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What Is The Survival Rate Of Metastatic Prostate Cancer

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Metastatic Spread In Prostate Cancer Patients Influencing Radiotherapy Response

Metastatic Prostate Cancer Death Rate Remains Unchanged
  • 1National Center for Tumor Diseases , Dresden, Germany
  • 2German Cancer Research Center , Heidelberg, Germany
  • 3Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
  • 4Helmholtz-Zentrum DresdenRossendorf , Dresden,Germany
  • 5Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

Enzalutamide Improves Survival In Patients With Metastatic Prostate Cancer

Summary

In an international randomizedphase III clinical trial, the hormone therapy enzalutamide extended survival in men with metastatic prostate cancer that had progressed during treatment with androgen deprivation therapy. Participants in the trial had not received chemotherapy.

New England Journal of Medicine, June 1, 2014.

Background

Early in their development, prostate cancers need relatively high levels of male sex hormones to grow. The testes are the main source of androgens, and treatments that stop the testes from producing male sex hormonesknown as hormone therapy or androgen deprivation therapy are therefore a common treatment for androgen-sensitive prostate cancer. However, most prostate cancers eventually become castrate resistantthat is, they can grow even when androgen levels in the blood are very low. ADT does not block production of the small amount of androgen that is made by the adrenal glands and by prostate cancer cells themselves, and this low level is sufficient to fuel the growth of castrate-resistant prostate cancers.

Enzalutamide is among several hormone therapies that have been developed to prevent the androgen-fueled growth of castrate-resistant prostate cancers. This drug works by keeping androgens from binding to the androgen receptors on prostate cancer cells.

The Study

Men in the trial were randomly assigned to receive 160 mg of enzalutamide or a placebo taken orally once daily.

Results

Limitations

  • Posted:June 27, 2014

Who Gets This Cancer

Prostate cancer occurs only in men, and it is more common in older men than younger men. It is more likely to occur in men with a family history of prostate cancer and men of African American descent. The rate of new cases of prostate cancer was 111.3 per 100,000 men per year based on 20142018 cases, age-adjusted.

Rate of New Cases per 100,000 Persons by Race/Ethnicity: Prostate Cancer

Males

SEER 21 20142018, All Races, Males

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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.

Outlook For Men With Localised Prostate Cancer

When prostate cancer spreads, where it goes matters

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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Stages Of Prostate Cancer

In order to determine the stage of a patients prostate cancer, most doctors start by using the TNM staging system, which helps describe different aspects of the cancers growth.

  • T the T category measures the size and extent of the Tumor
  • N the N category measures whether and how far the cancer has spread to the Lymph Nodes
  • M the M category whether the cancer has spread to other organs in the body (a process called Metastasis

The score for each of these categories is determined based on a pre-determined set of criteria. Your doctor cannot feel or see the tumor with a score of T1. A score of T3 means that the tumor has begun to grow outside of the prostate.

After calculating the TNM categories, doctors will combine the TNM score with the patients Gleason score and PSA levels assigning of a specific stage to the patients cancer.

Prostate cancer prognosis and survival rates can help give patients an idea of their chances of surviving the disease based on the stage and time of diagnosis. While some patients may find this information helpful, others may not want to know.

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.

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Facts About Metastatic Cancer Survival Rate

Metastatic cancer survival rate is very important to patients. This refers to how they can deal with the cancer in order to survive. Prognosis of any cancers especially at this point is extremely relevant.

Metastatic Cancer Survival Rate

The hope to survive is what patients are concerned about. Surviving from metastatic cancer is the goal of every patient.

Metastatic cancer, which is also known as metastasis, is the spreading of cancerous cells to various organs and other tissues. These cells extend through the blood stream. If cancer cells begin to spread, other organs become affected which may result to damage. Generally, this condition exists during later stages. The essential thing that you must consider is the malignant cells. These cells should be well controlled so the disease will not worsen. Treating this disease right way is vital so metastatic cancer survival rate lung cancer, brain cancer or no matter what type would increase.

