Sunday, March 3, 2024

What Is Stage 4 Prostate Cancer

Bone Pain In Prostate Cancer

What is Life Expectancy for Stage 4 Prostate Cancer?

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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What Does It Mean For Prostate Cancer To Spread

Cancer cells can spread to other parts of the body. Doctors say the cancer has âmetastasizedâ or spread if this occurs.

Prostate cancer can spread to:

These symptoms can also occur with aging and an enlarged prostate. As a result, some people may ignore them instead of seeking medical attention.

According to the Prostate Cancer Foundation, age is the biggest contributing factor to prostate cancer risk. Doctors diagnose an estimated 60% of all prostate cancers in males older than 65 years of age.

It states that additional risk factors for prostate cancer include:

  • Family history: People with a close relative who has had prostate cancer may be twice as likely to get prostate cancer as those who do not.
  • Race: Males of African descent are about 75% more likely to develop prostate cancer than white males and more than twice as likely to die from the condition.
  • Smoking: A history of smoking is associated with a higher risk of aggressive prostate cancer.

Researchers are also studying a link between diet and increased prostate cancer risk. Diets high in calcium or low in vegetables may cause an increased risk of aggressive prostate cancer.

What Is My Outlook

If youre diagnosed with advanced prostate cancer, you may want to know how well your treatment is likely to control your cancer and for how long it will control it. This is sometimes called your outlook or prognosis. But not all men will want to know this.

While it isnt possible to cure advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain.

No one can tell you exactly what your outlook will be, as it will depend on many things such as where the cancer has spread to, how quickly it has spread, and how well you respond to treatment. Some men may not respond well to one treatment, but may respond better to another. And when your first treatment stops working, there are other treatments available to help keep the cancer under control for longer. Speak to your doctor about your own situation and any questions or concerns you have.

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Treatments To Control And Prevent Symptoms Caused By The Spread Of Prostate Cancer To The Bones

Palliative External beam radiotherapy

Radiopharmaceuticals: Strontium-89 , samarium-153

Radium-223 dichloride is now licensed and called Xofigo. This is not widely available in the UK but BPC is one of a relatively small number of specialist centres using this treatment.

Zolidronic acid a bisphosphonate given by a 15 minute intravenous infusion every 34 weeks. It reduces the risk of bone complications, including pain and fractures.

Xgeva : this is a newly licensed drug available at BPC.

Pain medications

Surgery may be undertaken to treat bone fractures or to relief the pressure on the spinal cord by bone metastases.

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Stage 2 Prostate Cancer

Staging Of 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

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Advanced Prostate Cancer And Bone Metastases

Most all prostate cancer patients worry about metastases. Metastases used to signal that death was near. Most prostate cancer metastases take place in bones. New treatments such as Xofigo have helped thousands of men delay health while maintaining a pain free high quality of life. Bone metastases are tumors that have spread from the prostate to your bones. Usually bone metastases occur in the pelvis, spine, thighs and ribs. But, they can develop in any bone anywhere in your body. Bone metastases can become extremely painful. Which is why it is reasonable and very human to fear bone metastases. So, if you are feeling anything that you imagine to be bone pain, talk to your doctor right away.

Diagnosing Bone Metastases

Bone metastases symptoms are sometimes confused with arthritis. The symptoms such as pain seem to be the same. So, if you are already diagnosed with prostate cancer, you must talk to your doctor about anything at all that you imagine to be pain in your bones. X-rays can diagnose bone metastases best, but bone scans, CT scans, PET scans, MRIs and blood tests are also used for diagnosis.

Untreated bone metastases in a man with castrate resistant prostate cancer could cause fractures and other skeletal problems none of which are pleasant.

Early detection of bone metastases allows more effective treatment to delay bone pain and other complications.

Preventing and Treating Bone Metastases

The most common side effects of Radium 223 are:

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Prostate Cancer Risk Groups

In addition to stage, doctors may use other prognostic factors to help plan the best treatment and predict how successful treatment will be. Examples of these include the National Comprehensive Cancer Network risk group categories and the Cancer of the Prostate Risk Assessment risk score from University of California, San Francisco.

