Staging Spread And Survival Rates
As with all cancers, doctors use the term stage to describe the characteristics of the primary tumor itself, such as its size and how far prostate cancer has spread when it is found.
Staging systems are complicated. The staging system for most cancers, including prostate cancer, uses three different aspects of tumor growth and spread. It’s called the TNM system, for tumor, nodes, and metastasis:
- T, for tumor describes the size of the main area of prostate cancer.
- N, for nodes, describes whether prostate cancer has spread to any lymph nodes, and how many and in what locations.
- M, for metastasis, means distant spread of prostate cancer, for example, to the bones or liver.
Using the TNM system, each man’s prostate cancer can be described in detail and compared to other men’s prostate cancer. Doctors use this information for studies and to decide on treatments.
As far as survival rates for prostate cancer go, however, the staging system is pretty simple. As we’ve mentioned, in terms of survival rates, men with prostate cancer can be divided into two groups:
What Lifestyle Changes Should I Make If I Am Diagnosed With Prostate Cancer
Nutrition changes are an important part of your cancer journey. These changes will help your body be prepared to better fight the disease. But there are also other lifestyle changes you can make.
- Be physically active You do not need to have a highly intensive physical activity, but moderate exercises need to be part of your daily routine.
- Maintain a healthy weight This is linked to having a healthy diet and exercising. Researchers have found that obese patients tend to develop more aggressive forms of prostate cancer. If you think that you should lose some weight, this is the time to do it.
- Limit your alcohol intake men who have 2 or more drinks/day have a 20% increased risk of prostate cancer
- Stop smoking Smoking increases the risk of any cancer
Grade And Risk Category
The biopsy results will show the grade of the cancer. This is a score that describes how quickly the cancer may grow or spread.
For many years, the Gleason scoring system has been used to grade the tissue taken during a biopsy. If you have prostate cancer, youll have a Gleason score between 6 and 10. A new system has been introduced to replace the Gleason system. Known as the International Society of Urological Pathologists Grade Group system, this grades prostate cancer from 1 to 5 .
Risk of progression
Based on the stage, grade and your PSA level before the biopsy, localised prostate cancer will be classified as having a low, intermediate or high risk of growing and spreading. This is known as the risk of progression. The risk category helps guide management and treatment.
Grading prostate cancer
|High risk. The cancer is likely to grow aggressive.|
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Psa And Gleason Score
Two other important factors that doctors and specialists use to assess cancer cells are the prostate specific antigen and the Gleason score.
PSA levels: PSA is a protein that appears in higher levels in the bloodstream when there is a problem with the prostate. Normally, PSA levels in the blood are very low, and a test cannot detect them. However, in some circumstance, such as prostate cancer, PSA levels start to rise.
Screening for prostate cancer uses a blood test for PSA. If PSA levels are high, the doctor may recommend further tests to see if prostate cancer is present.
There are various other reasons why PSA levels may rise, including sexual stimulation or an infection.
The grade and Gleason score: Different types of cancer cell act differently. Some types, or grades, are more aggressive and can spread more easily. The Gleason score and grade are different measures, but they both reflect how likely it is that a tumor will spread, and how quickly it will do so. Either a biopsy or surgery can determine the types of cancer cells present in the prostate tissues.
Nearly 50% of males have a condition known as prostatic intraepithelial neoplasia by the time they are 50 years old. PIN is when there are changes in the cells that line the prostate gland.
High grade PIN is not cancer, but the cells can become cancerous in the future. For this reason, a doctor may recommend treatment to remove the cells.
How Is Stage Ii Prostate Cancer Treated
The treatment methods for stage III of prostate cancer include:
- External beam radiation along with hormone therapy
- External beam and brachytherapy with hormone therapy
- Radical prostatectomy may or may not be followed by radiation therapy
External beam radiation:
It is a type of radiation therapy, a treatment method that involves use of high beams of X rays to kill cancerous cells. In external beam radiation therapy, also called EBRT, beams of radiation are focused on the prostate gland from a machine outside the body and it is used to treat the early stages of cancer.
Brachytherapy is a type of radiation therapy too. Also called seed implantation or interstitial radiation therapy, small radioactive pellets of the size of a grain of rice are placed directly inside the prostate gland. This treatment is used alone in patients in the early stages of cancer showing relatively slow growth. Otherwise, this is preferred in combination of other treatment methods. Read more about radiation therapy of prostate cancer here.
