Challenges To The Professional Caregiver
Oncologists and nurses caring for terminally ill cancer patients are at risk of suffering personally, owing to the clinical intensity and chronic loss inherent in their work. Lack of training in advance care planning and communication can leave oncologists vulnerable to burnout, depression, and professional dissatisfaction. One group of investigators studied oncologists grief related to patient death and found strong impact in both the personal and professional realms. Negative effects included a sense of distraction and withdrawal from patients.
One study made an important conceptual distinction, explaining that while grief is healthy for oncologists, stress and burnout can be counterproductive. Other terms used to describe professional suffering are moral distress, emotional exhaustion, and depersonalization. Moral distress was measured in a descriptive pilot study involving 29 physicians and 196 nurses caring for dying patients in intensive care units. Both groups of professionals experienced moral distress related to pressure to continue aggressive treatment they considered futile. Nurses experienced more moral distress than did physicians, and perceived less collaboration than did their physician colleagues.
Who Is At Risk Of Stage 4 Prostate Cancer
Each year almost 200,000 American men are diagnosed with prostate cancer. Obesity and smoking are linked to a higher risk of prostate cancer, but most prostate cancers happen to men over 55. The risk increases as you get older about 60% of prostate cancers are diagnosed in men over 65 years old.
Stage 4 prostate cancer happens when cancer becomes aggressive and spreads to other parts of your body. Some genetic mutations have been connected to an increased likelihood of developing aggressive prostate cancer, so men with family histories of the disease are at greater risk. Men with family members who have had pancreatic, breast, or ovarian cancers might also have a higher risk of prostate cancer.
Black or African-American men are also more likely to have aggressive forms of prostate cancer than men from other races.
Surgery For Metastatic Prostate Cancer
Unlike with localized prostate cancer, surgery isnt usually used to treat metastatic cancer. However, it may be used in some cases if it can help improve a patients quality of life, often to resolve urinary problems or stop bleeding.
If your cancer is locally advanced and hasnt spread far, a radical prostatectomy may still be an option. A radical prostatectomy is a surgical procedure in which the prostate is removed, along with any nearby tissue that contains prostate cancer cells.
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Metastatic Prostate Cancer Treatment
Treatments for metastatic prostate cancer may depend on where in the body the disease has spread. Options include:
How Is Prostate Cancer Diagnosed
Doctors describe the growth and spread of prostate cancer in stages. Doctors use these stages as guides when choosing treatment options or offering prognoses to their patients.
Prostate cancer staging is based on a number of different factors, including prostate cancer screening tests such as a digital rectal exam or prostate-specific antigen test and imaging studies like bones scans, MRIs, CT scans, and trans-rectal ultrasounds.
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What Happens When Prostate Cancer Is Left Untreated
While most men undergo some form of treatment for their prostate cancer, some men today choose to not be treated for their prostate cancer. Instead, they may choose to have their healthcare providers monitor their cancer.
Known as active surveillance, it is common when the cancer is expected to grow slowly based on biopsy results, confined to the prostate, not causing any symptoms, and/or small. In active surveillance, healthcare providers will initiate cancer treatment only if cancer starts growing.
Others men may choose to not undergo cancer treatment because of a short life expectancy or other serious medical problems. They may feel that the risks or side effects of cancer treatment outweigh their potential benefits.
This option is certainly OK and reasonable in the right circumstancesrequiring a careful and thoughtful discussion with your healthcare provider and family.
Stage 4 Prostate Cancer Clinical Trials
Clinical trials provide cancer patients with life-extending and curative new medicines. Clinical drug trials are critical in getting new medicines to patients who need them the most, as well as securing data so that regulatory clearances may be secured, and new drugs can enter broad clinical practice. Patients who take part in clinical trials benefit both treatment science and their fellow patients.
There are currently 100 Phase III drug trials and more than 500 Phase I/II trials related to prostate cancer treatment in progress in the United States alone. Those that are approved will join the 12 new drugs that have been approved for men with advanced/metastatic disease since 2010 and further improve outcomes for patients:
Using our AI-powered approach, Massive Bio leads patients through the most extensive clinical trial matching process available.