Information about the cancers stage and other prognostic factors will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

What Are Stage 4 Prostate Cancer Treatments

What are the Treatment Options for Stage 4 Prostate Cancer?

After prostate cancer has spread to other parts of your body and reached the final stage it is often incurable. Some treatments may be able to shrink tumors or slow the cancers spread.

Hormone blocking therapy

Prostate cancer needs the male hormone testosterone to grow. Blocking or preventing your body from making testosterone can potentially slow the cancers spread or even shrink tumors. Testosterone can be blocked with many different types of medications or surgery to remove your testicles.

In late-stage prostate cancer, hormone therapy is usually used alone but can also be combined with other treatments.

Radiation and chemotherapy

Radiation therapy may be recommended in stage 4 prostate cancer for men with very large tumors or cancer that has spread to the lymph nodes and other areas. It is often combined with hormone therapy or used after surgery to kill off any remaining cancer cells.

Chemotherapy might be recommended for people with stage 4 prostate cancer in combination with hormone therapy or other treatments. It can help relieve some of your prostate cancer symptoms and potentially prolong your life expectancy.

Surgical treatment

Pain relief and supportive care

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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.

The Tnm System For Prostate Cancer Stages

As they do for most cancers, doctors use the TNM system to describe prostate cancer stages. The system uses three different aspects of tumor growth and spread:

  • Tumor. Whatâs the size of the main area of prostate cancer?
  • Nodes. Has it spread to any lymph nodes? If so, how far and how many?
  • Metastasis. How far has the prostate cancer spread?

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Can Stage 5 Prostate Cancer Be Cured

Outlook for men with advanced prostate cancer

While it isnt possible to cure advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain. Some men may not respond well to one treatment, but may respond better to another.

Local Signs And Symptoms

Stage 4 Prostate Cancer With Bone Metastases Life Expectancy

In the pre-PSA era, patients with prostate cancer commonly presented with local symptoms. Urinary retention developed in 20-25% of these patients, back or leg pain developed in 20-40%, and hematuria developed in 10-15%. Currently, with PSA screening, 47% of cases are diagnosed in asymptomatic patients. In symptomatic patients, the most common complaints are urinary frequency , decreased urine stream , urinary urgency , and hematuria . However, none of these symptoms is unique to prostate cancer each can arise from various other ailments.

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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:

Can Stage 2 Prostate Cancer Be Cured

Patients with stage II prostate cancer are curable and have a number of treatment options, including surgical removal of the cancer with radical prostatectomy, radiation therapy with brachytherapy or External Beam Radiation or active surveillance without immediate treatment.

What is the survival rate of stage 4 prostate?

Stage IV Prostate Cancer PrognosisProstate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate.

What is the most successful prostate cancer treatment?

Radiation therapy is a good choice for many men with early-stage prostate cancer. It is also the best treatment for older men or those who have other health problems. There are different types of radiation therapy: External beam radiation.

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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 Doctors 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 hasnât 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.

Survival Rates For Prostate Cancer

Living with advanced prostate cancer

Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. These rates cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.

Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Ask your doctor, who is familiar with your situation, how these numbers may apply to you.

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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.

What Are My Treatment Options With Advanced Prostate Cancer

The treatments your doctor recommends will depend on factors specific to you, from your overall health to how advanced your cancer was when it was first diagnosed.

Many men receive ADT, a type of hormone therapy, which deprives the body of the male hormones that the cancer needs to keep growing.

For most men, however, hormone therapy stops working at some point. Alternatives to hormone therapy were approved by the Food and Drug Administration in 2018, and Tagawa often starts men on these therapies as soon as theyre diagnosed with bone metastases. Other treatment options may be available through clinical trials.

In addition, chemotherapy, surgery, and immunotherapy as well as radiation treatments, like external beam radiation, which directly target bone problems may be considered. Major cancer centers, such as Memorial Sloan Kettering Cancer Center in New York City and MD Anderson Cancer Center in Houston, have teams of prostate cancer specialists, as well as sophisticated radiation and other treatment equipment consolidated in one place, which can help with the coordination of care.

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