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Adenocarcinoma Cancers Being Usually In One Of The Following Organs:
Although it is the most commonly diagnosed cancer in american women, breast cancer can impact people of all genders. It may grow slowly and its typically treatable. Each with detailed information that has been medically reviewed. If you have been diagnosed with adenocarcinoma cancer, you have a cancer that developed in one of the glands that lines the inside of your organs. There are a number of different treatments doctors recommend. Although the percentage of cases in men is much lower than in women, male breast cancer accounts for a por. When malignant cancer cells form and grow within a persons breast tissue, breast cancer occurs. Of course, your specialist is the main person whose advice you should follow but it doesnt do anyone harm. One in seven men in the united states will receive a prostate cancer diagnosis during his lifetime. Here are 10 more facts about prostate cancer. Prostate cancer is a common type of cancer in men, according to the mayo clinic. However, as with other types of cancer,. The pancreas is located behind the stomach, so having pancreatic cancer doesnt involve a palpable mass that you can feel.
What Are Prostate Cancer Survival Rates By Stage
Staging evaluation is essential for the planning of treatment for prostate cancer.
- A basic staging evaluation includes the patient examination, blood tests, and the prostate biopsy including ultrasound images of the prostate.
- Further testing and calculations may be performed to best estimate a patient’s prognosis and help the doctor and patient decide upon treatment options.
Prognosis refers to the likelihood that the cancer can be cured by treatment, and what the patient’s life expectancy is likely to be as a consequence of having had a prostate cancer diagnosis.
If a cancer is cured, your life expectancy is what it would have been had you never been diagnosed with prostate cancer. If the cancer cannot be cured due to it recurring in distant locations as metastases, or recurs either locally or in an area no longer able to be treated in a curative manner, then estimates can be made of what is likely to be your survival based again on group statistics for people who have been in the same situation.
Nomograms are charts or computer-based tools that use complex math from analysis of many patients’ treatment results.
The prognosis for prostate cancer varies widely, and depends on many factors, including the age and health of the patient, the stage of the tumor when it was diagnosed, the aggressiveness of the tumor, and the cancer’s responsiveness to treatment, among other factors.
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What Can I Expect After Prostate Cancer Treatment
After treatment, you may be relieved to know that your cancer is gone and you can get back to your normal life. Your urinary and sexual functions may be a little disrupted after treatment and you may suffer from the usual side-effects. But, if you have undergone radical prostatectomy, you have to know that these side-effects are ephemeral and you will resume your normal activities as soon as possible.
The incontinence improves slowly over a period of 6 months. After treatment, you can start doing Kegel exercises, to strengthen your pelvic muscles.
After prostate surgery, many men have problems with erections. Normally, these symptoms are gone after a short while. It all depends on various factors: your age, your overall health, and whether or not you have been on ED medication before surgery. Normally, your sexual function will return almost back to normal. But, if not, there is a series of erectile dysfunction treatments, such as Viagra or vacuum pump, that have great results in these cases.
As a last thought, remember that being diagnosed with prostate cancer is not a death sentence. It is a challenge that many men have overcome and you are one of them!
Diagnosis Of Stage 3 Prostate Cancer
Daniel J. George, MD:This case presentation involves a 65-year-old gentleman who presented to his urologist with some urinary incontinence. His digital rectal exam was normal, but he was found to have a PSA of 10.8 ng/mL. This prompted a transrectal ultrasound and a biopsy, revealing Gleason score 7 cancer, 3+4, and multiple cores. He underwent a workup with a bone scan and a CT scan, showing no evidence of metastatic disease, and was presented with treatment options for intermediate-risk prostate cancer. He elected to undergo radical prostatectomy, and pathology confirmed the Gleason score 7 cancer but with evidence of extra capsule extension in negative nodes, which is pathological T3aN0 disease. After surgery, his PSA was undetectable.
This is a very common presentation. The patient is about the average age for prostate cancer and, on his initial PSA screening, was found to have 10.8 ng/mL. Although the urinary incontinence doesnt necessarily go along with common symptoms associated with prostate cancer, we can see it as a urinary obstructive symptom from overflow incontinence. This patient may have had an enlarged prostate and evidence of some urinary obstruction resulting in that incontinence.
Transcript edited for clarity.
- Two years later the patient developed disease progression
- PSA level increased rapidly to 15 ng/mL
- He was asymptomatic
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Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
What Is Your Prostate Cancer Stage
Your prostate cancer stage is set after testing. Stage describes if the tumor was detected or felt during the digital rectal exam. The prostate cancer stage also indicates whether or not the cancer may have spread to lymph nodes or other organs. Clinical stage is based on all information available prior to any treatment and designated by the TNM system as shown below.
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Prostate Cancer Survival Rates
Prostate cancer is the second leading cause of cancer death in the United States. A mans individual survival depends on the stage of cancer. Most prostate cancers are identified at an early stage when they are organ-confined. According to the American Cancer Society, the 5-year survival rate for men with local or regional prostate cancer is nearly 100%. The relative 10-year survival rate is 98% and the 15-year relative survival rate is 91%.