We can assist you if you have been diagnosed with any of the following prostate cancer subtypes:
- Transitional Cell Carcinoma
- Small Cell Carcinoma
If you do not know which type of prostate cancer you have, that is okay. Additional testing can help you determine your exact diagnosis.
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Stage Iv Cancer Life Expectancy
The five-year relative survival rate for prostate cancer that has spread to distant organs is 28%. This means about 28% of the patients with stage 4 prostate cancer will live for five years.
According to certain studies, about 98% men with low or intermediate grade prostate cancer will live for more than five years. However, only 67% men with end stage prostate cancer will live for more than five years.
End stage prostate cancer life expectancy is normally less than five years. It may vary according to the age and overall health of the patient, the type of treatment, and the extent and location of metastases , etc.
Studies show that the five-year survival rate for prostate cancer without bone metastasis is 56%. For prostate cancer with bone metastasis, it is only 3%.
The five-year survival rate for prostate cancer with bone metastasis and skeletal involvement is unfortunately less than 1%.
Usually, at stage IV, doctors assure life only for three years. The life expectancy not only depends on the treatment, but also on the physical and mental health of the patient. Patients who are loved and cared by their family members can fight the disease courageously. Those with strong will power live longer. There are examples of patients who have lived for eight years, or even further. Some recent studies show that a prostatectomy, even in late stage prostate cancer, can double or triple the life expectancy of a patient . But more studies are required to prove this fact.
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 whats 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, were 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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What Are The Stages Of Prostate Cancer
Cancer staging is first described using what is called a TNM system. The âTâ refers to a description of the size or extent of the primary, or original, tumor. âNâ describes the presence or absence of, and extent of spread of the cancer to lymph nodes that may be nearby or further from the original tumor. âMâ describes the presence or absence of metastases â usually distant areas elsewhere in the body other than regional lymph nodes to which the 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 patientâs 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:
Traditionally, advanced prostate cancer was defined as 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 lower grade disease with an increased risk of progression and/or death from prostate cancer in addition to those with widely metastatic disease.
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 preventing further spread of cancer
- Control or prevent the symptoms caused by the spread of prostate cancer to the bones
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Chemotherapy For Metastatic Prostate Cancer
Chemotherapy may be used for patients with metastatic prostate cancer, with the aim of slowing any further spread of cancer and improving quality of life.
The most commonly used chemotherapy medications, typically given via an intravenous line, are docetaxel combined with prednisone. However, there are several chemotherapy drugs available, so ask your doctor which types may be most appropriate for your treatment.
In some cases, these treatments are considered palliative, intended to relieve difficult symptoms and improve quality of life.
Prostate cancer treatment: The care you need is one call away
Your multidisciplinary team will work with you to develop a personalized plan to treat your prostate cancer in a way that fits your individual needs and goals.
Treating Advanced Prostate Cancer
If the cancer has reached an advanced stage, itâs no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.
Treatment options include:
- hormone treatment
If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.
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About Half Of Men Older Than 50 Have An Enlarged Prostate Here Are Some Of The Basic Facts You Need To Know About This Common Condition
As men age, many experience prostate gland enlargement. This condition is known as benign prostatic hyperplasia .
The prostate gland surrounds the urethra, the hollow tube that carries urine out of the body. When the prostate gets bigger, it can squeeze or partially block the urethra, which leads to problems urinating.
BPH is quite common in older men. In fact, the condition impacts about 50% of men between the ages of 51 and 60. For men 80 and older, the prevalence of BPH is approximately 90%, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
What Treatments Are Available
If you have advanced prostate cancer, treatment wont cure your cancer. But it can help keep it under control and manage any symptoms.
If youve just been diagnosed with advanced prostate cancer, you may be offered the following treatments:
Research has found that having radiotherapy together with one of the main treatments listed above can help some men with advanced prostate cancer to live longer. But radiotherapy isnt suitable for all men with advanced prostate cancer.
If you live in Scotland, you may also be offered a type of hormone therapy called abiraterone acetate together with standard hormone therapy. In the rest of the UK, abiraterone is currently only given to men with advanced prostate cancer that has stopped responding to other types of hormone therapy. The National Institute for Health and Care Excellence is currently deciding whether to make it available for men who have just been diagnosed with advanced prostate cancer.
