Lymph

Prognosis of Metastatic Prostate Cancer

Prostate Cancer Prognosis for Stage III

Stage III prostate cancer is the third in the common four stage TNM (Tumor/Nodes/Metastases) prognosis system. If your cancer has received a stage III diagnosis, this is characterized by a regionalized tumor than has spread beyond the prostate. At this point, the tumor has moved through the capsule that encloses the prostate and possibly into the seminal vesicles. While it has moved beyond the prostate, stage III prostate cancer generally has not yet reached the lymph nodes or any other distant sites in the body (such as bone metastases). Tests such as computed tomography, bone scans, and endorectal coil magnetic resonance imaging can determine if the cancer has spread elsewhere in the body and help classify the stage in which the prostate cancer is in.

Tumors that have been classified as Stage III tumors can often cause many difficulties including difficulties with urination due to their large size and bone pain. Common methods of treating difficulties with urination include surgical transurethral resection of the prostate (TURP), radiation therapy, surgery, or hormonal therapy. Bone pain can be lessened by radiation therapy.

One of the most common methods of treating stage III cancers is external beam radiation. External beam radiation uses a linear accelerator which produces high-intensity x-rays. These x-rays are then concentrated in a beam toward the prostate. This method is less invasive than alternatives such as surgery, but is a more effective option for larger, ?bulky? tumors. Radiation therapy can be used at all stages, both before surgery or if surgery fails. At this point, if the patient has not undergone surgery, some patients may opt for surgery, and still others may simply wait.

If surgery has occurred, and it is found that the cancer has spread through the capsule or into the lymph nodes, the tumor is reclassified as stage III. At this point, patients may go on to have postoperative radiation therapy. At this time, studies are being conducted to evaluate the effectiveness of this procedure.

The prognosis for men with stage III prostate cancer varies depending on the extent of the spread of the disease. The chances of progression once the cancer has broken through the prostate capsule are about 50/50. If the cancer has been found to have spread to the seminal vesicles the chances of reoccurrence are significantly increased. One study was conducted where cases of men who were treated with radiation therapy for prostate cancer were revisited 20 years later found that nearly half of the men in the study had eventually succumbed to the disease. At the same time, nearly as many of the studies? patients had died of other causes with no evidence of a prostate cancer recurrence.

Prostate Cancer Prognosis for Stage IV

Once the cancer has spread to the lymph nodes or other distant parts of the body, it is reclassified as Stage IV or metastatic prostate cancer. At this point in the disease, hormone therapy can be used to improve the symptoms for the patient and slow down the progress of the cancer for 2 or 3 years. If just the lymph nodes are involved, hormonal therapy can have even better success- possibly delaying the progress even further. Once the lymph nodes have been positively identified as cancerous, the majority of patients will remain at high risk of developing additional metastatic disease in the 10 years following the application of hormonal treatment. If bone metastases occur they may be less responsive to the hormonal therapy treatments. Radiation therapy, however, can be used to treat the often painful bone metastases common with stage IV prostate cancer.