Prostate Cancer Prognosis (Cont.)

Prostate Cancer Prognosis for Stage III

If your prostate cancer is stage III, it is a regionalized tumor that has spread beyond the prostate -- through the capsule that encloses the prostate and perhaps into the seminal vesicles. However, it has not yet, as far as can be determined, reached the lymph nodes or any more distant sites in the body.
 
External beam radiation therapy is often used to treat stage III cancers. Besides being less invasive than prostate cancer surgery, it is better suited for bulky tumors. A few men have surgery, while others rely on watchful waiting.
 
Men whose tumors are reclassified as stage III after surgery (because cancer is found to have spread through the capsule or into the lymph nodes) sometimes go on to have radiation therapy postoperatively. Studies are in progress to evaluate this approach.
 
Stage III tumors are often large enough to create difficulties with urination. These may be treated in a variety of ways, including:
 
  • Radiation therapy
  • Surgery
  • Transurethral resection of the prostate (TURP)
  • Hormonal therapy.
     
The long-term prostate cancer prognosis for men with stage III cancer depends on the extent of disease. Once cancer has broken through the prostate capsule, chances that the disease will progress in the next 10 years are about 50-50. Spreading to the seminal vesicles further increases the likelihood of a recurrence. One study, following up on men who had been treated with radiation therapy 20 years earlier, found that close to half of them eventually died of prostate cancer, although nearly as many had died of some other cause, with no sign of cancer recurrence.
 

Prostate Cancer Prognosis for Stage IV

If your prostate cancer has spread to the nearby lymph nodes or to distant parts of the body, it is called metastatic prostate cancer. Hormonal therapy will generally improve symptoms and delay the progress of the cancer for another 2 to 3 years. If just the lymph nodes are involved, a man may use hormonal therapy to delay the progress of prostate cancer even longer; however, the vast majority of those with positive lymph nodes at the time of getting hormonal therapy will remain at risk of developing additional metastatic disease within 10 years after the treatment.
 
Bone metastases tend to be less responsive to hormonal therapy.
 
(Prostate Cancer Prognosis Continued: Page 3)

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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD