Prostate Cancer Survival Rates Are Favorable Overall
Thinking about survival rates for prostate cancer takes a little mental stretching. Keep in mind that most men are around 70 when diagnosed with prostate cancer. Over, say, five years, many of these men will die from other medical problems unrelated to prostate cancer.
To determine the prostate cancer survival rate, these men are subtracted out of the calculations. Counting only the men who are left provides what’s called the relative survival rate for prostate cancer.
Taking that into consideration, the relative survival rates for most kinds of prostate cancer are actually pretty good. Remember, we’re not counting men with prostate cancer who die of other causes:
- 92% of all prostate cancers are found when they are in the early stage, called local or regional. Almost 100% of men who have local or regional prostate cancer will survive more than five years after diagnosis.
- Fewer men have more advanced prostate cancer at the time of diagnosis. Once prostate cancer has spread beyond the prostate, survival rates fall. For men with distant spread of prostate cancer, about one-third will survive for five years after diagnosis.
Many men with prostate cancer actually will live much longer than five years after diagnosis. What about longer-term survival rates? According to the American Society of Clinical Oncology, for men with local or regional prostate cancer:
- the relative 10-year survival rate is 98%
- the relative 15-year survival rate is 96%
Learn The Facts About Prostate Cancer
Most people dont think prostate cancer is going to happen to them, unless their father or brother had it, says Oliver Sartor, MD, a professor of medicine and urology at the Tulane University School of Medicine in New Orleans.
However, given that about 164,000 men in the United States will be diagnosed with the disease in 2018, according to the American Cancer Society , its likely that you or someone you know will be affected. Prostate cancer is the second leading cause of death from cancer in American men, right behind lung cancer.
But while its a serious disease, and it does take lives, most men dont die from it. In fact, the ACS says that more than 2.9 million Americans whove been diagnosed with prostate cancer are still alive today.
Despite this prevalence, myths and confusion abound when it comes to understanding your own personal level of risk, and what to do when your doctor says you have prostate cancer.
The diagnosis almost always hits people out of the blue, Dr. Sartor says. It’s not what you plan on, and of course it’s very disruptive. For many men, prostate cancer creates a general cognitive dissonance: Why me? What did I do wrong? What am I going to do about it now that my life is being threatened?
Additional reporting by Andrea Peirce
Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for prostate cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead it groups cancers into localized, regional, and distant stages.
- Localized: There is no sign that the cancer has spread outside the prostate.
- Regional: The cancer has spread outside the prostate to nearby structures or lymph nodes.
- Distant: The cancer has spread to parts of the body farther from the prostate, such as the lungs, liver, or bones.
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What Is A 5
A relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of prostate cancer is 90%, it means that men who have that cancer are, on average, about 90% as likely as men who dont have that cancer to live for at least 5 years after being diagnosed.
The Difference Between Prostate Cancer And Bph
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
Both prostate cancer and benign prostatic hyperplasia can cause an enlarged prostate, but beyond causing common symptoms, the similarities end there.
During your yearly physical, your doctor might do a rectal exam or request you get a blood test to check your prostate-specific antigen level checked. If your prostate is enlarged or your PSA test comes back high, your doctor may do a biopsy to determine if your abnormal results are caused by prostate cancer or BPH. Here’s what you need to know about the two conditions and their similarities and differences.
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As Screening Falls Will More Men Die From Prostate Cancer
In active monitoring, men with localized prostate cancer do not get surgery or radiation right after theyre diagnosed. Instead, they have regular biopsies, blood tests, and MRIs to see if their cancer is progressing. If it is, they can receive treatment.
Although some oncologists advise men with early, low-grade prostate cancer to choose active surveillance and professional groups such as the American Society of Clinical Oncology recommend it many patients recoil at what sounds like lets just wait for your cancer to become really advanced. A decade ago fewer than 10 percent of men diagnosed with prostate cancer chose monitoring, UCLA researchers found. But that is changing. Now at least half of men do.
That made sense to Garth Callaghan, author of the best-selling Napkin Notes, a book of missives he tucked into his daughters lunch box. Diagnosed with early prostate cancer in 2012, he said, none of the choices seemed particularly attractive to a 43-year-old man who dreaded the possibility of side effects of surgery or radiation, including incontinence and impotence. I was completely torn. My previous experience was, just get it out of my body. But after his doctor explained that prostate cancer is grossly overtreated in the United States, I did a complete 180 and chose active monitoring.