However, if the cancer is stage IVB and has spread to distant parts of the body such as the lungs, liver, or bones there is only a 30% relative 5-year survival rate.
Things to consider when understanding the statistics:
- These numbers/rates apply only for the first-diagnosed cancer
- There are many more factors that can influence the survival rate of an individual
- These rates are calculated over a 5-year period. Treatments improve over time and the survival rates may positively change.
Early detection makes this deadly disease curable. Do not ignore any prostate cancer signs or symptoms and get screened as early as possible, especially if you are at high risk of developing prostate cancer, based on your family history, race or age. Talk to your doctor about your Gleason Score, Grade Group and Stage and decide upon the best treatment option for prostate cancer.
Stage 3 Prostate Cancer
Prostate cancer is the most common type of cancer found in men. ‘Stage 3’, is a term used by physicians to classify the extent to which prostate cancer has developed within the body. Stage 3 may be expressed using Roman numerals .
If prostate cancer is classed as stage 3, a cancerous tumor in the prostate has extended through the membrane of this gland. At stage 3, no other areas are affected except for, in some cases, the seminal vesicles .
Stage 3 prostate cancer is known as ‘locally advanced’. Whilst the cancer may have extended through the prostate gland and invaded the seminal vesicles, it has not spread to nearby lymph nodes or other areas of the body. Stage 3 is the penultimate stage . At stage 4, prostate cancer has metastasized, spreading to lymph nodes and other areas of the body.
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Results Of Oncological Treatment
shows the KaplanMeier curves for carcinoma-specific survival in patients with tumor stage pT3a, pT3b, pT4, pN1 and/or preoperative PSA > 20 ng/mL and/or prostatectomy Gleason score 8.
Prostate carcinoma-specific survival after radical prostatectomy for patients with confirmed locally advanced tumors and/or confirmed lymph-node metastases and/or preoperative PSA > 20 ng/mL and or Gleason score 8 in the prostatectomy specimen. The dotted lines show the 95% confidence interval. a) Prostate carcinoma-specific survival, stratified according to pT stage. b) Prostate carcinoma-specific survival in patients with lymph-node metastases. c) Prostate carcinoma-specific survival in patients with preoperative PSA > 20 ng/mL. d) Prostate carcinoma-specific survival in patients with prostatectomy Gleason score 8.
The 10-year carcinoma-specific survival rates were:
98% for patients with stage pT3a
87% for patients with stage pT3b
77% for patients with stage pT4
81% for patients with confirmed lymph-node metastases
Among patients with a high-risk tumor constellation, the 10-year carcinoma-specific and 10-year overall survival rates were 93% and 85% respectively for those with a preoperative PSA level > 20 ng/mL and 70% and 58% for those with a prostatectomy Gleason score 8 . The corresponding 10-year biochemically recurrence-free survival rates were 32% and 25%.
Tnm Staging System The Most Widely Used Staging System For Prostate Cancer Isthe Ajcc Tnm System For Prostate Cancerthere Are 4 Stages Often The Stages 1 To 4 Are Written As The Roman Numeralsi Ii Iii And Iv Generally The Higher The Stage Number The More The Cancerhas Spread The Stages Can Be Further Divided Into A B Or C An Earlier Lettermeans A Lower Stage Talk To Your Doctor If You Have Questions About Staging Tnm Staging Is Based On The Following: T Describes Thetumour And Whether Doctors Can Feel It Or See It On Imaging Tests It Alsodescribes Whether The Tumour Has Grown Outside Of The Prostate To Thesurrounding Tissues T Is Usually Given As A Number From 1 To 4 A Highernumber Means That The Tumour Takes Up More Of The Prostate Or That The Tumourhas Grown Outside Of The Prostate Into Nearby Tissues Some Stages Are Alsodivided Further Into A B Or C An Earlier Letter Means A Lower Stage The Clinical T Is Your Doctor’s Best Estimate Of Theextent Of The Cancer Based On A Physical Exam A Digital Rectal Exam A Prostatebiopsy And Imaging Tests If You Have Surgery To Remove Your Prostate Apathological T Will Be Given Pt Is More Accurate Than Ct T The Tumour Has Grown Outside The Prostate And Into The Seminal Vesicles T4 The Tumour Has Grown Outside The Prostate And Into Nearby Structures Suchas The Bladder Rectum Pelvic Muscles And Pelvic Wall
N describeswhether the cancer has spread to lymph nodes near the prostate. N0 means that thecancer hasn’t spread to any nearby lymph nodes. N1 means that it has spread tonearby lymph nodes.
M describeswhether the cancer has spread to other parts of the body. M0 means that the cancerhas not spread to other parts of the body. M1 means that it has spread to otherparts of the body.
PSA level describes the amount of the prostate-specificantigen in the blood.
Grade Group is a measureof how likely the cancer is to grow and spread.
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