- Extent of tumor
When the cancer is confined to the prostate gland, the long-term prognosis is excellent. Patients with locally advanced cancer are not usually curable, but 5-year survival is still very good. If prostate cancer has spread to distant organs, current therapy will not cure it.
- The histologic grade of the tumor
Poorly differentiated tumors are more likely to have metastasized before diagnosis and are associated with a poorer prognosis.
- Patient’s age and health
Any benefits of definitive local therapy with curative intent may take years to emerge. Therefore, therapy with curative intent is usually reserved for men with a sufficiently long life expectancy. For example, radical prostatectomy is often reserved for men with an estimated life expectancy of at least 10 years.
- Prostate-specific Antigen (PSA) level
PSA, an organ-specific marker, is often used as a tumor marker. The higher the level of PSA at baseline, the higher is the risk for metastatic disease or subsequent disease progression. However, it is an imprecise marker of risk.
- Serum acid phosphatase levels
Elevations of serum acid phosphatase are associated with poor prognosis in both localized and disseminated disease.
Staging of prostate cancer
- Stage 1 – The cancer is small and contained within the prostate.
- Stage 2 – The cancer is larger and maybe in both lobes of the prostate, but is still confined to the organ.
- Stage 3 – cancer has spread beyond the prostate and may have invaded the adjacent lymph glands or seminal vesicles.
- Stage 4 – cancer has spread to other organs, or to the bone.
Treatment of Prostate Cancer:
Treatment options also may depend on the following:
- Whether the patient has other health problems.
- The expected side effects of treatment.
- Past treatment for prostate cancer.
- The wishes of the patient.