What is the prognosis for men with prostate cancer?

There are several factors that affect the likely course of disease for men with prostate cancer:

  • The state of the cancer (level of prostate-specific antigen, PSA), Gleason score, grade of the tumor, how much of the prostate is affected by the cancer, and whether or not the cancer is localized to the prostate or has become metastatic, meaning it has spread to other places in the body
  • The age of the patient
  • Whether the cancer has just been diagnosed for the first time or has recurred (come back) after initial diagnosis
  • Family history

Doctors work with men who have prostate cancer to determine their individual prognosis and determine an appropriate course of treatment based on these factors and on the severity and impact of prostate cancer on daily life (shown as disease burden).

 

sequence of disease progression

 

How does prostate cancer progress?

The majority of men with prostate cancer have localized disease at the time of diagnosis, meaning that the cancer has not spread outside the prostate gland.  Prostate cancer screening may help increase the chances of early diagnosis, when the disease is still contained within the prostate. Prostate cancer is considered advanced if it has spread, or metastasized, beyond the prostate gland and the area around the prostate.

 

Some men who present with localized disease may be cured with localized treatment such as with surgery and/or radiation therapy.  Those that progress following such treatments are usually started on hormonal therapy to decrease levels of the androgen testosterone, the male hormone that causes prostate cancer to grow. This treatment is called androgen deprivation therapy (ADT), and it can stop your body from making testosterone or stop the action of testosterone.  The journey through the course of prostate cancer can take from several years to decades from the time of diagnosis.