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Is Stage 4 Prostate Cancer A Death Sentence

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Radiation Therapy And Radiopharmaceutical Therapy

Stage 4 Breast Cancer: Is It a Death Sentence?

External-beam radiation therapy

Candidates for definitive radiation therapy must have a confirmed pathologic diagnosis of cancer that is clinically confined to the prostate and/or surrounding tissues . Staging laparotomy and lymph node dissection are not required.

Radiation therapy may be a good option for patients who are considered poor medical candidates for radical prostatectomy. These patients can be treated with an acceptably low complication rate if care is given to the delivery technique.

Long-term results with radiation therapy are dependent on stage and are associated with dosimetry of the radiation.

Evidence :

  • A retrospective review of 999 patients treated with megavoltage radiation therapy showed that cause-specific survival rates at 10 years varied substantially by T stage: T1 , T2 , T3 , and T4 . An initial serum PSA level higher than 15 ng/mL is a predictor of probable failure with conventional radiation therapy.
  • Several randomized studies have demonstrated an improvement in freedom from biochemical recurrence with higher doses of radiation therapy as compared with lower doses . None of the studies demonstrated a cause-specific survival benefit to higher doses.
  • After a median follow-up of 10 years, despite a statistically significant improvement in biochemical PFS with the higher dose of radiation, the 10-year OS rate was the same in both groups: 71% . Likewise, there were no differences in prostatecancer-specific survival.
  • Evidence :

    Brachytherapy

    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?

    Stage 3c Lung Cancer: Spread Throughout Chest

    Stage 3C lung cancer has spread to all or part of the chest wall or its inner lining, the phrenic nerve, or the membranes of the sac that surrounds the heart.

    Cancer has also reached stage 3C when two or more separate tumor nodules in the same lobe of a lung have spread to nearby lymph nodes. In stage 3C, the lung cancer has not spread to distant parts of the body.

    Like stage 3A, stages 3B and 3C cancer may have spread to other chest structures. Part or all of the lung may become inflamed or collapse.

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    Deaths From Prostate Cancer

    Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 41 will die of prostate cancer.

    Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 3.1 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.

    Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

    American Cancer Society. Facts & Figures 2021. American Cancer Society. Atlanta, Ga. 2021.

    National Cancer Institute. SEER Cancer Stat Facts: Prostate Cancer. Accessed at https://seer.cancer.gov/statfacts/html/prost.html on March 15, 2019.

    Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA . SEER Cancer Statistics Review, 1975-2015, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2015/, based on November 2017 SEER data submission, posted to the SEER web site, April 2018.

    American Cancer Society. Facts & Figures 2021. American Cancer Society. Atlanta, Ga. 2021.

    National Cancer Institute. SEER Cancer Stat Facts: Prostate Cancer. Accessed at https://seer.cancer.gov/statfacts/html/prost.html on March 15, 2019.

    Last Revised: January 12, 2021

    How To Make The Right Treatment Decision

    Late

    Current expert guidelines for treatment of localized prostate carcinoma recommend potentially curative therapy for patients whose life expectancy is at least 10 years., Patients with limited life expectancy are more likely to die from health conditions other than prostate cancer. Men with a life expectancy of more than 10 years are more likely to die from progressive prostate cancer. This 10-year rule enjoys broad acceptance among urologists and radiation oncologists.,

    Conservative management proved to be an acceptable treatment option for men with low-grade Gleason scores, clinically localized disease, and life expectancies of less than 10 years. Increasing age was described as a risk factor for receiving inadequate treatment for prostate cancer. Thus, older men have been shown to receive potentially curative therapy less often than younger men., Radical prostatectomy is preferred treatment in men younger than 70 years, whereas radiation therapy is applied predominantly in patients older than 70 years. Conservative therapy such as watchful waiting or androgen deprivation by luteinizing hormone-releasing hormone analogs is preferentially applied in men older than 80 years. Watchful waiting or hormonal therapy is used to treat 82% of men older than 80 years.

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    Myth: Prostate Cancer Is For Older Men

    Fact: While its true that the majority of men diagnosed with prostate cancer are older, it can strike younger men, too. About 40 percent of all cases occur in men younger than 65, according to the ACS. Its not uncommon at all for men in their fifties and some in their forties to have prostate cancer, says Sartor.

    The exact age you should start getting regularly screened for prostate cancer is still an area of confusion and debate. At least start talking to your doctor about PSA testing once youre 50 years old, the ACS recommends. The exception to this is if the disease runs in your family, in which case its a good idea to start PSA screening earlier, at age 40 or 45.

