Prostate cancer can be defined as the development of abnormal cells within the prostate gland. Because of their abnormal nature, these cells have the ability to multiply in an uncontrolled manner. When their tendency is to multiply faster, the disease is aggressive and fast-growing.
Usually, prostate cancer is not an aggressive disease, it has slow-growing rates, and many men have high survival rates after their first diagnosis. But, there are also cancers that may have been diagnosed in an advanced stage or may have developed to an advanced stage. When this happens, the cancerous cells may have spread to other parts of the body, besides the prostate, causing metastasis.
The signs and symptoms of the disease vary depending on the stage of cancer.
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What are the stages of prostate cancer?
Each prostate cancer diagnosis corresponds to a stage of the general development of the disease. These stages describe how much cancer has already spread, how risky it is, and also what is its aggressiveness. Prostate cancer stages are based on the screening tests, such as the digital rectal exam or the PSA test, MRI scans, or other biopsies. Staging the prostate cancer helps the doctor better understand the condition and makes it easier to develop a care plan.
Usually, prostate cancer is grouped into four main stages:
- Stage 1 – In stage 1, the cancer is confined to the prostate. It is slow-growing and can be detected in a DRE. It is often called early-stage prostate cancer and can be treated by means of surgery, radiation, or other treatment options.
- Stage 2 – Stage 2 prostate cancer is still confined to the prostate, but the cells may grow faster than in stage 1. Stage 2 has 3 levels of development, 2A, 2B, and 2C. It is important to know that this stage does not involve any regional or distant metastasis.
- Stage 3 – In stage 3, cancer has spread beyond the prostate and may have reached the seminal vesicles. Stage 3 also has 3 levels of development. However, even though cancer has spread beyond the prostate, it did not reach the lymph nodes or other distant areas.
- Stage 4 – In stage 4, cancer has spread into other tissues, including the lymph nodes, bones, liver, or lungs. It is known as metastatic cancer.
Types of advanced prostate cancer
All cancers that have spread beyond the prostate are advanced cancers. Also, it is important to know that there are several types of advanced prostate cancer, including:
- Castration-resistant prostate cancer (CRPC) is the type of advanced prostate cancer that continues to grow even under testosterone deprivement treatment. Hormone therapy lowers the natural testosterone levels and is also called testosterone depleting therapy or androgen deprivation therapy. Hormone therapy is based on the fact that testosterone is fueling prostate cancer, and lowering the testosterone levels may result in slowing cancer’s growth. However, there are cases when cancer cells do not react to hormone therapy and continue growing at the same pace. This is castration-resistant prostate cancer.
- Metastatic prostate cancer is cancer that has spread to the lymph nodes, bones, or other organs. It is less likely to be diagnosed with metastatic prostate cancer at the first diagnosis, it usually happens after the first treatment or even many years after. The cases when men are first diagnosed with metastatic prostate cancer are sporadic.
- Non-metastatic castration-resistant prostate cancer (nmCRPC) is the type of advanced cancer that causes the PSA levels to rise even after undergoing hormone therapy. The imaging tests can not identify that cancer has spread, but the PSA continues to stay high.
- Metastatic castration-resistant prostate cancer (mCRPC) is cancer that has been treated by means of hormone therapy, but the PSA levels continue to remain high, while the imaging tests have signs of cancer spreading to other parts.
- Metastatic hormone-sensitive prostate cancer (mHSPC) is cancer that has spread outside the prostate but has not been treated by means of hormone therapy. This indicates that testosterone deprivation therapy may result in stopping the hormones from fueling cancer cells.
Symptoms of advanced prostate cancer
If you are concerned about having one of these types of advanced prostate cancer, you may want to know what are the symptoms to look after. It is important to be aware of the fact that there are no symptoms specific only to advanced prostate cancer, they are also common to other conditions. Also, patients with advanced prostate cancer may or may not have symptoms, It all depends on the size of the tumor and the organs where it has already spread. But, if you have started being concerned about advanced prostate cancer, do not hesitate to schedule an appointment with a urologist. Always remember, the sooner the prostate cancer is diagnosed, the higher the chances to be treated successfully.
Here are some of the usual symptoms of end-stage prostate cancer:
- A frequent or sudden need to urinate
- Problems passing the urine (troubles when starting to urinate or not being able to start the flow)
- Blood in the urine or in the semen
- Feelings of extreme tiredness (fatigue)
- Weight loss
- Pain in the lower back or upper thighs
- Bone pain (if cancer has already spread to the bones)
It is important to remember that these symptoms may be caused by other health conditions, except prostate cancer. Do not become overly anxious if you are experiencing some of these symptoms but consider seeing a doctor as soon as possible. Did you know that you can now schedule an online appointment with Dr. David Samadi? Click here to easily schedule your appointment and take advantage of the chance to talk to a professional about your symptoms.
There are many screening tests that can accurately diagnose if you are suffering from advanced prostate cancer or not.