Before you start treatment
Before you start any treatment, make sure you have all the information you need. Its important to think about how you would cope with the possible side effects. Speak to your doctor or nurse about this.
It can help to write down any questions you want to ask at your next appointment. It may also help to take someone with you, such as your partner, a family member or friend.
If you have any questions, speak to our Specialist Nurses.
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What Is The Survival Rate Of Stage 4 Prostate Cancer
Doctors use the term stage to characterize the characteristics of the original tumor itself, such as its size and how far prostate cancer has spread when it is discovered, as they do with all malignancies.
Staging systems are difficult to understand. Most malignancies, including prostate cancer, are staged using three different elements of tumor growth and dissemination. The TNM system stands 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.
The TNM approach allows each mans prostate cancer to be characterized in depth and compared to the prostate cancers of other men. Doctors utilize this information to conduct research and make treatment decisions.
However, in terms of prostate cancer survival statistics, the staging method is straightforward. As previously stated, males with prostate cancer can be split into two groups in terms of survival rates:
- Men with prostate cancer that is localized to the prostate or just nearby.
- Prostate cancer has a high long-term survival percentage in these men. Almost all men will live for more than five years after being diagnosed with prostate cancer, and many will live for much longer.
- Men whose prostate cancer has spread to distant areas, like their bones.
Metastatic Liver Cancer Symptoms
Liver cancer symptoms often do not appear in the early stages. As a result, liver cancer tends to be diagnosed at a more advanced stage. If youve had other diseases of the liver or a family history of liver cancer, you have a higher risk of developing liver cancer and you should have regular follow-up visits with a doctor.The symptoms of metastatic liver cancer vary depending on where new tumors form. For example, if the liver cancer spreads to the bones, it may cause bone fractures.
Common symptoms of metastatic liver cancer include:
- Pain occurring near the right shoulder blade or in the upper abdomen
- Loss of appetite, weight loss or nausea
- Abdominal swelling or bloating in the abdomen
- Yellowing of the skin and eyes
- Ongoing fatigue or weakness
- Unexplained fever
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Factors Influencing Survival Rates
The variability in survival rates highlights one key reality about stage 4 lung cancer: no two people have the same disease. Arguably more than any other stage of the disease, stage 4 lung cancer survival is influenced by multiple factors. Some of these are fixed and others can be changed .
There are seven factors known to influence survival times in people with stage 4 NSCLC.
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White Patients Derive A Larger Conditional Mortality Benefit Than Non
In order to determine whether race interacted with survival, we repeated our initial analyses after stratifying by race and by modeling an interaction term. Among patients with M1 disease, conditional mortality was similar between white and non-white patients . However, among patients with N1 disease, non-white patients did not have a significant reduction in conditional mortality at 5, 10, or 15 years of survival compared to diagnosis , while white patients had similar mortality as the overall cohort, with adjusted hazard ratios of 1.10 , 0.898 , and 0.712 , respectively. While non-white patients with T4 disease had improved 5-year PCSM after having survived 5, 10, or 15 years, their improvements were 20-39 % smaller than those of white patients .
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Study Design And Population
A retrospective, cross-sectional study of the SEER-Medicare database files were used for this analysis between 2001 and 2009. Briefly, the US population-based SEER registries collect demographic, stage and historical type, and types of initial cancer treatments in PEDSF. Medicare files include claims for each beneficiary that fee-for-service covered hospitalizations, outpatient, and physician services. In this study, SEER-Medicare data were used and the study was approved by the Institutional Review Board of Inova Fairfax Hospital the approval number is: 13-.1432.
There were 20,409 HCC cases in SEER-Medicare, 20012009. The following cases were excluded: missing information on date of HCC diagnosis, n=233 diagnosis confirmed only after autopsy or death, n=312 missing information on the Charlson Comorbidity Index , n=5,714 HIV infection, n=210 not continuously enrolled for at least 12-months on Medicare fee-for-services, n=3,105 and unknown information on the surgical resection, n=193. The above excluded cases with missing information on CCI and not continuously enrolled on fee-for-service for at least 12-months had an average 65 years old, 76% male, 54% local staging HCC.