What Are The Stages Of Prostate Cancer
Cancer staging is first described using what is called a TNM system. The “T” refers to a description of the size or extent of the primary, or original, tumor. “N” describes the presence or absence of, and extent of spread of cancer to lymph nodes that may be nearby or further from the original tumor. “M” describes the presence or absence of metastases — usually distant areas elsewhere in the body other than regional lymph nodes to which cancer has spread. Cancers with specific TNM characteristics are then grouped into stages, and the stages are then assigned Roman numerals with the numerals used in increasing order as the extent of the cancer being staged increases or the cancer prognosis worsens. Prognosis is finally reflected by considering the patient’s PSA score at presentation as well as their Gleason score in assigning a final stage designation.
The American Joint Commission on Cancer system for prostate cancer staging is as follows:
The primary tumor
Traditionally, advanced prostate cancer was defined as a disease that had widely metastasized beyond the prostate, the surrounding tissue, and the pelvic lymph nodes and was incurable. However, a more contemporary definition includes patients with the lower-grade disease with an increased risk of progression and/or death from prostate cancer in addition to those with widely metastatic disease.
CT scan is used for the initial staging in select patients including
The regional lymph nodes
The distant metastasis
Lifetime Risk Of Developing Or Dying From Cancer
The lifetime risk of developing or dying from cancer refers to the chance a person has, over the course of their lifetime , of being diagnosed with or dying from cancer. These risk estimates are one way to measure of how widespread cancer is in the United States.
The following tables list lifetime risks of developing and dying from certain cancers for men and women in the US. The information is from the National Cancer Institutes Surveillance Epidemiology and End Results database, and is based on incidence and mortality data for the United States from 2016 through 2018, the most recent years for which data are available.
The risk is expressed both in terms of a percentage and as odds.
- For example, the risk that a man will develop cancer of the pancreas during his lifetime is 1.7%. This means he has about 1 chance in 59 of developing pancreatic cancer .
- Put another way, 1 out of every 59 men in the United States will develop pancreatic cancer during his lifetime.
These numbers are average risks for the overall US population. Your risk may be higher or lower than these numbers, depending on your particular risk factors.
Castrate Refractory Prostate Cancer: A Wider Range Of Options
In this section, we explain the treatments available at Birmingham Prostate Clinic for patients once their disease becomes resistant to hormone treatment, called castrate refractory prostate cancer. Two types of treatments are needed to:
- Control the cancer and prevent further spread of cancer
- Control or prevent the symptoms caused by the spread of prostate cancer to the bones
Recommended Reading: What Is Aggressive Prostate Cancer Symptoms
Who Dies From This Cancer
Because we have screening for prostate cancer, most of the time it is caught before it spreads to other parts of the body. Men who have prostate cancer that is characterized as localized or regional are not as likely to die as men whose cancer is distant. In general prostate cancer has excellent survival rates, but death rates are higher in African American men, men who have advanced stage cancer, and men who are between the ages of 75 and 84. Prostate cancer is the fifth leading cause of cancer death in the United States. The death rate was 18.9 per 100,000 men per year based on 20152019, age-adjusted.
Death Rate per 100,000 Persons by Race/Ethnicity: Prostate Cancer
What Are The Chances Of Survival From Prostate Cancer
The 5-year survival rate for most men with local or regional prostate cancer is 100%. Ninety-eight percent are alive at 10 years. For men diagnosed with prostate cancer that has spread to other parts of the body, the 5-year survival rate is 30%.
Can prostate cancer be completely cured?
The short answer is yes, prostate cancer can be cured, when detected and treated early. The vast majority of prostate cancer cases are discovered in the early stages, making the tumors more likely to respond to treatment. Treatment doesnt always have to mean surgery or chemotherapy, either.
Also Check: How Long Does Radiation Last For Prostate Cancer
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.
Impact Of Age On Treatment
The rising number of men diagnosed with prostate cancer is a result of increasing life expectancy as well as the current practice of screening by prostate-specific antigen blood tests.10 Besides PSA and Gleason score, age is considered a key prognostic factor in treatment decision making. Although organ-confined disease can be cured by radical prostatectomy and full-dose local radiation therapy, treatment options for advanced- stage disease remain palliative. They include active surveillance, or watchful waiting, early versus delayed hormonal therapy to control disease progression, and continuous or intermittent androgen deprivation. Observational studies of older men with early stage disease have suggested conservative management as a viable option.11,12
Chodak and associates12 evaluated 828 men who were managed expectantly in a series of nonrandomized trials. Median follow-up was approximately 6.5 years. Patients with poorly differentiated cancers had a 10-fold increased risk of death from prostate cancer as compared with men showing highly differentiated prostate cancer. A 5-year disease-specific survival of only 34% was found in men with poorly differentiated prostate cancer. In contrast a 5-year disease-specific survival of 87% was described in men with well-or moderately differentiated cancers.
