Prostate cancer natural history, complications and prognosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]
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Overview
Prognosis of prostate cancer is generally good, and the 5-year survival rate is approximately 98.9%. The prognosis varies with the stage of tumor; Localized and regional tumors have the most favorable prognosis.
Natural History
- Public health records document that men in the United States have a one in six lifetime risk of developing prostate cancer.[1]
- Many men will die from competing medical hazards, not prostate cancer. Prostate cancer is often a slowly progressive disease.
- Men with newly diagnosed disease often face difficult choices regarding appropriate treatment. To make an informed decision, men require information concerning the natural history of prostate cancer, the impact of competing medical hazards, and the efficacy of treatment.
- During the last several decades, a number of researchers have contributed to the understanding of the natural history of prostate cancer. *Their work was performed in the era preceding widespread testing for prostate-specific antigen (PSA).
- Since the introduction of testing for PSA during the late 1980s, the incidence of prostate cancer has risen dramatically and mortality from this disease has declined.
- Unfortunately, no long-term outcome data are available from the PSA era. Patients and clinicians therefore need to evaluate historic series in the context of contemporary practice.
Prognosis
- Between 2004 and 2010, the 5-year relative survival of patients with prostate cancer was 98.9%.[2]
- When stratified by age, the 5-year relative survival of patients with prostate cancer was 99.1% and 98.8% for patients <65 and ≥ 65 years of age respectively.[2]
- The survival of patients with prostate cancer varies with the stage of the disease. Shown below is a table depicting the 5-year relative survival by the stage of prostate cancer:[2]
| Stage | 5-year relative survival (%), (2004-2010) |
| All stages | 98.9% |
| Localized | 100% |
| Regional | 100% |
| Distant | 28% |
| Unstaged | 73.9% |
- Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 2004 and 2010 of prostate cancer by stage at diagnosis according to SEER. These graphs are adapted from SEER: The Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.[2]
References
- ↑ Kessler B, Albertsen P (May 2003). "The natural history of prostate cancer". Urol. Clin. North Am. 30 (2): 219–26. PMID 12735499.
- ↑ 2.0 2.1 2.2 2.3 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.