Hormone Therapy In Older Patients
The backbone of prostate cancer treatment is hormonal therapy, which aims to limit the activation of the androgen receptor with testosterone. This limitation of AR activation may occur through agents that decrease circulating testosterone, such as gonadotropin-releasing hormone agonists or antagonists. The use of these agents also decreases testosterone precursors and other off-target effects of testosterone. Agents such as nonsteroidal anti-androgens block AR activation and yet preserve circulating testosterone levels.
Providers must carefully consider the toxicities of androgen deprivation therapy in a physiologically older population. These patients have less reserve to absorb additional imbalances or conditions that will impact their current steady state. In general, agents that result in a hypogonadal state can lead to toxicities within the following domains: metabolic and body composition sexual health and mood and central nervous system symptoms .
Prostate Cancer Life Expectancy
Cancer life expectancy depends on the stage of the cancer and on the treatment that the patient undergoes. Early detection of cancer and prompt treatment help increase the life expectancy of the patient. Once prostate cancer is detected, prostatectomy , radiotherapy , watchful waiting , hormone therapy, and other types of treatments are recommended by doctors.
To undergo a prostatectomy, the cancer needs to be detected in the early stages. Once the cancer metastasizes, it is difficult to remove it, or it is difficult to control its growth. So, survival rate and life expectancy for stage 4 prostate cancer cannot be favorable.
Metastatic Prostate Cancer Treatment
If a patient has been diagnosed with prostate cancer and he or she is concerned about prostate cancer metastasis, they should talk with a doctor about the risk of prostate cancer metastasis and corresponding treatment options.
Treatments for stage 4 prostate cancer may depend on where in the body the disease has spread. Options include:
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Better Prognosis For Resectable Tumors
Patients whose tumors are found before they have metastasized or become locally advanced tend to have longer survival rates, on average, because their tumors can usually be resected .
About 15 to 20 percent of all pancreatic tumors are resectable. These include stage I and stage II tumors. Rarely, locally advanced stage III tumors, which are typically considered unresectable , are characterized as borderline and may be removed if the patient has access to an experienced, highly trained surgeon.
Tumors can still grow back in many patients. So, on average, patients whose tumors were resected live for 2.5 years after their diagnosis and have a five-year survival rate of 20 to 30 percent.
Surgically Removing The Prostate Gland
A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.
Like any operation, this surgery carries some risks, such as urinary incontinence and erectile dysfunction.
In extremely rare cases, problems arising after surgery can be fatal.
It’s possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.
Studies have shown that radiotherapy after prostate removal surgery may increase the chances of a cure, although research is still being carried out into when it should be used after surgery.
You may want to ask your doctors about storing a sperm sample before the operation so it can be used later for in vitro fertilisation .
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How Prostate Cancer Is Diagnosed And Staged
Cancer staging helps you and your doctor understand how advanced your cancer is and how much it has spread at the time of diagnosis. Knowing your cancer stage also helps your doctor determine the best treatment options for you and estimate your chance of survival.
The most widely used staging system for cancer is the TNM system that classifies cancer from stage 1 to stage 4.
TNM stands for:
- Tumor: the size and extent of the tumor
- Nodes: the number or extent of nearby lymph node involvement
- Metastasis: whether cancer has spread to distant sites in the body
The TNM scale is used for many types of cancer. When a doctor uses it to determine your prostate cancer stage, theyll consider several other factors as well, including:
Life Expectancy Of Stage 4 Pancreatic Cancer
The life expectancy for stage 4 pancreatic cancer is considered one of the lowest, since the disease is considered one of the worst of the existing types of cancer. As of now, many medical resources pin the median survival rate for stage 4 pancreatic cancer patients to be about three to five months, depending on the condition of the patient.
The lower life expectancy is due to the fact that the cancer, at this point, spreads to the surrounding organs. Since this happens, its difficult for a patient to recover from the cancers damage, even if undergoing treatment.
Treatment for stage 4 pancreatic cancer often involves chemotherapy and the administration of pain-relieving drugs for patients. Patients also receive palliative surgery, which may include a biliary bypass, gastric bypass and/or an endoscopic stent placement.
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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.
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. Thats 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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Factors That Can Influence Survival Times
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.
Questions about life expectancy are often the first ones asked when someone is diagnosed with stage 4 non-small cell lung cancer . This is the most advanced stage of the disease in which cancer has spread from the primary tumor to distant organs.
The median survival time for those with stage 4 lung cancer is around four months. That means that 50% of patients will still be alive four months after their diagnosis.
As distressing as this statistic may be, it is important to remember that stage 4 lung cancer has no set course. Many will live for months and even years longer than this.
Multiple factors can influence survival times, some of which are modifiable. Newer targeted therapies and immunotherapies are also helping people with stage 4 cancer live longer with fewer side effects and a better quality of life.
This article discusses stage 4 lung cancer life expectancy and what factors may influence the outcome of a diagnosis.
Verywell / Jessica Olah
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.
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A Note About Sex And Gender
Sex and gender exist on spectrums. This article will use the terms male, female, or both to refer to sex assigned at birth. .
- neuroendocrine tumors
Experts believe some males can also have a mixed type, which combines a common and a rare type of prostate cancer. Rare forms of prostate cancer are more likely to metastasize.
Prostate cancer overall is the second most common cancer in males after skin cancer. Doctors discover most prostate cancers in the prostate or nearby tissues. However, about 16% of new cases spread into distant locations.
Between 2012 and 2018, about more cases of prostate cancer occurred in the United States.
Research has shown the incidence of prostate cancer for African American males is that of people who are white. Among African Americans, the cancer types tend to be more aggressive, and deaths are double compared with white Americans.
