Prostate cancer is the most common cancer after skin cancer in men in the US and the second leading cause of cancer death. Prostate-specific antigen (PSA) testing has made the detection of prostate cancer easier in its early stages. Ninety-two out of 100 men get diagnosed when the cancer is limited to the prostate.
Most men are diagnosed with prostate cancer in their senior years and only 1 out of 36 men die from it. Death from prostate cancer most often happens when cancer has spread (metastasized) to other organs in the body. This is known as the advanced stage of prostate cancer.
The chances of survival decrease as cancer spreads beyond the prostate. If cancer has metastasized to other parts of the body, only three out of 10 men will survive for five years after the diagnosis.
Advanced stage prostate cancer or metastasized prostate cancer
Cancerous cells may spread to organs other than the site of origin. In the case of prostate cancer, this tendency is decreased, but it can happen. Advanced stage prostate cancer is defined based on the Gleason score, which is based on the TNM staging of cancer. T stands for tumor size, N stands for lymph node involvement and M stands for metastasis.
Prostate cancer can kill in the end through metastases that can develop in
Metastasis to the bone can cause too much bone calcium to be released into the blood. The condition is known as hypercalcemia. Hypercalcemia can disrupt the functioning of organs, such as the kidney and heart. In severe cases, high calcium levels can lead to death.
Metastasis to the lungs can cause the affected lung to collapse or cause a lung infection that becomes difficult to treat. This can severely decrease the affected person’s ability to draw oxygen into the body.
Paraneoplastic syndrome associated with prostate cancer may cause symptoms such as neuropathy, difficulty walking, loss of muscle tone, loss of fine motor coordination, memory loss, seizures, sensory loss in the limbs and vertigo or dizziness. Paraneoplastic syndromes are a group of rare disorders that are triggered by an abnormal immune system response to cancerous cells. These cells mostly attack the nerve and the muscle cells throughout the body.
Advanced stage cancer leads to malnutrition, which can cause muscle wasting, weight loss and fatigue. It may even repress the healthy immune system to an extent that the person develops fungal infections and sepsis.
How is advanced prostate cancer treated?
Androgen deprivation therapy (ADT) is usually the choice of treatment of metastatic prostate cancer. Also known as hormone therapy, it is also used for treating patients who are unfit or unwilling to undergo surgery or/and radiation therapy.
Examples of hormone therapies for advanced prostate cancer include
Other treatment options for prostate cancer are
- Radiation therapy involves the use of high-energy waves to destroy cancer cells. It is the most preferred cancer therapy for older men or those with other coexisting conditions.
- This is a treatment involving anticancer medications that kill rapidly multiplying cells. Examples of chemotherapy medications in advanced prostate cancer include
- Also known as biologic therapy, immunotherapy involves using the immune system to fight cancers. Examples include
- Colony-stimulating factors
- Monoclonal antibodies
Patients with advanced prostate cancer may decide to stop the medications because of the severe side effects that come with the treatment. They may opt for hospice or palliative care, which is available in many hospitals. Palliative care is a special kind of treatment reserved for people with a terminal illness. It aims to alleviate the symptoms as well as provide them comfort and better quality of life.
Alternative practices, such as yoga and meditation, also help people affected with cancer feel relaxed and enable them to take control of their situation.
Participating in a prostate cancer support group can also help the affected person to deal with their cancer effectively. They can ask their doctor or search online for such support groups.
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Early-Stage Prostate Cancer Treatment
If prostate cancer is detected early and appears to be slow-growing, invasive procedures, chemotherapy, radiation and other approaches can sometimes do more harm than good. Many prostate cancer treatments come with side effects, like incontinence or impotence, so it’s in the patient’s interest to put off invasive treatments as long as is medically safe. Active surveillance is where doctors "watch and wait" for changes that could prompt medical intervention.
How Is Prostate Cancer Diagnosed?