    Risk Of Prostate Cancer

    About 1 man in 8 will be diagnosed with prostate cancer during his lifetime.

    Prostate cancer is more likely to develop in older men and in non-Hispanic Black men. About 6 cases in 10 are diagnosed in men who are 65 or older, and it is rare in men under 40. The average age of men at diagnosis is about 66.

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    How To Understand The Gleason Score

    The Gleason score, which resulted after the screening methods, is certainly present in your medical documentation. If your physician has not explained to you what does the Gleason score means, here you will find out.

    The Gleason score grading system is based on identifying 2 important cell patterns: how advanced is the tumor in most areas and what is the state of cells living next to the largest cancerous area. Each predominant pattern receives a score. Grade 1 is considered low-grade and Grade 5 is considered high-grade. After assigning a grade to each of these 2 patterns, they are added together and result in the Gleason score. Thus, scores can vary from 2-10, but pathologists usually assign a score from 6-10 to most prostate cancer. What is your Gleason score?

    A Gleason score of 6 is considered low-grade, the cancer being slow-growing.

    A Gleason score of 7 is considered an intermediate grade. In this case, it is important to know what is the primary grade, that is the score of the predominant area of the tumor. If the primary grade is 3 and the second is 4, then the chances of having it spread fast are low. But if the primary score is 4, then the cancer is more likely to spread. Do not forget to ask about the primary Gleason grade.

    A Gleason score between 8-10 is considered high-risk. In this case, cancers are more likely to spread quicker. But if your cancer is grade 8, do not panic. There are treatments for advanced prostate cancer.

    What Are The Foods To Be Avoided For Prostate Cancer

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    It is known that a healthy diet rich in nutrient fruits and vegetables can have a positive effect on fighting prostate cancer.

    Red meat, processed meats, and fatty foods are bad for men diagnosed with prostate cancer. Instead, try eating more plant-based foods, such as soy, cruciferous vegetables such as broccoli or cauliflower, or tomatoes and carrots. Lycopene, particularly contained in tomatoes, is a very powerful antioxidant. Some researchers believe lycopene may retard the growth of prostate cancer cells.

    Pomegranate juice is another important cancer-fighter. Researchers have already proved that it has positive effects in reducing cancer. You can incorporate this nutrient into a balanced diet.

    But what about palmetto berries for prostate cancer?

    These have been identified as potentially helpful supplements for certain prostate conditions, such as BPH, but the effects on prostate cancer have not yet been proven. Also, saw palmetto seemed to have more benefits when taken along with African palm tree bark extract. But these are not supplements regulated by the FDA and there is no guarantee that they will actually work.

    Should you avoid dairy intake if you have prostate cancer?

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    How Long Can Someone Live With Stage 4 Cancer

    Doctors usually give a prognosis for cancer in terms of an estimated survival rate over 5 years. These survival rates are a rough guide based on data from thousands of other people with a similar cancer and stage.

    Survival rates vary depending on the location or type of cancer. Despite how far cancer spreads, doctors will still refer to the type of cancer by where it started.

    The stage 4 survival rates for some of the most common forms of cancers include the following:

    Standard Treatment Options For Stage I Prostate Cancer

    Standard treatment options for patients with stage I prostate cancer include the following:

  • Interstitial implantation of radioisotopes.
  • Watchful waiting or active surveillance/active monitoring

    Asymptomatic patients of advanced age or with concomitant illness may warrant consideration of careful observation without immediate active treatment. Watch and wait, observation, expectant management, and active surveillance/active monitoring are terms indicating a strategy that does not employ immediate therapy with curative intent.

    Evidence :

  • In a retrospective pooled analysis, 828 men with clinically localized prostate cancer were managed by initial conservative therapy with subsequent hormonal therapy given at the time of symptomatic disease progression.
  • This study showed that the patients with grade 1 or grade 2 tumors experienced a disease-specific survival of 87% at 10 years and that their overall survival closely approximated the expected survival among men of similar ages in the general population.
  • Radical prostatectomy

    Radical prostatectomy, usually with pelvic lymphadenectomy is the most commonly applied therapy with curative intent. Radicalprostatectomy may be difficult after a transurethral resection of the prostate .

    Because about 40% to 50% of men with clinically organ-confined disease are found to have pathologic extension beyond the prostate capsule or surgical margins, the role of postprostatectomy adjuvant radiation therapy has been studied.

    Evidence :

    Evidence :

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    Stage 4 Prostate Cancer Treatments And Prognosis

    Stage 4 prostate cancer is the most advanced stage of the disease. It means that cancer has spread beyond the prostate to distant areas of the body. Learn more about this stae, what treatments are available, and the prognosis.

