Prostate cancer: Prognosis, stages, and more

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According to the American Cancer Society (ACS), the overall 5-year survival rate for all stages is 97%, suggesting doctors diagnose most prostate cancers early.

According to the ACS, prostate cancer is second to skin cancer as the most common type of cancer in males in the United States. About 1 in 8 US males will receive a prostate cancer diagnosis in their lifetime. It becomes more likely as a person ages. About 60% of males who receive a diagnosis of prostate cancer are over 65 years.

The outlook for people with prostate cancer is good when they receive an early diagnosis.

Improved screening tools, especially prostate-specific antigen (PSA) testing, can help doctors detect cancer in its early stages and identify people at a higher risk of cancer.

According to the ACS, 5-year survival rates are as follows:

• Localized cancer: Greater than 99%.
• Regional cancer: Greater than 99%.
• Distant or metastatic cancer: 32%.

The overall 5-year survival rate is 97%.

Treatment for prostate cancer can cause some complications and side effects. Prostatectomy, the removal of the prostate, may cause erectile dysfunction (ED) and urinary incontinence.

Radiation to the prostate may cause side effects such as:

• difficult or painful urination
• urinary leakage or urgency to urinate
• diarrhea
• ED
• blood in urine
• rectal bleeding

What is prostate cancer?

Prostate cancer is cancer that originates in the glands of the prostate. The prostate is a gland that makes components of seminal fluid. It sits under the bladder and in front of the rectum.

Prostate cancer occurs when cells in the prostate grow out of control, forming a tumor. Over time, the cancer can spread to nearby locations and other body regions. This is metastatic prostate cancer.

Learn more about prostate cancer here.

Several different staging systems exist, including the three-stage tumor model. This model assesses the size of the tumor using the TNM staging system, the PSA score, and the grade group, which is based on the Gleason score. These systems reveal specific information about the behavior of the cancer and whether the tumor has spread.

One of the most important factors in assessing prostate cancer is whether the cancer has spread outside the prostate. Cancer that has spread significantly is harder to treat and cure. The stages are as follows:

• Localized: This means prostate cancer exists only where it is found, with no spreading. Risk groups for recurrence can be very low, low, intermediate, high, or very high.
• Regional: This means the cancer is possibly in nearby structures, the lymph nodes, or both.
• Metastatic: This means the cancer has spread into distant lymph nodes or bones.

Learn more about the stages of prostate cancer here.

Early prostate cancer does not usually cause symptoms. However, it may cause symptoms similar to benign prostatic hyperplasia or an enlarged prostate in some males. Those symptoms include:

• blood in the urine
• painful urination
• trouble urinating
• frequently urinating at night
• difficulty maintaining a consistent urine stream

Learn about the latest treatments for an enlarged prostate.

Prostate cancer occurs when cells in the prostate grow abnormally and out of control. As with other cancers, genetics may play a role. People with a family history of prostate cancer may develop more aggressive cancer earlier.

Age is the most significant prostate cancer risk factor, with about 80% of males developing it by the age of 80. However, the aggressiveness of cancer tends to decrease with age.

Other risk factors include:

• hypertension
• obesity
• sedentary lifestyle
• agent orange exposure
• elevated testosterone
• family history

Learn about prostate cancer in Black males.

The most common treatments for prostate cancer that has not spread include:

• Observation: If the cancer is slow-growing and low risk, a doctor may recommend delaying treatment and instead continuing to test for signs that the cancer has spread.
• Prostatectomy: Prostatectomy is surgery to remove the prostate and the cancer.
• Radiation: This is a treatment to kill cancer cells, often along with surgery.

Other less common or experimental treatments include:

• cryotherapy to freeze the cancer, if it has not spread
• chemotherapy to treat metastasized cancer that is resistant to hormonal treatment
• hormonal therapy to stop testosterone from reaching the cancer cells.
• biological therapy to help the body fight the cancer

Correct treatment depends on a person’s age, overall health, treatment goals, and cancer stage.

Learn more about prostate cancer treatment by stage.

It is not possible to prevent all cases of prostate cancer. An active lifestyle, avoiding harmful chemicals, and managing conditions such as hypertension may lower the risk.

Doctors may prescribe the drugs finasteride and dutasteride to people who have a high risk of developing prostate cancer. These medications may reduce the risk of cancer but not the risk of dying of cancer. These drugs can also cause side effects such as ED.

A person should discuss their risk factors with a doctor.

Learn about some natural ways to try to prevent prostate cancer.

Most people survive prostate cancer with minimal complications. If the cancer is localized and grows slowly, many people do not immediately need treatment. But prostate cancer can still be fatal.

People with cancer can work with an oncologist to discuss treatment and outlook, and all males should consider asking a doctor about their prostate cancer risk.

Anyone concerned about prostate cancer might consider talking with a doctor.