The differences in outcomes for African American males may originate from:
- Physical: Higher prostate-specific antigen levels in the blood.
- Genetic: Some African American males carry certain gene mutations or chromosomal abnormalities that can increase prostate cancer risk.
- Environmental: Social disparities may cause people from historically marginalized groups to live on a lower income and have limited access to healthy food.
- Social: Disparities in healthcare can limit genetic screening or disease treatment access, leading to underdiagnosis.
Other people should begin screening at the age of 50.
Improve Quality Of Life With Palliative Care
Palliative or supportive care can relieve symptoms and improve quality of life. In stage 4 mesothelioma, doctors may recommend palliative care such as pain medication, oxygen therapy and respiratory therapy. These treatments control pain and improve lung function.
Many long-term mesothelioma survivors have incorporated complementary and alternative medicine into their stage 4 treatment plan. Complementary therapies, such as acupuncture and massage, may help some patients when used alongside traditional medicine to ease symptoms and reduce treatment side effects.
Find a Top Mesothelioma Doctor
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Survival By Disease Recurrence
If a man develops an elevated PSA level after cancer surgery, then the disease is viewed as recurrent.
The number of lymph nodes at the time of prostatectomy can influence the risk of recurrence. One study suggests the removal of a large number of nodes is associated with an improvement in odds of recurrence, but this doesnât appear to impact overall survival.
But disease recurrence doesnât always influence survival times. If a recurrence does occur, the 15-year survival rate at the time of diagnosis may be as high as 94% in those with low-risk recurrence.
The main factors influencing survival rates are:
- The Gleason score
- The PSA doubling time
- Whether the recurrence occurred within three years or after three years
A recurrence that occurs within three years reduces survival rates by anywhere from 15 to 20%and even more, if the doubling time is short.
In the past, the life expectancy of men with metastatic prostate cancer was 2-3 years. But with advancements in medicine and care, the life expectancy of men with metastatic prostate cancer has increased to about 5-6 years.
The 5-year survival rate of metastatic prostate cancer is 28%, which is much lower than local and regional prostate cancers. This refers to the percentage of people diagnosed with a particular cancer who can expect to live for at least 5 years after diagnosis.
Stage 4 Cancer Explanation
What are stage 4 metastatic cancers? First of all, before we go to the life expectancy part, you should know more about this stage. As we mentioned above, this is the last or the most severe stage. It means cancer at this stage has a high mortality rate. It can kill the patients most of the time when they receive no proper treatment.
Why does it have a high mortality rate? You can see it from its name. Cancer in this stage has metastasized. It means the cancer cells have spread and attacked another area or organ outside the initial area where it appears. For example, if you have lung cancer in this stage, the cancer cell has spread to other organs near the lungs, such as the heart and liver.
Compared to the earliest stage, metastasized cancer is more challenging to treat. We can even call it impossible for certain cases. The cancer cell has grown significantly, so the focused treatment doesnt work for it. Because of that, it is also known for its high mortality rate.
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Stage 4 Cancer Treatments
Stage 4 cancer has the highest mortality rate. Therefore, many people who have stage 4 cancer or know their family or friend has one, have already given up. They only see the people with this cancer as those who only wait for the end of their life.
The truth is the opposite. Thanks to medical sciences growth, nowadays, many data and tests show a patient with stage 4 cancer is treatable and even curable. As mentioned earlier, there are two purposes of the treatment. It is either to stop the growth and kill the cancer cell or to control the growth and wait for the end.
Regardless of the purposes, the treatment for cancer in stage 4 is similar. Here, we have the examples of the standard treatment for stage 4 cancer:
· Chemotherapy is said to be the safest method to treat stage 4 cancer. However, if cancer has spread extensively, this treatment could risk affecting other organs, which can cause another health problem for the patient.
· Radiation therapy this treatment is also suitable for cancer that hasnt spread too much. The doctor uses this treatment to reduce the size of the cancer cell and relieve the symptoms.
· Immunotherapy this method uses the natural immune system of the patients body to fight the cancer cell. It has a high success rate for low-grade cancer cells.
· Surgery remove the cancer cell or tumor and the problem is gone. Of course, it is only doable for cancer in the earlier stage of metastasis.
An Overview Of Liver Cancer
Liver cancer is often referred to as Hepatoma or Hepatocellular Carcinoma . Liver cancer is categorized into stages based on its intensity, and the 4th stage is advanced of them all. In this stage, cancer has begun to spread to the nearby lymph nodes and or the distant lymph nodes and organs. Liver cancer cases are comparatively fewer and are more common in men than in women.
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Understanding The Nature Of Stage 4 Cancer
A person with stage 4 cancer may not feel ready to face the likelihood of death, which causes them to be willing to try any kind of treatment, even with a small chance of success, according to the study.
Sometimes, doctors do not speak in straightforward terms with patients about the limited chances of success in curing stage 4 cancer. Patients need to ask questions of doctors about the actual chances of recovery when facing stage 4 cancer. They also should ask about the benefits of hospice care, such as those outlined by the Mayo Clinic.
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Stage 4 Pericardial Mesothelioma
Doctors use general staging guidelines for pericardial mesothelioma since no staging system exists for this variant. Pericardial mesothelioma develops on the hearts protective lining, which is known as the pericardium.
This mesothelioma is exceedingly rare, making it challenging to diagnose before the patients death. In the late stages of pericardial mesothelioma, cancer may spread throughout the chest cavity, esophagus, abdomen or other parts of the respiratory and digestive system.
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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 whatâs 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, weâre 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 95%
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