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Is Prostate Cancer Usually Fatal?

Prostate cancer is the result of the out-of-control growth of prostate cells. When prostate cancer is detected early (usually during routine screening tests), the prognosis is good and the survival rate is nearly 100%.
Prostate cancer is the result of the out-of-control growth of prostate cells. When prostate cancer is detected early (usually during routine screening tests), the prognosis is good and the survival rate is nearly 100%.

Prostate cancer occurs when cells in the prostate grow out of control. The prostate is a gland in men that helps produce fluid that goes into semen. The prostate is located in front of the rectum and just below the bladder. 

Because of routine screening tests, prostate cancer is often detected early, before the cancer has spread (metastasized) to other organs and it is not usually fatal. When detected early, there are various treatment options and a good chance of a cure. 

Life expectancy for prostate cancer is often expressed in five-year survival rates, that is, how many people will be alive five years after diagnosis. For men with localized prostate cancer, where there is no sign the cancer has spread outside the prostate, and regional prostate cancer, in which the cancer has spread outside the prostate to nearby structures or lymph nodes only, the five-year survival rate is nearly 100%. 

However, once the prostate cancer has spread (metastasized) to other organs such as the lungs, liver, or bones, the five-year survival rate drops to 30%.

What Are Symptoms of Prostate Cancer?

Early-stage prostate cancer often causes no symptoms. As the disease progresses, symptoms of prostate cancer may include: 

  • Problems urinating
    • Frequent urge to urinate, especially at night
    • Slow or weak urinary stream 
  • Blood in the urine or semen
  • Trouble getting an erection (erectile dysfunction, or ED)
  • Loss of bladder or bowel control from the cancer pressing on the spinal cord
  • Pain in the hips, back (spine), chest (ribs), or other areas from cancer that has spread to bones
  • Weakness or numbness in the legs or feet

What Causes Prostate Cancer?

The cause of prostate cancer is unknown but it is thought to be due to inherited or acquired genetic changes. 

Risk factors for developing prostate cancer include: 

  • Age: increased risk in men after age 50
  • Race/ethnicity: more common in African-American men and in Caribbean men of African ancestry than in men of other races
  • Geography: most common in North America, northwestern Europe, Australia, and the Caribbean islands
  • Family history
  • Gene changes
  • Other factors that might increase the risk of developing prostate cancer — though these links are less clear and have not been conclusively proven — include: 
  • High consumption of dairy products 
  • Obesity
  • Smoking
  • Prostatitis (inflammation of the prostate gland) 
  • Sexually transmitted infections, such as gonorrhea or chlamydia 
  • Vasectomy
  • Certain chemical exposures, such as Agent Orange

How Is Prostate Cancer Diagnosed?

Prostate cancer is diagnosed with a patient history and physical examination, which includes a digital rectal examination in which a doctor inserts a gloved finger into the rectum to examine the prostate to check for:

  • Size, firmness, and texture of the prostate
  • Hard areas, lumps, or growths beyond the prostate
  • Pain when touching or pressing on the prostate

Other tests to diagnose prostate cancer include: 

What Is the Treatment for Prostate Cancer?

Treatment for prostate cancer depends on whether cancer is in part or all of the prostate, if it has spread (metastasized) to other parts of the body, and the age and overall health of the patient, and may include one or more of the following:

  • Watchful waiting (active surveillance)
  • Surgery: removal of the entire prostate and some nearby tissue
  • Radiation therapy
    • Brachytherapy (internal radiation)
    • External beam radiation
  • Cryotherapy (also called cryosurgery or cryoablation)
    • Uses very cold temperatures to freeze and kill prostate cancer cells and most of the prostate
  • Hormone therapy
    • Androgen deprivation therapy (ADT) uses surgery or medicines to lower the levels of androgens made in the testicles
    • Orchiectomy (surgical castration)
    • Luteinizing hormone-releasing hormone (LHRH) agonists (also called LHRH analogs or GnRH agonists) are drugs that lower the amount of testosterone made by the testicles (also called medical castration)
    • LHRH antagonists
      • Degarelix (Firmagon) 
      • Relugolix (Orgovyx) 
  • Chemotherapy 
  • Immunotherapy 
    • Cancer vaccine (doesn’t stop prostate cancer from growing, but may help men live several months longer): Sipuleucel-T (Provenge) 
    • Immune checkpoint inhibitors
    • PD-1 inhibitor: pembrolizumab (Keytruda) 
  • Targeted therapy 
    • PARP (poly(ADP)-ribose polymerase) inhibitors
      • Olaparib (Lynparza) 
      • Rucaparib (Rubraca) 
  • Treatments for prostate cancer spread to bones
    • Bisphosphonates: zoledronic acid (Zometa) 
    • Denosumab (Xgeva) 
    • Corticosteroids
    • External radiation therapy
    • Radiopharmaceuticals
      • Radium-223 (Xofigo)
      • Samarium-153 (Quadramet)
      • Strontium-89 (Metastron)
  • Surgery
    • Kyphoplasty: stabilizes a painful collapsed bone in a spine that is weakened by prostate cancer
  • Pain medicines

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References
https://www.cancer.org/cancer/prostate-cancer.html