Life Expectancy of Metastatic Prostate Cancer

The life expectancy of someone with cancer depends on the extent of metastasis and which organs are involved. Metastatic prostate cancer is designated as stage IV:

• Stage IVA: Cancer has progressed to surrounding lymph nodes but not to distant locations.
• Stage IVB: Cancer has progressed to distant tissues and organs, such as the bones or smooth muscles.

Generally, prostate cancers do not spread rapidly to other areas of the body. Most prostate tumors grow slowly and may not cause symptoms or complications for years, if at all.

Even when prostate cancer has spread to other regions of the body, it is usually treatable for an extended period. As a result, even men with advanced prostate cancer can enjoy good health for many years. However, if not properly treated, prostate cancer can cause serious symptoms and even turn fatal.

The main cause of prostate cancer is unknown. However, several factors may increase the risk of developing the disease:

• Age: As you become older, your chances of acquiring prostate cancer increase. Most of the prostate cancer cases are observed in men over the age of 50 years.
• Ethnicity: Prostate cancer is more common in Black men and less common in Asian men for unknown reasons.
• Genetics: Men who have a parent or sibling who has had prostate cancer are at a slightly higher risk of developing prostate cancer.
• Obesity: Studies have revealed that obesity may potentially raise the risk of prostate cancer.

The prostate is a tiny, walnut-sized gland located under the bladder and is part of the male reproductive system. The main function of the prostate is to produce a fluid that, when combined with sperm produced by the testicles, creates semen.

Men with advanced prostate cancer may or may not show any symptoms. Symptoms vary depending on the size and location of the tumor. In severe cases, you may experience some or all of the following symptoms:

• Difficulty passing urine
• Blood in urine
• Pain
• Fatigue
• Weakness
• Weight loss
• Bone pain, if the prostate cancer has spread to the bones

Treatment for prostate cancer is determined based on the size of the tumor and extent of metastasis and may include the following:

Hormone therapy

Hormone treatment deprives the body of the male hormones needed for prostate cancer growth. Orchiectomy or luteinizing hormone-releasing hormone analogs are used alone or in conjunction with an anti-androgen.

Newer hormonal drugs that decrease androgen production (abiraterone) and block androgen receptor signaling (enzalutamide) have been approved by the FDA for the treatment of metastatic prostate cancer following chemotherapy, and they are being studied for early usage in the disease.

Abiraterone

Abiraterone is an oral targeted medication that inhibits androgen synthesis not only in the testes but also in the adrenal glands and the tumor itself. When used with prednisone, abiraterone has been demonstrated to improve quality of life and decrease pain progression in patients with hormone-refractory prostate cancer (HRPC). 

Although this drug is normally well tolerated, adverse effects such as tiredness, elevated blood pressure, and electrolyte or liver problems are possible, and patients must be checked on a regular basis.

Enzalutamide

Enzalutamide interferes with molecular processes that enable prostate cancer growth by targeting various stages in the androgen-receptor-signaling cascade. Furthermore, the medicine does not cause the typical adverse effects of chemotherapy, such as nausea and hair loss. 

In men with HRPC, enzalutamide has been found to enhance survival, lower the risk of cancer progression, and postpone the need for more chemotherapy.

Chemotherapy

Chemotherapy involves using cancer-fighting medications that circulate in the blood to areas of the body where the disease has spread and can kill or eradicate cancer cells in areas far from the initial tumor. Several chemotherapeutic medicines have been shown to destroy cancer cells in advanced prostate cancer patients, including mitoxantrone, docetaxel, paclitaxel, and estramustine.

Targeted therapy

Recently, several novel chemotherapy medications and targeted therapy medications for the treatment of advanced prostate cancer have been licensed. Targeted therapy is one that is intended to treat just cancer cells while causing minimal harm to normal, healthy cells. Treatments that target cancer cells have the benefit of having fewer treatment-related adverse effects and better results. Doctors are researching the optimum sequence, combinations, and time for using newer chemotherapy and targeted treatment medications.

Immunotherapy

Immunotherapy is known by several other names, including biological therapy, immunologic therapy, immunotherapy, and biotherapy. Biological therapy is a type of treatment that employs the immune system to help kill cancer cells. Interferon, interleukin, monoclonal antibodies, colony-stimulating factors (cytokines), and vaccinations are examples of biological therapies.

Sipuleucel-T

Sipuleucel-T is a type of immunotherapy that stimulates the immune system to fight cancer cells. A Phase III clinical trial known as IMPACT (Immunotherapy for Prostate Adenocarcinoma Treatment) led to the FDA approval of sipuleucel-T by demonstrating an improvement in overall survival for men treated with sipuleucel-T. Chills, fever, and headache were the most common adverse effects recorded.