How long can you live with stage 4 prostate cancer with treatment

Medically Reviewed by Nazia Q Bandukwala, DO on March 01, 2022

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.

Prostate Cancer Is Common With Aging

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.

Prostate Cancer Survival Rates Are Favorable Overall

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:

  • 92% of all prostate cancers are found when they are in the early stage, called local or regional. Almost 100% of men who have local or regional prostate cancer will survive more than five years after diagnosis.
  • Fewer men (about 7 %) have more advanced prostate cancer at the time of diagnosis. Once prostate cancer has spread beyond the prostate, survival rates fall. For men with distant spread (metastasis) of prostate cancer, about one-third will survive for five years after diagnosis.

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:

  • the relative 10-year survival rate is 98%
  • the relative 15-year survival rate is 95%

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.

  • Signs & Symptoms
    • What Are Warning Signs & Symptoms of Prostate Cancer?
  • Causes & Risk Factors
    • What Are Causes of Prostate Cancer?
  • Diagnosis
    • How Do You Get a Prostate Cancer Diagnosis?
  • Treatment
    • How Is Prostate Cancer Treated?
  • Guide
    • What Is the Life Expectancy of Someone with Stage 4 Prostate Cancer? Topic Guide

How long can you live with stage 4 prostate cancer with treatment

Prostate cancer has a nearly 100% survival rate when it's localized (has not spread to other parts of the body), or regional prostate cancer, when it's spread to nearby structures or lymph nodes. Stage 4 prostate cancer that has spread to other organs has a 30% five-year survival rate.

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 long can you live with stage 4 prostate cancer with treatment

SLIDESHOW

Screening Tests Every Man Should Have See Slideshow

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) 
  • 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

From
How long can you live with stage 4 prostate cancer with treatment

Reviewed on 6/2/2021

References

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

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

What is the average life expectancy with stage 4 prostate cancer?

Stage IV Prostate Cancer Prognosis Prostate 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.

Is chemotherapy worth it for stage 4 prostate cancer?

Chemotherapy can slow the growth of cancer cells, relieve signs and symptoms of cancer, and prolong the lives of men with advanced prostate cancer.

Is stage 4 prostate cancer always terminal?

Treatments may slow or shrink an advanced prostate cancer, but for most men, stage 4 prostate cancer isn't curable. Still, treatments can extend your life and reduce the signs and symptoms of cancer.

How long can you live when prostate cancer spreads to bones?

Findings from one 2017 study estimated that in those with prostate cancer that spreads to the bones: 35 percent have a 1-year survival rate. 12 percent have a 3-year survival rate. 6 percent have a 5-year survival rate.