The prognosis for prostate cancer is influenced by many different factors, making it challenging to provide an exact estimate of an individual's life expectancy. However, early detection plays a crucial role in successful treatment and long-term disease-free status.
Fortunately, the majority of prostate cancers are identified through timely screening measures, allowing for effective curative interventions. As a result, the overall long-term prognosis for prostate cancer is highly favourable.
Survival By Stage
Survival rates and the likelihood of recurrence are based on averages and do not necessarily reflect any individual patient’s outcome.
Your doctor will provide an individualised prognosis based on your specific disease.
Approximately 80 - 85% of all prostate cancers are detected in the local or regional stages, which represent stages 1, 2 and 3. Most men diagnosed and treated at the local or regional stages will be disease-free after five years.
Stage 1 means the cancer is completely contained within the prostate gland and in only half of one side of the prostate, or less. Almost all patients will survive Stage 1 cancer for 5 years or more after they are diagnosed.
Stage 2 means the cancer is still completely contained within the prostate gland but is in more than half of one side of the prostate. Almost all patients will survive Stage 2 cancer for 5 years or more after they are diagnosed.
Stage 3 means the cancer has spread through the capsule (covering) of the prostate gland. It may have spread into the seminal vesicles (tubes that carry semen).
Around 95% will survive their cancer for 5 years or more after diagnosis.
Stage 4 means that the cancer has spread to other parts of the body. Prostate cancers detected at stage 4 have a much lower survival rate compared to local and regional cancers of the prostate.
The prognosis for metastatic prostate cancer can be discouraging, but some innovative, individualised therapies do have the potential to improve outcomes.
Stage 4 includes several progressions, including:
- the cancer has spread into nearby body organs, such as the back passage or bladder
- the cancer has spread to nearby lymph nodes
- the cancer has spread to other parts of the body outside the pelvis, such as the lungs or liver
Around 30 - 50% will survive Stage 4 cancer for 5 years or more after they are diagnosed, depending on the extent to which the cancer has spread (metastasised).
Survival For All Stages Of Prostate Cancer
Generally, for men with prostate cancer in England:
- more than 95% will survive their cancer for 1 year or more
- more than 85% will survive their cancer for 5 years or more
- almost 80% will survive their cancer for 10 years or more
Prostate Cancer Survival By Age
Five-year survival for prostate cancer shows an interesting pattern with age: survival gradually increases from 91% in men aged 15-49 and peaks at 94% in 60-69 year olds. Survival falls thereafter, reaching only 66% in 80-99 year old patients diagnosed with prostate cancer. The higher survival in men in their sixties is probably because of higher rates of Prostate-Specific Antigen (PSA) testing in this age group.
After an initial therapy, such as surgery or radiation, there is always a possibility that the cancer will reoccur. About 20 – 30% of men will relapse after the five-year mark, with cancer being detected by a PSA blood test.
The likelihood of recurrence depends on the extent and aggressiveness of the cancer.
The Role Of PSA Testing
Prostate cancer recurrence is determined by rising PSA levels following treatment.
PSA levels should drop to zero after surgery. When PSA levels increase above 0.2 ng/mL, the cancer is considered recurrent. After treatment with radiation, PSA levels seldom drop completely to zero. However, the PSA should level out at a low number (called the nadir). When PSA increases 2 points from its lowest value, the cancer is considered recurrent.
What Can Affect My Prognosis?
You might want to know whether you are likely to survive or die from prostate cancer. There is no exact answer although your doctor might be able to give you an idea based on the outcomes of other men. This is sometimes called your outlook, prognosis, or life expectancy.
How prostate cancer affects you will usually depend on the following:
- Your Stage: Your stage of cancer relates to whether your cancer is localised, locally advanced, or advanced.
- Your Gleason Score Or Grade Group: The higher your Gleason score, the more aggressive the cancer, and the more likely it is to spread. Your Gleason score is calculated by adding together two Gleason grades. i.e., the most common grade plus the highest other grade in the samples.
- Your Treatment Options: Treatment options vary between getting rid of the cancer and keeping the cancer under control.
- Your health: You may have fewer treatment options if you have other health problems (called co-morbidities). You might also be more likely to die from another condition, such as heart disease.
- Your PSA level: PSA tests are a good way of monitoring your prostate cancer and checking how you are responding to treatment.
Outlook For Men With Localised Prostate Cancer
Most localised prostate cancer is slow-growing and may not need treatment or shorten a man’s life. For many men who have treatment for localised prostate cancer, the treatment will get rid of the cancer.
Outlook For Men With Advanced Prostate Cancer
Although advanced prostate cancer cannot be cured, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain.
Men may also respond better to some treatments compared to others. If your first treatment stops working, there are other treatments available to help keep the cancer under control for longer.