What Is Prostate Cancer
Prostate cancer is cancer that affects the prostate gland in men. Prostate cancer is the second-leading cause of cancer deaths for men in the US.
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.
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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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:
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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.
Questions To Ask Your Doctor Or Nurse
- What type of hormone therapy are you offering me and why?
- Are there other treatments I can have?
- What are the advantages and disadvantages of my treatment?
- What treatments and support are available to help manage side effects?
- Are there any lifestyle changes that might help me manage my cancer, symptoms, or side effects?
- How often will I have check-ups and what will this involve?
- How will we know if my cancer starts to grow again?
- What other treatments are available if that happens?
- Can I join any clinical trials?
- If I have any questions or get any new symptoms, who should I contact?
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What Does It Mean To Have Stage 5 Prostate Cancer
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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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Stage 2 Prostate Cancer
In stage 2, the tumor is still confined to your prostate and hasnt spread to lymph nodes or other parts of your body. A doctor may or may not be able to feel the tumor during a prostate exam, and it may appear on ultrasound imaging. The survival rate is still .
The PSA score for stage 2 is less than 20 ng/mL.
Stage 2 cancer is further divided into three phases depending on the grade group and Gleason scores:
- Gleason score: 6 or less
Screening For Prostate Cancer
There are no tests available with sufficient accuracy to screen populations of men for early signs of prostate cancer. However, early detection and treatment can significantly improve prostate cancer survival.
The test most commonly used to aid early detection of prostate cancer is the prostate specific antigen blood test. This is not a diagnostic test as it can only indicate changes in the prostate. If you are concerned about prostate cancer you should talk to your doctor and make an informed choice about whether to have one of the tests designed to find early signs of prostate cancer, in view of the potential risks and benefits.
There are no proven measures to prevent prostate cancer.
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How Long Can Someone Live With Stage 4 Cancer
Doctors usually describe a persons outlook using the 5-year survival rate. These are calculated based on data from thousands of other people with a similar cancer at a similar stage.
The original location of the cancer determines its type. Survival rates vary, depending on the type of cancer and how far it has spread within the body.
Below, we describe the survival rates for some of the most common forms of cancer in stage 4:
Survival Rates By Tnm Stage
The first approach is based on the TNM stage statistical survival times are matched to the stage of the disease.
|TNM Lung Cancer Stage|
By contrast, the one-year survival rate for stage 4 lung cancer was reported in one study to be between 15% and 19%, meaning this portion of patients with metastatic disease lived for at least a year.
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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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Coping With Prostate Cancer
The diagnosis of cancer can cause great anxiety to the individual and his family and friends. At times, one may have troubles coping with the diagnosis, the disease, and its treatment. Searching online for information may prove overwhelming also and may not be the best resource. Ask your physician or local hospital about local resources. Often, there are local prostate cancer support groups which may help you cope with your feelings and provide local resources for more knowledge.
You may consider contacting one or more of the following organizations:
- US Prostate Cancer Foundation,
- Centers for Disease Control and Prevention ,
- American Cancer Society, and
- Patient Advocates for Advanced Cancer Treatment.
The Internet has provided access to a number of sites focusing on prostate cancer treatment and outcomes. The National Cancer Institute and the National Comprehensive Cancer Network have patient information, as well as the American Urological Association.
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Stage 4 Prostate Cancer Prognosis
Doctors need to know how far the cancer has advanced, or its stage, in order to choose the best treatment. A pathologist, a specialist who specializes in studying cells obtained from a prostate biopsy, will provide two starting points: the cancers grade and Gleason score.
- Cancer grade: When the pathologist looks at prostate cancer cells, the most common type of cells will get a grade of 3 to 5. The area of cancer cells in the prostate will also be graded. The higher the grade, the more abnormal the cells.
- Gleason score: The two grades will be added together to get a Gleason score. This score tells doctors how likely the cancer is to grow and spread.
After a biopsy reveals prostate cancer, the patient may be subjected to additional testing to determine whether the disease has spread to other regions of the body via the blood or lymph nodes. These are typically imaging examinations, such as a bone scan, positron emission tomography scan, or computed tomography scan.
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Treatments To Help Manage Symptoms
Advanced prostate cancer can cause symptoms, such as bone pain. Speak to your doctor or nurse if you have symptoms there are treatments available to help manage them. The treatments above may help to delay or relieve some symptoms. There are also specific treatments to help manage symptoms you may hear these called palliative treatments. They include:
This is the team of health professionals involved in your care. It is likely to include:
- a specialist nurse
- a chemotherapy nurse
- a diagnostic radiographer
- a therapeutic radiographer
- other health professionals, such as a dietitian or physiotherapist.
