Prostate cancer occurs as a result of out-of-control growth of cells in the prostate. The prostate is a gland located in front of the rectum and just below the bladder in men where the fluid that goes into semen is produced.
Life expectancy for prostate cancer is calculated in five-year survival rates. This means the percentage of people who may be alive five years after their diagnosis.
For men with localized prostate cancer, where there is no sign cancer has spread outside the prostate, and regional prostate cancer, in which cancer has spread outside the prostate to nearby structures or lymph nodes only, the five-year survival rate is nearly 100%.
Once the prostate cancer has reached stage 4 and spread (metastasized) to other organs such as the lungs, liver, or bones, the five-year survival rate drops to below 30%. At stage 4, prostate cancer is unlikely to be cured, but many patients can live several years with effective treatment. Life expectancy depends on the patient and the specific characteristics of his cancer.
However, because of routine screening tests, prostate cancer is often detected early, before cancer has spread to other organs and it is not usually fatal. When detected early, there are a number of treatment options and a good chance of a cure.
What Are Warning Signs & Symptoms of Prostate Cancer?
Prostate cancer often causes no symptoms, especially with early-stage prostate cancer. As prostate cancer progresses, symptoms may include:
- Trouble urinating, which can include:
- Going to the restroom frequently, especially at night
- Slow or weak urinary stream
- Blood in urine or semen
- Difficulty getting an erection (erectile dysfunction, or ED)
- Loss of bladder or bowel control if the cancer presses on the spinal cord
- Pain in the hips, back (spine), chest (ribs), or other areas from cancer that spreads to bones
- Weakness or numbness in the legs or feet
What Are Causes of Prostate Cancer?
The cause of prostate cancer is unknown but it may be due to inherited or acquired genetic changes.
Risk factors for developing prostate cancer include:
- Age: increased risk in men after age 50
- Family history
- Gene changes
- 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
- Other factors that might increase the risk of developing prostate cancer – though these links are less clear and have not been conclusively proven — include:
- Smoking
- High consumption of dairy products
- Obesity
- Sexually transmitted infections, such as gonorrhea or chlamydia
- Prostatitis (inflammation of the prostate gland)
- Vasectomy
- Certain chemical exposures, such as Agent Orange
How Do You Get a Prostate Cancer Diagnosis?
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, texture, and firmness of the prostate
- Lumps, hard areas, or growths beyond the prostate
- Pain when touching or pressing the prostate
Other tests to diagnose prostate cancer include:
- Blood test to check prostate-specific antigen (PSA) levels
- Prostate health index (PHI) blood test
- Prostate cancer urine test
- Imaging test of the prostate gland
- Magnetic resonance imaging (MRI) (especially multiparametric MRI)
- Transrectal ultrasound (TRUS)
- Biopsy of the prostate
How Is Prostate Cancer Treated?
Treatment for prostate cancer depends on whether cancer is in part or all of the prostate, if the cancer has spread (metastasized) to other parts of the body, and the age and overall health of the patient. Treatment 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)
- Goserelin (Zoladex)
- Histrelin (Vantas)
- Leuprolide (Lupron, Eligard)
- Triptorelin (Trelstar)
- LHRH antagonists
- Degarelix (Firmagon)
- Relugolix (Orgovyx)
- Chemotherapy
- Cabazitaxel (Jevtana)
- Docetaxel (Taxotere)
- Estramustine (Emcyt)
- Mitoxantrone (Novantrone)
- 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)
- PARP (poly(ADP)-ribose polymerase) inhibitors
- 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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https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-advancements-in-screenings
https://www.texasoncology.com/types-of-cancer/prostate-cancer/stage-iv-d-prostate-cancer