As cancer diagnoses go, prostate cancer is often a less serious one.
Prostate cancer is frequently slow-growing and slow to spread. For many men, prostate cancer is less serious than their other medical conditions. For these reasons, and possibly because of earlier detection of low-grade prostate cancers,
prostate cancer has one of the highest survival rates of any type of cancer. WebMD takes a look at prostate cancer survival rates and what they mean to you. After skin cancer, prostate cancer is the most common cancer in men. About 1 in 7 men will be diagnosed with prostate cancer in their lifetime. And these are just the men who are diagnosed. Among very elderly men dying of other causes, a
surprising two-thirds may have prostate cancer that was never diagnosed. Only 1 in 36 men, though, actually dies from prostate cancer. That's because most prostate cancers are diagnosed in older men in whom the disease is more likely to be slow-growing and non-aggressive. The majority of these men eventually pass away from heart disease,
stroke, or other causes -- not their prostate cancer. Thinking about survival rates for prostate cancer takes a little mental stretching. Keep in mind that most men are around 70 when diagnosed
with prostate cancer. Over, say, five years, many of these men will die from other medical problems unrelated to prostate cancer. To determine the prostate cancer survival rate, these men are subtracted out of the calculations. Counting only the men who are left provides what's called the relative survival rate for prostate cancer. Taking that into consideration, the relative survival rates for most kinds of prostate cancer are actually pretty good. Remember, we're not counting men
with prostate cancer who die of other causes: Many men with prostate cancer actually will live much longer than five years after diagnosis. What about longer-term survival rates? According to the American Society of Clinical Oncology, for men with local or regional prostate cancer:Prostate Cancer Is Common
With Aging
Prostate Cancer Survival Rates Are Favorable Overall
Staging, Spread, and Survival Rates
As with all cancers, doctors use the term stage to describe the characteristics of the primary tumor itself, such as its size and how far prostate cancer has spread when it is found.
Staging systems are complicated. The staging system for most cancers, including prostate cancer, uses three different aspects of tumor growth and spread. It's called the TNM system, for tumor, nodes, and metastasis:
- T, for tumor (which means a swelling, a growth or mass, and describes the cancer as found in its place of origin) 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 the 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, the staging system is pretty simple. As we've mentioned, 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. about 30% will survive their prostate cancer for more than five years.
Staging prostate cancer is a sometimes-complex process that involves multiple tests, measurements and other factors. The aim is to determine the size, extent and aggressiveness of the cancer.
This article will cover:
- Types of staging
- Understanding prostate cancer’s progression
- Prostate cancer stages
- Prostate cancer survival rate
- Questions to ask your doctor
Types of staging
There are two types of staging for prostate cancer.
- Clinical staging: This is based on the results of pre-surgery procedures such as a prostate-specific antigen (PSA) test, a digital rectal exam (DRE), a Gleason score (a grade based on how cancer cells behave on a micro level) and imaging tests. A doctor uses these results to determine the stage of the cancer and decide whether to recommend further diagnostic exams, such as a magnetic resonance imaging (MRI) scan.
- Pathological staging: This type of staging is based on information uncovered after prostate surgery. The prostate tissue is examined to get a more detailed, and sometimes more accurate, stage of the disease.
Understanding prostate cancer’s progression
To determine the appropriate treatment, doctors need to know how far the cancer has progressed, or its stage. A pathologist, the doctor trained in analyzing cells taken during a prostate biopsy, will provide two starting points—the cancer’s grade and Gleason score.
- Cancer grade: When the pathologist looks at prostate cancer cells, the most common type of cells will get a grade of 3 to 5. The area of cancer cells in the prostate will also be graded. The higher the grade, the more abnormal the cells.
- Gleason score: The two grades will be added together to get a Gleason score. This score tells doctors how likely the cancer is to grow and spread.
After a biopsy confirms prostate cancer, the patient may undergo additional tests to see whether it has spread through the blood or lymph nodes to other parts of the body. These tests are usually imaging studies and may include a bone scan, positron emission tomography (PET) scan or computed tomography (CT) scan.
Your multidisciplinary team will work with you to develop a personalized plan to treat your prostate cancer in a way that fits your individual needs and goals.
Stages of prostate cancer
Doctors use the results of all these tests to help determine the stage of the prostate cancer, or how far it has progressed. Widely used staging criteria is based on the TNM system developed by the American Joint Committee on Cancer.
TNM staging system
The three key components of the TNM system, include:
- T (tumor) describes the tumor’s size, location and how deep it has grown into the tissue.
- N (node) indicates whether cancer cells have spread to nearby lymph nodes or the channels connecting the lymph nodes.
- M (metastasis) refers to whether the cancer cells have spread to distant organs or tissue.
The stage of cancer will help doctor and patient determine the most appropriate options for treatment. Prostate cancer stages range from 1 through 4.
- Stage 1 prostate cancer
- Cancer is on one side of the prostate.
- Cancers usually grow slowly.
- PSA level may not be high and the cancer may not be felt during a DRE.
- There is no lymph node involvement nor metastasis.
- Some cancers that are felt during a DRE may still be classified as stage 1 if the Gleason score is 6 or less and the PSA is lower than 10.
- Stage 2 prostate cancer means the cancer remains confined to the prostate gland. It has
three substages:
- Stage 2A:
- The cancer is on one or both sides of the prostate gland.
- The PSA blood test level is between 10 and 19.
- The Gleason score is 6 or less.
- Stage 2B:
- The cancer is on one or both sides.
- The PSA is lower than 20.
- The Gleason score is 7.
- Stage 2C:
- The cancer is on one or both sides.
- The PSA is lower than 20.
- The Gleason score is 7 to 8.
- Stage 2A:
- Stage 3 prostate cancer means the cancer is locally advanced. The tumor has progressed and is more likely to grow and spread, with both the Gleason score and the PSA being high. This stage also has three substages:
- Stage 3A:
- The cancer is on one or both sides of the prostate.
- The PSA is 20 or higher.
- The Gleason score may be as high as 8.
- Stage 3B:
- The cancer has spread outside the prostate gland to nearby tissues but not to the lymph nodes.
- The PSA may be any level.
- The Gleason score may be up to 8.
- Stage 3C:
- This stage is similar to 3B, but the cancer may not be growing beyond the prostate.
- The Gleason score is 9 or 10.
- Stage 3A:
- Stage 4 prostate cancer means the
cancer has spread to lymph nodes or to other parts of the body. It is further divided into two substages:
- Stage 4A: The cancer has spread to nearby lymph nodes but may or may not have spread to nearby tissues.
- Stage 4B: The cancer has spread to another area of the body, such as the bones or distant lymph nodes.
Learn more about metastatic stage 4 prostate cancer
Prostate cancer survival rate
If the prostate cancer hasn’t spread to distant parts of the body (stages 1 to 4A), the five-year survival rate is almost 100 percent, according to the American Cancer Society. The survival rate for stage 4B is about 30 percent.
Questions to ask your doctor
To help understand the progression of prostate cancer, discuss these questions with your doctors:
- What is my Gleason score?
- Has the cancer spread outside my prostate?
- What’s my prostate cancer stage?
- Are other tests needed to determine my cancer stage?
- What are the treatment options for my stage of prostate cancer?
- Can I avoid treatment right now and go on active surveillance?