By Kathryn E. Vinson, MS, CCRC
In our world today, there are many types of cancer that can be found early, and when found early, have a high survival rate. For the gentlemen in our lives, prostate cancer is one of those. When it is found early (with local or regional spread) the five-year survival rate is nearly 100%. Seriously, it doesn’t get better than numbers like that (although the treatments can be life altering). Sadly though, when it isn’t caught early, and has spread to distant parts of the body, that survival rate falls to about 30%. Let’s take some time today to talk about late stage prostate cancer, its symptoms, outlook, and treatment options.
What are the symptoms of stage 4 prostate cancer?
While prostate cancer has very recognizable symptoms, the big problem is that these symptoms are very similar to other conditions, such as benign prostatic hypertrophy (BPH), and many men brush them off as “just getting older.” While many of these symptoms can be attributed to aging, it is vital for men to understand that they should not be ignored or marginalized. These symptoms should always be taken seriously. According to the American Cancer Society and the Mayo Clinic, symptoms of prostate cancer, and more specifically, stage 4 prostate cancer may include:
- Painful urination
- Weak urine stream
- Blood in the urine and/or semen
- Erectile dysfunction
- Bone pain, often in the hips, back, and upper legs
- Swelling in the legs
Experiencing these symptoms, especially a combination of these symptoms, is a sign that you need to see your physician without delay. As a wife, sister, and daughter, I have heard the men in my life, quite vociferously, explain how they don’t want to go to the doctor – especially for “that” exam. Please gentlemen, we beg you – get it checked, and get it checked regularly – a very quick exam could save your life. The American Cancer Society recommends the following screening times (directly quoted):
- Age 50 for men who are at average riskof prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high riskof developing prostate cancer. This includes African Americans and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).
- Age 40 for men at even higher risk(those with more than one first-degree relative who had prostate cancer at an early age).
While we are talking about getting screened for prostate cancer, I want to let you know about some exciting new research that has the potential to dramatically increase the chance of early diagnosis. Researchers at the University of East Anglia and the Norfolk and Norwich University Hospital have found a way to detect prostate cancer from a man’s first morning urine sample. Their small-scale studies showed a higher rate of diagnosis via their urine test that a digital rectal exam. Though this test is still a ways away from being on the market – it gives tremendous hope for early diagnosis.
What is the prognosis for stage 4 prostate cancer?
As I mentioned earlier, when prostate cancer is caught early, or even after it has spread some – it has an incredibly high five-year survival rate – approaching 100%. Sadly though, once the disease has spread out of the pelvis to places like other organs, the bones, and distant lymph nodes, the survival rate falls to about 30%.
How is stage 4 prostate cancer treated?
Stage 4 prostate cancer treatments are most often aimed at controlling the patient’s symptoms, rather than having a “curative” purpose. As prostate cancer is fueled by testosterone, one of the first lines of therapy in stage 4 prostate cancer is blocking that hormone. This can be accomplished with medications that block the production of testosterone, medications that prevent the uptake of testosterone by cells, or by surgical removal of the testicles. Many prostate cancers adapt to the low testosterone environment and must be treated in other ways.
Other treatment options for stage 4 prostate cancer include radiation, chemotherapy, and immunotherapy. Also, of note are medications to help build bone mass. As testosterone levels plunge, men are more susceptible to osteoporosis, as well as the risk of metastases to the bones. Both of these conditions can result in painful fractures.
Surgical options are often not on the table as they are not curative and can cause more problems that they alleviate. Radical prostatectomy (removal of the prostate) is considered if the patient is experiencing symptoms such as difficulty urinating, as this relieves pressure on the urethra, allowing urine to pass more freely. It must be noted, that radical prostatectomy comes with extreme side effects including, but not limited to: inability to achieve erection and incontinence.
Further treatments are considered palliative – aimed treating pain and increasing quality of life.
As always, much love, many prayers, and abundant blessings to all of the warriors out there!!