    Brianna Gilmartin / Verywell

    Stage 4 Metastatic Prostate Cancer Doesn’t Have To Be A Death Sentence

    Inside Todd Seals

    Nearly 12 years ago, I was diagnosed with Stage 4 prostate cancer and told I had one year to live. I was 42.

    My journey with prostate cancer started in 2005, when I went to the doctor for pneumonia and my doctor noticed a solitary pulmonary nodule on my lungs. I should have gotten it checked out like my doctor suggested, but I didn’t.

    Later, I began experiencing intense back pain that lasted months — and blew it off . Then, I saw blood in my urine, and I knew something was wrong. After explaining my symptoms to another doctor, who took a secondary X-ray, it was discovered that I had dozens of lesions on my lungs. “I’m very scared for you,” he proclaimed. I was scared, too.

    My lungs looked like Chester Cheetah. The doctors put two and two together, with the blood in my urine and the nodules in my lungs, and sent me for a PSA check. My PSA was very high, and the doctors immediately took a biopsy. In 2006, I was diagnosed with Stage 4 metastatic prostate cancer, which means the cancer had spread to other parts of my body. I had a Gleason score of 7 out of 10 — the higher the Gleason score, the more likely it is that your cancer will grow and spread quickly.

    Discovering I had cancer was a low point for me. I was referred to an oncologist who was hopeful that he could treat the disease. This made me feel hopeful, as well. Within a year of being diagnosed, I married my wife, and that night I promised her 30 years of marriage.

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    Prostate Cancer Treatment Health Professional Version

    On This Page

    The median age at diagnosis of carcinoma of the prostate is 66 years. Prostate cancer may be cured when localized, and it frequently responds to treatment when widespread. The rate of tumor growth varies from very slow to moderately rapid, and some patients may have prolonged survival even after the cancer has metastasized to distant sites, such as bone. The 5-year relative survival rate for men diagnosed in the United States from 2010 to 2016 with local or regional disease was greater than 99%, and the rate for distant disease was 30% a 98% survival rate was observed for all stages combined. The approach to treatment is influenced by age and coexisting medical problems. Side effects of various forms of treatment should be considered in selecting appropriate management.

    Many patientsespecially those with localized tumorsmay die of other illnesses without ever having suffered disability from the cancer, even if managed conservatively without an attempt at curative therapy. In part, these favorable outcomes are likely the result of widespread screening with the prostate-specific antigen test, which can identify patients with asymptomatic tumors that have little or no lethal potential. There is a large number of these clinically indolent tumors, estimated from autopsy series of men dying of causes unrelated to prostate cancer to range from 30% to 70% of men older than 60 years.

    Stage 3 Lung Cancer Treatment

    Treatment for stage 3 lung cancer typically begins with surgery to remove as much of the tumor as possible, followed by chemotherapy and radiation. Surgery alone is generally not indicated for stage 3B.

    Your doctor may recommend radiation or chemotherapy as a first course of treatment if surgery is not possible to remove the tumor. Treatment with radiation and chemotherapy, either at the same time or sequentially, is associated with improved stage 3B survival rates compared with radiation-only treatment, according to the National Cancer Institute.

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    Can The Cancer Stage Change

    Once diagnosed, a cancers stage never changes. Even if the patient improves or gets worse, their cancer is the same as when diagnosed.

    Once diagnosed with stage 4 cancer, you will always have stage 4 cancer. That doesnt mean that you cannot sustain a long period of disease-free survival.

    Part of the reason for this is statisticalstages help scientists track and reevaluate survival statistics and treatment protocols. But they also let doctors track the efficacy of treatments for your stage.

    Doctors use cancer stages to compare patients with similar diagnoses, to more easily study the effectiveness of treatments, to track a persons cancer progression, and as a way to estimate survival rates for specific cancers.

    Part of the confusion regarding staging status arises from the fact the disease is sometimes re-staged. Re-staging determines if there has been a progression or remission of the disease.

    If cancer is re-staged or recurs , doctors keep the initial staging diagnosis and add a new stage to the patients diagnosis. New staging diagnoses get differentiated with letterslike c for clinical, p for pathological , or y for after treatment.

    For instance, stage 2 breast cancer that suddenly spreads to the lungs is stage 2 breast cancer with lung metastases rather than stage 4 breast cancer. Similarly, if stage 4 breast cancer meets the definition of remission after treatment, they describe it as stage 4 breast cancer with no evidence of disease.

    What Can I Expect After Prostate Cancer Treatment

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    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!

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