You May Like: What Is A High Psa Level For Prostate Cancer
What Is The Life Expectancy Of A Man With Prostate Cancer
The life expectancy of a man with prostate cancer is favorable. Most of the aged men detected of prostate cancer die of other comorbidities. The life expectancy is as follows:
- Almost 100% of men who have early-stage prostate cancer will survive more than 5 years after diagnosis.
- Men with advanced prostate cancer or whose cancer has spread to other regions have lesser survival rates. About one-third will survive for 5 years after diagnosis.
The longer-term survival rates for early-stage prostate cancer include:
- The relative 10-year survival rate is 98%.
- The relative 15-year survival rate is 96%.
Clues In Diet And Lifestyle
To clarify the prognosis for a tumor, HSPH researchers are homing in on other factors that might affect susceptibility to prostate cancer, especially the aggressive form of the disease. Edward Giovannucci, professor of nutrition and epidemiology, recently looked at nine diet and lifestyle factors. He found that smoking, obesity, and lack of physical activity raise the risk of developing a more virulent cancer. According to Giovannucci, The question is whether there are two types of prostate canceran aggressive and nonaggressive formor whether certain factors cause a nonaggressive form to become more aggressive. Evidence provided by HSPH researchers suggests that an increase in insulin in the bloodstream, caused by obesity and physical inactivity, may encourage tumor growth.
Other investigations have linked dietary factors to the disease. A 2011 study by HSPH research associate Kathryn Wilson, together with Mucci and Giovannucci, professor of nutrition and epidemiology Meir Stampfer, and other colleagues, found that men who drank coffee had a notably lower risk of aggressive prostate cancer. Those who consumed six cups or more a day were 20 percent less likely to develop any form of the disease, and 60 percent less likely to develop a lethal disease those who consumed one to three cups a day showed no difference in developing any form of the disease, but had a 30 percent lower risk of developing a lethal form.
Recurrence Of Prostate Cancer How To Prevent It
The key secret is inside the prostate cancer treatment options. So, if a radiation therapy is the therapy of choice, it is preferably combined with androgen ablation therapy .
The second choice is Flutamide as an anti-androgen. In additon to this, some uroglogists suggest for castration in order to block the influence of androgen.
On the other hand, the clinicians follow a reasonable guide-line. In case of medical castration, Gonadotrophic Releasing Hormone analogue is used. This hormone centrally down-regulates the secretion of testosterone and gradually blocks the secretion completely.
To the surgical measure, orchiectomy is the choice. There are some withdrawal effects seen in case of prolonged androgen withdrawal. Sometime, Ketoconazole and Hydrocortisone are used to suppress them.
Keep in mind that everything regarding prostate cancer recurrence depend on the personal clinical experience of the clinicians. In case of younger patiens, the principal choice is Surgical Intervention followed by Medication.
Similarly, in aged patients, where life expectancy is normally less, watchful waiting is the most preferred.
You May Like: Best Treatment For Localized Prostate Cancer
Does Overdiagnosis Lead To Overtreatment Of Older Men
The widespread use of PSA screening has led to an increase in the diagnosis and treatment of early localized prostate cancer. Data from the US Cancer of the Prostate Strategic Urological Research Endeavor database suggest a significant decrease in risk in the last 2 decades in the United States, with more patients being identified with low-risk disease at diagnosis,29 but the role of active treatment of low- and intermediate-risk disease in elderly men remains controversial.
The median time from diagnosis to death from prostate cancer for men with nonpalpable disease is approximately 17 years.30,31 Considering that the US male life expectancy at the age of 65 years is 16 years, aggressive therapy will hardly extend life expectancy of older men with no palpable prostate cancer at the time of diagnosis.32 Twenty to 30% of prostate cancers detected by PSA screening programs show Gleason scores of 6 or lower and, thus, are not poorly differentiated and have volumes smaller than 0.5 cm3.3335
Histologic evaluation of radical prostatectomy specimens demonstrated that about 20% to 30% of cancers are small volume, show low Gleason scores, and are consequently clinically harmless.35,36 Many of these cancers pose little threat to life, especially for older men. Has PSA screening resulted in prostate cancer overdiagnosis?
