in survival based on treatment, but it was fairly small.
After 10 years, 83 percent of the men who had gotten a prostatectomy were still living, compared to 75 percent who had undergone radiotherapy and 72 percent who took a watchful waiting approach.
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