Are Older Men Undertreated
Schwartz and colleagues reviewed the treatment decisions and factors influencing them in a cohort of men with localized prostate cancer. Age, comorbidity, and Gleason score were found to be independent predictors of suboptimal treatment. It was concluded that most men older than 70 years with moderately or poorly differentiated tumors and no to mild comorbidity were given suboptimal treatment. Most of these men were undertreated, receiving watchful waiting therapy when potentially curative therapy could have been applied. With optimal treatment, clinical outcomes could have been improved.
Thompson and colleagues investigated otherwise healthy octogenarians diagnosed with prostate cancer who underwent radical prostatectomy. At the last follow-up visit, 10 patients had survived more than a decade after surgery, and 3 patients had died within 10 years of surgery. The remaining 6 patients were alive at less than 10 years of follow-up. Seventy-four percent of patients were continent. No patient had died of prostate cancer, and the 10-year, all-cause survival rate was similar to that observed in healthy patients 60 to 79 years old undergoing radical prostatectomy. These findings indicate that careful selection of patients even older than 80 years can achieve satisfactory oncologic and functional outcomes after surgery. It is important to note, however, that the rate of urinary incontinence after surgery exceeds that of younger counterparts.
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Can Prostate Cancer Be Completely Cured
Prostate cancer is the second most common cancer in men. The average age of diagnosis is 66 year olds, although it may affect younger men as well. By age 80, more than half of all men have some cancerous growth in their prostate.
Due to routine screening of prostate-specific antigen levels in the United States, nearly 90% of prostate cancers get detected in early stages. In most cases, the cancer is confined only to the prostate and does not spread to other organs. With the widespread use of screening tests in the United States, early diagnosis of prostate cancer has become much easier.
When found early, there are several treatment options available and prostate cancer has a high chance of getting cured. Moreover, prostate cancer is a slow-growing cancer that takes many years to become big enough to cause symptoms. It also takes quite long to spread to other organs. This gives sufficient time for the doctors to treat it.
Oncologists recommend patients to not rush and take some time to understand the various treatment options available after consulting with more than one doctor. Patients can discuss various modes of treatment with the doctor and select the most appropriate option for their prostate cancer.
The 5-year survival rate for most men with local or regional prostate cancer is nearly 100%. There are more than three million survivors of prostate cancer in the United States today.
Myth: Prostate Cancer Treatment Always Causes Impotence
Fact: According to research published in the December 2014 issue of the International Journal of Urology, theres been progress in developing models to predict erectile dysfunction after localized treatment for prostate cancer. Sartor says avoiding impotence depends on many factors, including the skill of the surgeon who is operating on you. But as surgical techniques are improving, people are recovering faster and having fewer side effects.
According to Sartor, one year after surgery, approximately 25 percent of patients will say their function is fine, 25 percent will have mild dysfunction, 25 percent will have moderate dysfunction, and 25 percent say they have severe dysfunction.
Age can also be a complicating factor, adds Wei: As men get into their sixties and seventies, a lot of them already have some compromise of sexual function. Prostate cancer treatment certainly wont correct this problem, but it also isnt likely to make it significantly worse for most men.
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Incidence Of Fatal Prostate Cancer In The Us And England
The normal probability plot of residuals for each country-specific ageperiodcohort model demonstrated overall good fit thus all models were suitable for between-country comparisons. Between 1995 and 2005, 11% of US men newly diagnosed with prostate cancer died from their disease within 10 years , compared with 17% of men diagnosed in England . In 1995, the US outpaced England 3-to-1 with an age-standardised fatal prostate cancer incidence rate of 85.8 per 100,000 . By 2005, the incidence rates of fatal prostate cancer between the two countries had switched owing to a 55% decline in the US and a corresponding 100% increase in England . In the US, the fatal prostate cancer incidence rate declined for each single age group , with the sharpest declines occurring among those aged 6069 years . By contrast, the EAPC for fatal prostate cancer incidence in England increased at every age , with the highest rate of increase observed among men aged 4549 years.
