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Prostate Cancer is one of the most common types of cancer that develop in men and is the second leading cause of cancer deaths in American men, behind lung cancer and just ahead of colorectal cancer. The Prognosis for Prostate Cancer, as with any cancer, depends on how advanced the cancer has become, according to established stage designations. Prostate gland is a walnut - size gland present only in men, found in the pelvis below the bladder. Prostate gland wraps around urethra and lies in front of the rectum. Prostate glands secrete part of the liquid portion of semen, or seminal fluid, which carries sperm made by testes. Fluid is essential to reproduction. The term stage Cancer is meant to describe the obvious extent of cancer in the body at the time that cancer is first diagnose. Clinical staging of Prostate Cancer is based on pathology results, physical examination, PSA, and, if appropriate, radiologic studies. Stage of Cancer helps doctors understand the extent of cancer and plan Cancer Treatment. Knowing overall results of different treatments for similarly stag prostate cancers can help doctors and patients make important decisions about choices of treatment to recommend or to accept. Prostate Cancer comprises nearly always adenocarcinoma cells - cells that arise from glandular tissue. Cancer cells are named according to the organ in which they originate, no matter where in the body we find such cells. If Prostate Cancer cells spread from body to bones, it is labelled Prostate Cancer metastatic to bones, not bone Cancer. Metastasis is a process of cancer spread through the blood or lymphatic system to other organs / areas throughout the body. In late stages of disease, Prostate Cancer more commonly metastasizes to lymph nodes in the pelvis and to bones. Cancer staging is first described using what is called the TNM system. T refers to description of size or extent of primary, or original, tumor. N describes the presence or absence of, and extent of spread of cancer to lymph nodes that may be nearby or further from the original tumor. M describes the presence or absence of metastases - usually distant areas elsewhere in the body other than regional lymph nodes to which cancer has spread. Cancers with specific TNM characteristics are then grouped into stages, and stages are then assigned Roman numerals with numerals used in increasing order as the extent of cancer being stag increases or cancer prognosis worsens. Prognosis is finally reflected by considering the Patient's PSA Score at presentation as well as their Gleason Score in assigning final stage designation. The American Joint Commission on Cancer system for Prostate Cancer staging is as follow: T designations refer to characteristics of Prostate Cancer primary tumor. T1 Prostate cancers cannot be seen on imaging tests or felt on examination.
As with all cancers, doctors use the term stage to describe characteristics of the primary tumor itself, such as its size and how far prostate cancer has spread when it is find. Staging systems are complicate. Staging systems for most cancers, including prostate cancer, use three different aspects of tumor growth and spread. It's called TNM system, for tumor, nodes, and metastasis: t, for tumor describes the size of the main area of prostate cancer. N, for nodes, describes whether prostate cancer has spread to any lymph nodes, and how many and in what locations. M, for metastasis, means distant spread of prostate cancer, for example, to bones or liver. Using the TNM system, each man's prostate cancer can be described in detail and compared to other men's prostate cancer. Doctors use this information for studies and to decide on treatments. As far as survival rates for prostate cancer go, however, staging system is pretty simple. As we 've mention, in terms of survival rates, men with prostate cancer can be divided into two groups: men with prostate cancer that is localized to the prostate or just nearby. These men have a high long - term survival rate for their prostate cancer. Almost all will survive their prostate cancer for longer than five years - and well beyond for many men. Men whose prostate cancer has spread to distant areas, like their bones. These men may need more aggressive treatment for their prostate cancer. Fewer of these men - about one - third - will survive their prostate cancer for more than five years.
There are no UK - wide statistics available for all stages of prostate cancer. Survival for all stages is available for England and Wales. These figures are for people diagnosed between 2010 - 2011. Generally, for men with prostate cancer in England and Wales: almost 95 out of 100 will survive their cancer for 1 year or more around 85 out of 100 will survive their cancer for 5 years or more almost 85 out of 100 will survive their cancer for 10 years or more survival for prostate cancer is also report in Scotland and Northern Ireland. But it is difficult to compare survival between these countries because of differences in the way information is collect.
When prostate cancer spreads beyond the prostate to another organ, most frequently it spreads to the bone. Prostate cancer that spreads to the bone is still prostate cancer when doctors look at it under microscope. It is still treated with therapy for prostate cancer. Men whose prostate cancer spread to the bone do not have bone cancer. He has prostate cancer that now has the ability to travel through his blood, land in his bones, and grow. More than 60 percent of men with advanced prostate cancer will eventually develop bone metastases. The bones most commonly affected are the spine, hips, and ribs. Once prostate cancer has spread to the bone, it can become a painful process, but treatments like pain medications or radiation therapy for those areas can dramatically reduce pain and improve quality of life. When making treatment plan, it is important to include strategies to maintain good bone health. In addition to complications from the spread of cancer, prostate cancer treatment can negatively affect bones and increase the risk of fracture and skeletal related events. Fortunately, there are several treatments available to strengthen bones, prevent metastases, and manage spread and pain. These include bisphosphonates or denosumab, radiation, and radiopharmaceuticals.
