Prostate cancer occurs when prostate cells grow out of control and spread beyond the prostate, which is a small gland at the base of the penis. When this happens, it’s called advanced prostate cancer or stage 4.
If a person has advanced prostate cancer, they may experience problems urinating, blood in their urine and/or semen, back or hip pain, or fatigue. It’s important to discuss treatment options with a doctor if you have these symptoms.
There are many treatment options for people with stage 4 prostate cancer. They include hormone therapies, chemotherapy, and radiation therapy. A doctor may also prescribe some medications to help relieve symptoms and improve quality of life.
Doctors use different tests to diagnose prostate cancer and find out how much the disease has progressed. They can give your cancer a stage based on what parts of the body it has affected, and the results of a biopsy. They can also use a system called the Gleason score to rate how closely prostate cancer cells look like healthy tissue.
Your doctor will determine your clinical staging based on the results of a digital rectal exam, PSA test and possibly other exams and scans. A biopsy will be done to get a more precise tumor size and Gleason grade. The doctor can then match your stage to the best treatment option for you.
In this stage, the cancer is visible through a digital rectal exam or imaging test but has not spread outside of the prostate or to the seminal vesicles. If the cancer is localized to the prostate, it has a 5-year survival rate of nearly 100%.
For those with localized stage 4 disease, active surveillance is an option if the tumor has a low Gleason score or hasn’t spread to the lymph nodes.
Doctors can also perform a surgical procedure to remove the prostate, called radical prostatectomy. This surgery is usually only recommended if the disease has progressed to stage 5 or if you’ve had other health conditions that raise your risk of complications.
In stage 4, a doctor may recommend radiation therapy to kill any remaining cancer cells and reduce your chances of the disease coming back. This treatment is usually given through a vein (intravenous, or IV). The doctor will give you medicines to prevent side effects, such as nausea.
Hormone therapy is used to reduce the amount of androgens, or male hormones, in the bloodstream. This can slow or stop cancer growth and relieve a man’s symptoms. Radiation and hormone therapy can be given together or separately. Chemotherapy is another option for those with stage 4 prostate cancer. It uses drugs that travel through the body and destroy quickly growing cancer cells as well as some healthy cells. The most common chemotherapy drugs for prostate cancer are docetaxel and prednisone. These drugs are given through a vein (intravenous, IV). They may be combined with other types of treatment, such as radiation or hormonal therapy.