Improving metastatic cancer survival rate uterine is not difficult at all. With complete and proper treatments, any patient of uterine cancer at this late stage can still have a huge chance of surviving. The survival rate of this type of cancer is not that low at all compared to others such as brain and liver cancer. Metastatic cancer survival rate brain and metastatic cancer survival rate liver are somewhat lower than metastatic uterine cancer.

Prostate Cancer Survival Rates Are Favorable Overall

Metastatic Prostate Cancer Death Rate Remains Unchanged

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 what’s 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, we’re 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 96%

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Changes In Psa Levels After Surgery

In patients with rising PSA levels after radical prostatectomy, the important prognostic factors are the :

  • pathologic stage
  • time taken post-operatively to reach detectable PSA levels
  • Gleason score at the time of prostatectomy
  • time required for doubling of PSA values

PSA doubling time of 15 months or more are better managed with surveillance. The have median time to metastatic disease in these years is about 8 years and the median survival is about 13 years. Patients with PSA doubling times of less than 3 months are at very high risk of prostate cancer related death and have a median survival of 5 to 6 years.

Staging Of Prostate Cancer

  • Stage I : The Gleason score is 6 or less, and the PSA level is less than 10. Cancer at this stage is normally not detectable in an ultrasound test or in a DRE test, as the tumor is very small. It is within the prostate and has not spread to nearby lymph nodes. It is usually discovered accidentally during a surgery carried out for another purpose. Prostate ultrasound and biopsy can be performed after detection of elevated blood PSA levels.
  • Stage II : From this stage onwards, the Gleason score and the PSA level may vary from person to person. As the tumor grows in size, it can be detected in a DRE test or sonogram, but the tumor is still confined to the prostate gland. It is in one half or less of only one side of the prostate. It hasnt spread to lymph nodes and nearby organs, or it has spread to nearby lymph nodes, but has not invaded nearby organs.
  • Stage III : The cancerous cells spread out from the original site and invade the seminal vesicles. They do not spread to nearby lymph nodes or to nearby organs in the body.
  • Stage IV : The cancer moves out of the seminal vesicles and invades the lymph nodes. The size and number of tumors increase, and the cancerous cells spread into the nearby organs, such as the bladder and the rectum. In stage four prostate cancer, even bones and other parts of the body like lungs and liver are likely to be invaded by the cancerous cells.

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Stage 4 Prostate Cancer Life Expectancy

The five year survival rate for stage 1 prostate cancer is 100%, but stage 4 prostate cancer life expectancy is not very encouraging. While providing information on late stage prostate cancer life expectancy, this HealthHearty article also describes what is meant by staging and grading of prostate cancer.

The five year survival rate for stage 1 prostate cancer is 100%, but stage 4 prostate cancer life expectancy is not very encouraging. While providing information on late stage prostate cancer life expectancy, this HealthHearty article also describes what is meant by staging and grading of prostate cancer.

Statistics show that more and more men are being diagnosed with prostate cancer every year. Various tests like PSA test, DRE test, ultrasound sonography, etc., help diagnose the cancer. Staging and grading of cancer not only help design the treatment but they also help determine how well the cancer may respond to the treatment. Staging, generally, is concerned with the spread of cancer. The Gleason grading system involves classification of cancer cells. It helps determine aggressiveness of the cells and their likelihood of spreading.

Bone Pain In Prostate Cancer

Prostate Cancer Survivor Rates, Statistics, &  Results

Many advanced prostate cancer patients often suffer from bone pain that adversely affect quality of life. The management of pain or other cancer related functional impairment is integral part of palliative care. Palliative management can include analgesics, glucocorticoids, palliative chemotherapy, radioisotopes or radiotherapy.

Radioisotopes that selectively concentrate in bone lesions are approved for the palliative treatment of painful bone metastases. The treatment is of more value in patients with multiple metastases . The radioisotopes have been found to reduce the need for opioid painkillers in such patients.

EBRT is effective in painful bone lesions in advanced prostate cancer patients but not an ideal option if there are multiple lesions at different sites. The lesions in multiple sites will progress after EBRT in one site and pain will reappear in a short time afterwards, unless other systemic therapies are initiated to control the disease process. Read more on EBRT under prostate cancer treatments.

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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.

Prostate Cancer Survival Trends Over Time

As with most cancers, survival for prostate cancer is improving. However, interpretation of prostate cancer survival trends is difficult as the case-mix on which they are based is likely to have changed over time with earlier diagnoses following the advent of TURP and PSA testing. The detection of a greater proportion of latent, earlier, slow-growing tumours in more recent time periods will have the effect of raising survival rates due to lead-time bias . Lead-time bias for prostate cancer is estimated to be between five and 12 years, varying with a man’s age at screening. Data from the European Randomized Study of Prostate Cancer estimates that for a single screening test, mean lead times are 12 years at age 55 and six years at age 75. Some of the increase may also be attributed to genuine improvements in survival due to more effective treatment, for both early, aggressive prostate cancers and advanced cases.

One-year age-standardised net survival for prostate cancer has increased from 66% during 1971-1972 to 94% during 2010-2011 in England and Wales an absolute survival difference of 28 percentage points.

Prostate Cancer , Age-Standardised One-Year Net Survival, Men , England and Wales, 1971-2011

Prostate Cancer , Age-Standardised Five-Year Net Survival, Men , England and Wales, 1971-2011

Prostate Cancer , Age-Standardised Ten-Year Net Survival, Men , England and Wales, 1971-2011

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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

Cdc Warns Incidence Of Metastatic Prostate Cancer On The Rise

Enzalutamide improves survival for men with metastatic hormone-sensitive prostate cancer

Jason M. BroderickUrology Times Journal

Although the overall incidence of prostate cancer has declined, the percentage of patients with metastatic disease at diagnosis has increased over the last decade.

Over the past decade, the incidence of metastatic prostate cancer in the United States has been on the rise, according to an analysis published in the Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.1

Between 2003 and 2017, the percentage of patients diagnosed with metastatic prostate cancer increased from 4% to 8%. This increase occurred even though the overall age-adjusted incidence of prostate cancer in the United States went down from 155 per 100,000 in 2003, to 105 per 100,000 in 2017.

Although approximately three-fourths of US men with prostate cancer have localized stage at diagnosis, an increasing number and percentage of men have received diagnoses of distant stage prostate cancer. Survival with distant stage prostate cancer has improved, but fewer than one-third of men survive 5 years after diagnosis, the investigators wrote.

Of note, when comparing 5-year relative survival for the periods of 2001-2005 and 2011-2016, the rate improved from 28.7% to 32.3% in patients with metastatic disease. The authors suggested that the improvement might be attributed to recent advances in the prostate cancer armamentarium, including novel antibody and hormone treatments.

Reference

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Imaging Of Metastasis Status In Prostate Cancer Patients

The screening for PSA level in the serum of patients was introduced in the late 1980s and enabled a dramatic increase in early PCa detection . On the other hand, PSA is not solely a PCa-specific biomarker and, as such, leads to overdiagnosis and overtreatment of clinically insignificant cases, representing a significant burden for patients . Moreover, absolute PSA level does not always correlate with prognosis . Therefore, more specific and sensitive PSA-based values like PSA density , PSA velocity , free-to-total PSA , and PSA doubling time are seen as options with stronger predictive value. For example, PSADT is defined as the length of time for two-fold PSA level increase. A PSADT < 6 months is strongly associated with metastatic disease, increased PCa mortality , and relapse . Nonetheless, the reported benefit of PSADT in PCa management did not enter clinical routine and some studies even reported discrepant results indicating that further studies are required to determine the reliability of PSADT and other available biomarkers .

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