Can You Ever Be Cured of Prostate Cancer?

Reviewed on 4/16/2021

When prostate cancer is detected early, the prognosis is good. For localized prostate cancer (cancer that hasn't spread to other areas), the five-year survival rate is nearly 100%. Once the cancer has spread to other organs, the five-year survival rate is 30%.
When prostate cancer is detected early, the prognosis is good. For localized prostate cancer (cancer that hasn't spread to other areas), the five-year survival rate is nearly 100%. Once the cancer has spread to other organs, the five-year survival rate is 30%.

The prostate is a gland in men that helps produce fluid that goes into semen. The prostate is located in front of the rectum and just below the bladder. Prostate cancer occurs when cells in the prostate grow out of control. 

Because of routine screening tests, prostate cancer is often detected early, before the cancer has spread (metastasized) to other organs. At this stage, there are a number of treatment options and there is a good chance of a cure. 

Life expectancy for prostate cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis. For men with localized prostate cancer, where there is no sign that the cancer has spread outside the prostate, and regional prostate cancer, in which the cancer has spread outside the prostate to nearby structures or lymph nodes only, the 5-year survival rate is nearly 100%. 

However, once the prostate cancer has metastasized to other organs such as the lungs, liver, or bones, the 5-year survival rate drops to 30%.

What Are Symptoms of Prostate Cancer?

Early-stage prostate cancer often causes no symptoms. When symptoms of prostate cancer occur, they may include: 

  • Problems urinating
    • Slow or weak urinary stream 
    • Frequent urge to urinate, especially at night
  • Blood in the urine or semen
  • Trouble getting an erection (erectile dysfunction, or ED)
  • Pain in the hips, back (spine), chest (ribs), or other areas from cancer that has spread to bones
  • Weakness or numbness in the legs or feet
  • Loss of bladder or bowel control from cancer pressing on the spinal cord

What Causes Prostate Cancer?

The cause of prostate cancer is unknown but it is believed to be due to inherited or acquired genetic changes. 

Risk factors for developing prostate cancer include: 

  • Age: risk increases in men after age 50, and about 60% of cases are diagnosed in men over age 65
  • 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
  • Family history
  • Gene changes
  • Other factors that may increase the risk of developing prostate cancer — though these links are less clear and have not been conclusively proven -- include: 

How Is Prostate Cancer Diagnosed?

Prostate cancer is diagnosed with a patient history and physical examination, which will include a digital rectal examination in which a doctor inserts a gloved finger into the rectum to examine the prostate to check for:

  • The size, firmness, and texture of the prostate
  • Hard areas, lumps, or growths that spread beyond the prostate
  • Pain that occurs when touching or pressing on the prostate

Other tests to diagnose prostate cancer include: 

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What Is the Treatment for Prostate Cancer?

Treatment for prostate cancer depends on whether cancer is in part or all of the prostate, if it has spread (metastasized) to other parts of the body, and the age and overall health of the patient, and may include one or more of the following:

  • Watchful waiting (active surveillance)
  • Surgery: removal of the whole prostate and some nearby tissue
  • Radiation therapy
    • External beam radiation
    • Brachytherapy (internal radiation)
  • Cryotherapy (also called cryosurgery or cryoablation)
    • Uses very cold temperatures to freeze and kill prostate cancer cells as well as 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)
    • LHRH antagonists
      • Degarelix (Firmagon) 
      • Relugolix (Orgovyx) 
  • Chemotherapy 
  • 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
      • Rucaparib (Rubraca) 
      • Olaparib (Lynparza) 
  • Treatments for prostate cancer spread to bones
    • Bisphosphonates: zoledronic acid (Zometa
    • Denosumab (Xgeva) 
    • Corticosteroids
    • External radiation therapy
    • Radiopharmaceuticals
      • Strontium-89 (Metastron)
      • Samarium-153 (Quadramet)
      • Radium-223 (Xofigo)
  • Surgery
    • Kyphoplasty: surgery to stabilize a painful collapsed bone in a spine weakened by prostate cancer
  • Pain medicines

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Reviewed on 4/16/2021
References
https://www.cancer.org/cancer/prostate-cancer.html