The survival rate in most people with advanced prostate cancer (Stage IV) is 30 percent at the fifth year of diagnosis. This means around 70 percent of the diagnosed men are not alive in the fifth year after diagnosis.
Most advanced-stage prostate cancer is diagnosed in older men. Studies have shown that some of the following complications are the most common cause of death:
- Cardiac causes
- Complications of surgical procedure
- Chronic lower respiratory disease
- Pulmonary embolism
What is prostate cancer?
The prostate lies below the bladder and in front of the rectum. In men, the size of the prostate increases with increasing age. In younger men, it is about the size of a walnut. Its primary function is to make fluid to nourish the semen.
Growth in the prostate can be of two types
- Benign growths: These are noncancerous growths and are rarely a threat to life. For example, benign prostatic hyperplasia.
- Malignant growths: These are cancerous growths that can sometimes be life-threatening.
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.
How is advanced-stage prostate cancer treated?
Prostate cancer diagnosed in the advanced stages is difficult to cure, although many people live for many years with effective treatment. Prostate cancer that has spread to distant organs and bones is treatable but cannot be cured with current standard therapies.
Treatment choices for advanced-stage prostate cancer involve
- Hormone therapy - Hormone therapy intends to lower a man’s testosterone or hormone levels. Testosterone is the main energy source for prostate cancer cells. Hormone therapy targets to slow down the prostate cancer growth in men with stage IV prostate cancer. Hormone therapy options include:
- Medications that stop the body from producing testosterone: Some of the commonly used medications include leuprolide, goserelin, triptorelin, histrelin, and degarelix.
- Orchiectomy: It involves the removal of testicles to lower testosterone levels in the body.
- Anti-androgens: Medications that block testosterone from reaching cancer cells include bicalutamide, flutamide, and nilutamide.
- Radiation therapy - Radiation therapy for advanced-stage prostate cancer uses a large machine that directs high-energy beams to the area around cancer. Radiation therapy may also be used to prevent pain or fractures caused by cancer spreading to the bone.
- Surgery - Surgery isn’t a treatment option for stage IV prostate cancer. However, it might be recommended in certain situations. Surgery is usually an option for men who are experiencing signs and symptoms that require surgical intervention.
- Chemotherapy - Chemotherapy can treat advanced-stage prostate cancer by
- Delaying the growth of cancer cells.
- Easing signs and symptoms of cancer.
- Extending the lives of men with advanced prostate cancer.
- Immunotherapy - Immunotherapy destroys cancer kills by using the immune system. Sipuleucel-T is used to destroy prostate cancer cells.
- Treatment directed at bone complications - These include drug therapy or radiation therapy. Drugs used to treat bone complications include
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American Cancer Society. Survival Rates for Prostate Cancer. https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/survival-rates.html
Mayo Clinic. Stage 4 Prostate Cancer. https://www.mayoclinic.org/diseases-conditions/stage-4-prostate-cancer/diagnosis-treatment/drc-20377972
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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).