Prostate CAncer is the second most common cause of CAncer death in Australian men. When localise, it can be cured with surgery or radiotherapy, but some patients will relapse with either overt metastases or isolated rise in Prostate specific antigen. A proportion of these patients are found to have local relapse and can have salvage Therapy, but the remainder of cases are considered to have incurable advanced disease. There is also a proportion of men who have metastases when Prostate CAncer is first diagnose. Management of advanced diseases is predominantly medical. While CAncer is incurable, it is not untreatable.
Early anti - androgens include non - steroidal drugs and steroidal drug cyproterone acetate. Even though these drugs have less benefit compared to newer drugs, they are widely used in castrate - resistant diseases as first - line drugs to achieve combined androgen blockade. This is for several reasons - current prescribing rules state that new anti - androgens are only subsidise in Australia for patients who are unfit for, or have already progress after, chemotherapy and many men wish to delay having chemotherapy. In addition, because of the longitudinal nature of prostate cancer treatment, these anti - androgens allow additional time for oral treatments. Many men will respond and these drugs can delay time to progression and need for newer drugs which can then be used later in the disease course. Bicalutamide is most widely used due to its once - daily dosing and better tolerability. 8 common adverse effects of first - line anti - androgens are similar to those of androgen deprivation therapy. Nilutamide causes changes in light accommodation. Cyproterone acetate increases cardiovascular risk and is not widely used. These drugs can also be used sequentially as second - line therapy after progression to another anti - androgen as there may be brief response in select cohort of patients. For example, flutamide could be tried after patient progress despite taking bicalutamide. 9 However, in the current era, older anti - androgens are rarely used in second - or third - line settings.
Discerning whether a patient has widely advanced disease versus locally advanced disease assists in determining what treatment options are available. Historically, systemic therapy for metastatic and advanced Prostate Cancer has involved androgen suppression. In metastatic disease, this palliative therapy has yielded median progression - free survival of 18 - 20 months and overall survival of 24 - 36 months. However, virtually all patients develop hormone - refractory disease. Although hormone therapy is associated with significant responses, its curative potential is limited because of the inherent heterogeneity of Prostate Cancer and inability of hormones to eradicate all Prostate Cancer clones, both androgen - dependent and androgen - independent components. Despite a steady decline in incidence of newly diagnosed metastatic Prostate Cancer and microscopic lymph node metastasis, from 20% in 1970s to 5% in 2013, risk of extraprostatic disease in patients with clinically localized disease remains high, at 30 - 60%. Depending on Prostate - specific antigen value, pathologic stage, and histologic grade of tumor, approximately 50% of clinically localized Prostate cancers are estimated to progress despite initial treatment with intent to cure. In some cases of hormone - refractory Prostate Cancer, Prostate Cancer may continue to exhibit hormone dependence. Currently, it is not possible to predict whether these patients may benefit from androgen withdrawal if they continue hormone therapy. Supportive inpatient care may be required for pain management in terminally ill patients with progressive Prostate Cancer in whom all measures have failed to elicit response. Patients diagnosed with impending paralysis due to spinal cord compression or patients with pathologic fractures should be immediately immobilized until appropriate consultations are obtain.
No cure for metastatic prostate cancer is currently available, but new therapies are extending life beyond what was possible few years ago. In general, your long - term outlook and life expectancy will depend on factors like: age, overall health, including other conditions you have, extent of metastases, grade of tumor Gleason score, prostate specific antigen levels types and response to treatments you receive prostate cancer and treatments can affect men differently. Some treatments will be more effective for some people than others. Your doctor will be able to discuss your long - term outlook with you. This can be helpful when making plans for the future.
The prognosis of stage 4 disease varies considerably depending on how far the cancer has spread. This can be done by breaking stage 4 down into two parts. Stage 4 with regional metastases: Prostate Cancer that is called stage 4 due to large tumor size or due to spread to nearby lymph nodes has a five - year survival rate of nearly 100%. Stage 4 with distant metastases: According to National Cancer Institutes SEER data, people who have stage 4 Prostate Cancer with spread to distant lymph nodes or to other regions of the body such as bones, had a five - year survival rate of 30.
Hormone therapy deprives man's body of male hormones necessary for prostate cancer to grow. Initial hormone therapy for prostate cancer can be achieved with orchiectomy or luteinizing hormone - releasing hormone analogues, alone or in combination with anti - androgen. Newer hormonal medications that inhibit synthesis of androgen Zytiga and block androgen receptor signaling Xtandi are now FDA - approved for treatment of metastatic prostate cancer after treatment with chemotherapy, and are being evaluated for earlier use in disease. Zytiga is an oral targeted agent that blocks production of androgens not only by testes, but also by adrenal glands and tumor itself. Zytiga when administered with prednisone has been shown to improve quality of life and delay patient - reported pain progression in HRPC patients. Although this medication is generally well - tolerate, side effects may include fatigue, high blood pressure, and electrolyte or liver abnormalities and patients need to be monitored regularly. Xtandi e nzalutamide targets multiple steps in the androgen - receptor - signaling pathway, interfering with molecular pathways that help prostate cancer grow. Whats more, drugs do not cause side effects commonly associated with chemotherapy, such as nausea and hair loss. Xtandi has been shown to improve survival, reduce risk of cancer progression, and delay the need for additional chemotherapy in men with HRPC.
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