Table 1 Fatal prostate cancer incidence rates in the United States and England between 1995 and 2005, among men aged 4584 years.
Your Cancer Care Team
People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.
The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.
Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
- whether the cancer has spread to other parts of your body
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What Is Metastatic Cancer
In metastasis, cancer cells break away from where they first formed , travel through the blood or lymph system, and form new tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor.
Cancer that spreads from where it started to a distant part of the body is called metastatic cancer. For many types of cancer, it is also called stage IV cancer. The process by which cancer cells spread to other parts of the body is called metastasis.
When observed under a microscope and tested in other ways, metastatic cancer cells have features like that of the primary cancer and not like the cells in the place where the metastatic cancer is found. This is how doctors can tell that it is cancer that has spread from another part of the body.
Metastatic cancer has the same name as the primary cancer. For example, breast cancer that spreads to the lung is called metastatic breast cancer, not lung cancer. It is treated as stage IV breast cancer, not as lung cancer.
Sometimes when people are diagnosed with metastatic cancer, doctors cannot tell where it started. This type of cancer is called cancer of unknown primary origin, or CUP. See the Carcinoma of Unknown Primary page for more information.
The Role Of Parathyroid Hormone
Parathyroid hormone is a hormone secreted by the parathyroid gland which plays an important role in bone remodeling. It stimulates bone resorption by osteoclasts indirectly through PTH binding receptors located on osteoblasts. Upon binding of PTH on osteoblasts, the expression of OPG is downregulated whereas the expression of RANKL is upregulated . Signaling to the bone marrow-derived osteoclast precursors, high levels of RANKL consequently stimulate their fusion, differentiation, and activation. PTH causes a net bone loss through an increased resorption process when administered in a continuous fashion, but a net bone gain through an enhanced formation process when administered intermittently. To our knowledge, only a handful of evidence documented the ectopic expression of PTH by the thyroid and other non-parathyroid tumors . Specifically, studies on the ectopic expression of PTH by prostate tumors are limited .
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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
- a radiologist
- 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.
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Outlook For Locally Advanced Prostate Cancer
Many men with locally advanced prostate cancer have treatment that aims to get rid of their cancer. For some men, this treatment can be very successful and they may live for many years without their cancer coming back or causing them any problems. For others, treatment may be less successful and the cancer may come back. If this happens, you might need further treatment. Read more about the risk of your cancer coming back.
Some men with locally advanced prostate cancer will have treatment that aims to help keep their cancer under control rather than get rid of it completely. For example, if you have hormone therapy on its own, it can help to keep the cancer under control, usually for several years. And there are other treatments available if your hormone therapy stops working.
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What Is The Most Effective Treatment For Prostate Cancer
The choice of treatment for prostate cancer depends on many factors such as the patients prostate cancer risk as calculated from prostate-specific antigen levels, Gleason score, and tumor staging. Patients can discuss the significance of these factors in the choice of treatment with their doctor.
The standard effective treatment choices for men with early-stage prostate cancer are as follows
- Active surveillance: Monitoring the progression/status of the low-risk or early-stage cancer with regular testing and not treating it right away.
- Prostatectomy: Surgical removal of the prostate.
- Radiation therapy: Use of high-energy waves to destroy cancer cells.
Radiation therapy is one of the most effective treatments for many men with early-stage prostate cancer. It is also the best prostate cancer therapy for older men or those with other co-existing diseases. It can be delivered to the patient in any of the two ways
- External beam radiation: Sending/focusing high-energy waves from an external machine into the tumor.
- Brachytherapy: Placing a radioactive dye in the tumor through an implant or hollow tubes.
For metastatic prostate cancer, androgen deprivation therapy is usually the choice of treatment. ADT is also the only option in patients with prostate cancer who are unfit or unwilling to undergo surgery or/and radiation therapy.
Low Mood And Personality Changes
A change in mood could be situational, however reoccurring low moods or ongoing personality changes should be recorded.
Mr Chaudry explained: “Whilst a low mood doesnt always result in depression, it is important to recognise the risk factors.
“Changes in personality or becoming withdrawn can also be a sign, and should be taken seriously.”
As well as speaking to your GP about changes, there are also a number of charities such as Mind and StrongMen who can offer confidential services or simply be there to listen to your concerns.
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