Recommended Reading: How To Massage Prostate By Yourself
Surviving Prostate Cancer: Here Are The Odds
A prostate cancer diagnosis usually comes as a shock to men. Those affected are tormented by the question of whether they will recover and what their chances of survival are. An expert explains what they depend on.
Prostate cancer, unlike many other cancers, often develops slowly and can be treated or monitored well in many cases. A cure is also possible. However, if the cancer has already spread to the lymphatic system and organs, this is no longer possible. But there are also great treatment options here.
In order to be able to detect prostate cancer before symptoms appear, two tests are offered: The costs for the palpation examination are covered by mandatory health insurance companies. The PSA test of the individual health service is the responsibility of the patient himself. One of several other IGeLs offered is the ultrasound prostate exam for early detection of prostate cancer. So far, there is no convincing scientific evidence for any of these tests that reduce the risk of death.
Prostate cancer can be detected with palpation or a PSA test before symptoms appear. However, both tests also have disadvantages: for example, the palpation exam can only detect tumors that grow on the side of the prostate facing the gut and that are larger than one centimeter. This means that very small and unfavorably located tumors cannot be detected by palpation.
The course of prostate cancer depends on the stage of the cancer:
Outlook For Men With Localised Prostate Cancer
Most localised prostate cancer is slow-growing and may not need treatment or shorten a mans life. For many men who have treatment for localised prostate cancer, the treatment will get rid of the cancer. For others, treatment may be less successful and the cancer may come back. If this happens, you might need further treatment.
Recommended Reading: How To Check If My Prostate Is Enlarged
To Treat Or Not To Treat
Up until now, with a few notable exceptions, doctors have myopically focused on treating prostate cancer, says Adami. They are willing to spend tens of thousands of dollars on chemotherapy that has minimal effects on cancer mortality, often with substantial side effects. But we ignore entirely the fact that large groups of prostate cancer patients die from other causes that actually are preventable.
Among older patients especially, that activity can take the form of vigorous walking. Recently, Mucci has spearheaded an intervention with Adami and other colleagues in Sweden, Iceland, and Ireland in which men walk in groups with a nurse three times a week. In a pilot study, researchers found improvements in just 12 weeks in body weight, blood pressure, sleep, urinary function, and mental health.
Scientists at HSPH are also searching for genetic and lifestyle markers that help predict how aggressive a patients prostate cancer will be. For example, an ongoing project led by Mucci and Adami draws on detailed cancer registries in Nordic countries, including an analysis of 300,000 twins, to tease out the relative contribution of different genes to prostate cancer incidence and survival.
is a Boston-based journalist and author of The Coke Machine: The Dirty Truth Behind the Worlds Favorite Soft Drink.
Active Surveillance And Watchful Waiting
If your cancer is not causing any symptoms, is slow growing or is small and confined to the prostate, your doctor may suggest active surveillance or watchful waiting.
- Active surveillance means your doctor closely monitors your cancer using prostate-specific antigen tests, digital rectal exams, ultrasounds and biopsies. If a change indicates your cancer is becoming more aggressive, your doctor will talk with you about treatment options.
- Watchful waiting involves less testing. You and your doctor monitor any changes in your symptoms to determine if you need treatment.
Prostate cancer can take 10 or more years to spread enough to become life threatening, so if you already have a life expectancy of less than 10 years, it might not make sense to undergo aggressive cancer treatment, and your doctor might suggest active surveillance or watchful waiting.
These methods might also be appropriate if:
- You have a low-grade cancer and wish to defer treatment and potential side effects until treatment is necessary.
- You prefer not to undergo aggressive treatment.
- You want to avoid side effects of aggressive treatment.
- You have health problems that prevent you from being a candidate for other types of treatment.
Recommended Reading: How To Touch Your Prostate
What Is Prostate Cancer
The prostate lies below the bladder and in front of the rectum. In men, the size of the prostate increases with increasing age. In younger men, it is about the size of a walnut. Its primary function is to make fluid to nourish the semen.
Growth in the prostate can be of two types
Prostate cancer starts in the prostate gland and may spread to the nearby areas: lymph nodes, organs, or bones in other parts of the body.
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.
You May Like: Can Prostate Problems Cause Frequent Urination
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.