Your MDT will meet to discuss your diagnosis and treatment options. You might not meet all the health professionals straight away.
Your main point of contact might be called your key worker. This is usually your clinical nurse specialist , but might be someone else. The key worker will co-ordinate your care and help you get information and support. You may also have close contact with your GP and the practice nurses at your GP surgery.
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What Are The Possible Treatment Options For Prostate Cancer
Staging is not the only information that doctors need. Symptoms and the patients age, life expectancy, co-existing health conditions and personal preferences may also be considered when deciding on treatment. Doctors use a general guideline for treatment based on stage groups.
Stage I prostate cancer:
Staging Prostate Cancer Grades And Stages
Overview by Professor Chris FosterProfessor of Molecular and Clinical Cancer MedicineMedical Director of Pathology HCA Healthcare UKPAGE AWAITING APPROVAL
Staging prostate cancer
Grades and Stages are used to describe what a cancer looks like under a microscope and the size and spread of the tumour.
The Cancer GradeThe Cancer Stage The TNM Staging system
- Tumour : How large is the primary tumour ? Where is it located ?
- Node : Has the tumour spread to the lymph nodes? If so, where, and how many ?
- Metastasis : Has the cancer metastasized to other parts of the body? If so, where and how much?
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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.
Stages Types And Grades Of Prostate Cancer
The tests and scans you have to diagnose prostate cancer give information about:
- the type of cell the cancer started in and where it began
- how abnormal the cells look under the microscope
- the size of the cancer and whether it has spread
In the UK, doctors use the Grade Groups or Gleason score to grade prostate cancer. Doctors now use the Grade Groups and other information to divide prostate cancer into 5 groups. This is called the Cambridge Prognostic Group .
You might also be told about the TNM stage, or you may see this on your pathology report. Another way doctors may describe your cancer is as localised, locally advanced and metastatic prostate cancer.
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General Prostate Cancer Survival Rate
According to the American Cancer Society:
- The relative 5-year survival rate is nearly 100%
- The relative 10-year survival rate is 98%
- The 15-year relative survival rate is 91%
Note: Relative survival rate means the percentage of patients who live amount of years after their initial diagnosis.
Keep in mind, however, that because the compiled list figures are of cancers diagnosed up to 15 years ago, you may have an even greater chance of survival than these indicate due to advances in prostate cancer treatment technology
Experimental Treatments For Advanced Prostate Cancer
Researchers are currently testing many new approaches and treatments for prostate cancer, including new medications. These include the following:
Immune checkpoint inhibitors
The immune system uses âcheckpointsâ to stop it from attacking the bodyâs healthy cells. These checkpoints are proteins on immune cells.
Cancer cells often use these checkpoints to keep the immune system from attacking them.
Immune checkpoint inhibitors are drugs that can these checkpoints on cancer cells. Inhibiting these checkpoints can allow a personâs immune system to attack the cancer cells.
Chimeric antigen receptor T cell therapy
This treatment involves taking immune cells from the personâs blood. A scientist then alters these cells in a lab to have receptors called chimeric antigen receptors on their surface.
These receptors help the cells attach to proteins on the surface of prostate cells. A scientist then multiplies these altered T cells in a lab before putting them back into the personâs blood.
Scientists hope these T cells can then find prostate cancer cells and launch a targeted immune attack.
However, this treatment is complicated and may have some serious side effects. This means it is currently only available as part of clinical trials.
Targeted drug therapies
Targeted drug therapies can act on specific parts of cancer cells and the environments surrounding them.
Two possible targeted therapy treatments are:
Treating prostate cancer that has spread to the bones
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Watchful Waiting And Active Surveillance
Watchful waiting is an adequate approach in patients who are at low risk of death from prostate cancer because of their limited life expectancy due to severe comorbidities.26,27 Watchful waiting resulted in similar overall survival when compared with radical prostatectomy, but disease-specific survival was better in patients who had undergone surgery.26 For some patients it turns out to be hard to persist on a watchful waiting policy, and many men drop out and seek active treatment within several years, mostly when PSA elevation is noted.
Active surveillance is a novel and fascinating approach to distinguish between patients who are at higher risk and need active therapy and patients who are at low risk for disease progression.27,28 This approach avoids the risks of therapy while allowing early detection of those patients who are prone to progress. In these high-risk individuals, delayed active treatment is offered. Periodic monitoring of the PSA serum level, digital rectal exam, and repeated prostate biopsies are performed in patients who are on active surveillance, and active therapy is started when predefined threshold values are reached. This concept makes it possible to offer curative treatment to individuals who are at high risk for disease progression as indicated by active surveillance parameters.