Prostate Cancer Prognosis
Your prostate cancer prognosis largely depends on what stage of cancer you are in when it is discovered, and what grade of cancer it is. The type of treatment you choose has a part in it too, but not as much as the spread of the cancer before it is diagnosed.
As you would probably expect, the best prognosis for prostate cancer patients is for those with well-differentiated, slow-growing and smaller tumors. There is good news here – about seventy-five percent of all prostate cancers newly diagnosed are localized and in stages one or two.
If your type of prostate cancer is limited to the gland itself, and it has a Gleason score of seven or lower, your five year outcome can be considered excellent, whether you treat with radiation, surgery or even watchful waiting. Even men who have had prostate cancer for ten years have a good outlook, if they are in stage one or two and have a low Gleason score.
Since the median age at diagnosis is about 72 years of age, many men who have prostate cancer actually die of other causes within ten to fifteen years of their initial diagnosis. Not many men who have localized, low grade disease will actually die of prostate cancer. The survival rate of the disease, excluding other causes of death, is close to ninety percent. Regardless of the type of treatment you select, even if it’s only watchful waiting, you may be able to consider your prostate cancer as a chronic disease, since you are more likely to die from another cause.
Men who have localized tumors who decide to just wait and watch, and if they live many years, may have a higher risk of developing – eventually – metastatic cancer. In a recent study, men with well-differentiated tumors had a nineteen percent chance of developing metastases within ten years. The
same test showed a forty-two percent risk among men who had moderately differentiated tumors.
Radiation therapy or surgery are normally the treatments chosen by men whose tumors may be localized, but that are poorly differentiated, with an eight to ten score on the Gleason scale. If aggressive treatment isn’t pursued, about seventy-five percent of these men will develop metastatic cancer in the next ten years. Two thirds of this group will die from prostate cancer without treatment, but the outcome is not all that much better even if they undergo therapies.
Not all cancers that seem localized are actually limited to the area within the prostate. When pathologists examine biopsy tissue, they find that nearly fifty percent show that the cancer has broken through the capsule of the prostate and invaded the seminal vesicles. So, many cancers that are technically in stage one or two should be reclassified as stage three after these findings are reported.
In some cases, even verified stage one or two cancers can still spread to other areas. Up to twenty-five percent of these patients will have a prostate cancer recurrence in the next several years. Medicare records have shown that more than thirty-three percent of men who are treated with a radical prostatectomy need additional treatments for cancer within five years.