Late stage prostate cancer has no cure, but with treatment you can manage the disease, control symptoms, and increase your life expectancy. Your treatment will depend on a number of different factors including specifics about your cancer, your current health, and your personal preferences related to potential treatments and side effects.
What is late stage prostate cancer?
Late stage prostate cancer usually means two things. First, late stage prostate cancer is generally metastatic. This means that the prostate cancer has traveled to other parts of your body such as the bone, adrenal gland, lung, or liver. This could be through direct extension from the prostate to nearby bones or other organs or structures, or it could be through the bloodstream or lymphatic systems (part of your immune system that helps fight off infection).
The second component of late stage prostate cancer is failure to respond to treatment. In general, most patients with late stage prostate cancer have failed standard therapy. This means that the patient experienced progression after some period of improvement or possibly did not respond to the treatment at all. Progression could be in the form of a rising PSA after initially dropping, or it could mean developing symptoms due to spread of the cancer.
While not very common, some men are diagnosed with late stage prostate cancer initially.
How long will I live?
While every patient is different, the 5- and 10-year survival rates for prostate cancer are excellent. However, as seen in the table below, the survival rate for late stage prostate cancer is less promising.
Stage – Local (No spread outside of the prostate)
5-Year Survival – Approaching 100%
Stage – Regional (Spread to nearby lymph nodes)
5-Year Survival – Approaching 100%
Stage – Distant (Spread to distant lymph nodes, bones, or other organs)
5-Year Survival – Approaching 28%
However, science and treatments have improved significantly over the last 5 years, so there may be more effective treatments if you have been recently diagnosed.
Treatments for late stage prostate cancer
While none offer a total cure for late stage prostate cancer, there are a number of treatment options. These treatments are all generally indicated after medical and surgical therapies have failed to lower testosterone levels or when patients have experienced spread to other parts of the body. Many patients will also have been treated with docetaxel before beginning these treatments. The treatments include:
- Provenge: This treatment is a immunotherapy. In a process similar to donating blood, immune cells are collected and then undergo a special treatment. Finally, the newly treated cells are given back to you as an infusion.
- Xofigo: This radioactive drug therapy is well tolerated by patients and is usually indicated when cancer has spread to the bones and other treatments have not been effective.
- Xtandi: This drug is specifically for patients who have already been treated with docetaxel. Xtandi kills, slows, and decreases the size of prostate cancer cells. It is different from the previously described treatments in that it is taken as a pill.
- Zytiga: This medication is an anti-androgen that is also used in metastatic castration-resistant prostate cancer. Unlike many other treatments, it is more patient friendly in that it is administered by mouth as a pill. Zytiga was approved by the FDA after it was shown to prolong life in patients previously treated with docetaxel (Taxotere). It is generally well tolerated and common side effects include joint pain and swelling, muscle pain, diarrhea, and cough.
Your health care provider can help you decide what treatment is best for you. Be sure to discuss your concerns about potential side effects and how that might effect your decision on whether or not to pursue a certain treatment.
Read more in our Prostate Cancer Health Center.
References
American Cancer Society. Prostate cancer.
Xtandi [prescribing information]. Northbrook, IL: Astellas Pharma US, Inc; 2012.
Kantoff PW et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. New England Journal of Medicine 2010; 363:411–22.