Prostate cancer is largely a disease of men over 40, so it’s around this age doctors recommend the first prostate screening. The first exam is a blood test to determine if there are abnormal prostate specific antigen (PSA) levels in your blood – PSA is produced by the prostate. If the PSA is high, your doctor will perform a digital rectal exam, during which the doctor feels your prostate from inside your rectum with a gloved finger. Other diagnostic tests include an endoscopic biopsy of tumor tissue for analysis in a lab.
Prostate CancerProstate cancer is the most common cancer in men after skin cancer. Risk factors include age, family history, ethnicity, and diet. Prostate cancer is diagnosed by digital rectal exam, prostate specific antigen (PSA) test, and prostate biopsy. Symptoms may include frequent need to urinate, incontinence, pain, blood in the urine, fatigue, and more. Prognosis and treatment depend on cancer staging. Watchful waiting, surgery, radiation, cryotherapy, and other management strategies are available. Research and clinical trials strive to find new and better treatments for prostate cancer.
Prostate Cancer QuizIs prostate cancer the most common cancer in men? Take this quiz to find out and learn the causes, symptoms and treatments of this disease.
Prostate Cancer Treatment: Chemotherapy, Bone-Targeted and Immune Therapy
Doctors may introduce chemotherapy and immune therapy if other measures fail to cure a case of prostate cancer. However, unlike with other forms of cancer, chemotherapy isn’t the first choice for early prostate cancer. Immune therapy uses the body's own immune system to attack the prostate tumor, while bone-targeted therapy aims to preserve bone and prevent metastasis.
Prostate Cancer SlidesProstate cancer is the most common cancer in men. Learn the signs and symptoms of prostate cancer, along with causes and treatments. Know the stages, survival rates and lower your risk of prostate cancer.
Prostate Cancer (Prostatic Cancer) Symptoms and Causes
Difficulty with urination – frequency, weak stream, trouble getting started, etc. – is usually the first sign of prostate cancer. But these and other early symptoms of prostatic cancer can also come from benign prostate conditions, so diagnostic testing is important, including PSA tests and digital rectal exam.
Prostate Cancer Treatment: Radiation, Brachytherapy and Radiopharmaceuticals
Radiation treatment for prostate cancer is a powerful tool at doctors’ disposal. Using radiation vs. surgery or other invasive treatments to kill cancer cells may still cause side effects, but ideally they are less severe. Radiation therapy can be performed via external beam therapy (EBRT) or the placement of radioactive seeds into the prostate (prostate brachytherapy) or using radioactive drugs (radiopharmaceuticals).
Prostate Cancer Treatment: Radical Prostatectomy Surgery
Radical prostatectomy, or surgical removal of the entire prostate gland, isn’t typically the first choice in prostate cancer treatment. Sometimes a radical approach is necessary to keep the cancer from metastasizing, however. Some cases are too severe or diagnosed too late for drugs or radiation to have much effect. In these cases, treatment teams may opt for a radical prostatectomy, despite potential side effects like impotence and incontinence.
Prostate Cancer ScreeningProstate cancer screening may be able to detect cancer before a person has developed any symptoms. Prostate cancer is the most common nonskin cancer among American men. Tests commonly used to screen for prostate cancer include a digital rectal exam and a prostate-specific antigen test (PSA test).
Prostate Cancer Staging and Prognosis
The prognosis for prostate cancer, as with any cancer, depends on how advanced the cancer has become, according to established stage designations. The patient's PSA score at diagnosis, as well as their Gleason score (the grading system used to determine the aggressiveness of prostate cancer) determines the prognosis and final stage designation. Prostate cancer has a high survival rate in general, but your chances depend on the stage of the cancer.
Prostate Cancer Treatment: Hormonal Therapy
Prostate cancer is highly sensitive to, and dependent on, the level of the male hormone testosterone, which drives the growth of prostate cancer cells. Testosterone belongs to a family of hormones called androgens, and today front-line hormonal therapy for advanced and metastatic prostate cancer is called androgen deprivation therapy (ADT).