Metastatic prostate cancer gleason score 10 life expectancy

As cancer diagnoses go, prostate cancer is often a less serious one. Prostate cancer is frequently slow-growing and slow to spread. For many men, prostate cancer is less serious than their other medical conditions.

Table of Contents Show

Prostate Cancer Is Common With Aging
Prostate Cancer Survival Rates Are Favorable Overall
Staging, Spread, and Survival Rates
How is prostate cancer staged?
What are the stages of prostate cancer?
Stratifying prostate cancer by risk
Health News
What are prostate cancer survival rates by stage?
Coping with prostate cancer
Subscribe to MedicineNet's Cancer Report Newsletter
What is the life expectancy with a Gleason score of 10?
Can a man live 10 years with metastatic prostate cancer?
How long can a man live with metastatic prostate cancer?
What is the survival rate for Stage 4 metastatic prostate cancer?

For these reasons, and possibly because of earlier detection of low-grade prostate cancers, prostate cancer has one of the highest survival rates of any type of cancer. WebMD takes a look at prostate cancer survival rates and what they mean to you.

Prostate Cancer Is Common With Aging

After skin cancer, prostate cancer is the most common cancer in men. About 1 in 7 men will be diagnosed with prostate cancer in their lifetime. And these are just the men who are diagnosed. Among very elderly men dying of other causes, a surprising two-thirds may have prostate cancer that was never diagnosed.

Only 1 in 36 men, though, actually dies from prostate cancer. That's because most prostate cancers are diagnosed in older men in whom the disease is more likely to be slow-growing and non-aggressive. The majority of these men eventually pass away from heart disease, stroke, or other causes -- not their prostate cancer.

Prostate Cancer Survival Rates Are Favorable Overall

Thinking about survival rates for prostate cancer takes a little mental stretching. Keep in mind that most men are around 70 when diagnosed with prostate cancer. Over, say, five years, many of these men will die from other medical problems unrelated to prostate cancer.

To determine the prostate cancer survival rate, these men are subtracted out of the calculations. Counting only the men who are left provides what's called the relative survival rate for prostate cancer.

Taking that into consideration, the relative survival rates for most kinds of prostate cancer are actually pretty good. Remember, we're not counting men with prostate cancer who die of other causes:

92% of all prostate cancers are found when they are in the early stage, called local or regional. Almost 100% of men who have local or regional prostate cancer will survive more than five years after diagnosis.
Fewer men (about 7 %) have more advanced prostate cancer at the time of diagnosis. Once prostate cancer has spread beyond the prostate, survival rates fall. For men with distant spread (metastasis) of prostate cancer, about one-third will survive for five years after diagnosis.

Many men with prostate cancer actually will live much longer than five years after diagnosis. What about longer-term survival rates? According to the American Society of Clinical Oncology, for men with local or regional prostate cancer:

the relative 10-year survival rate is 98%
the relative 15-year survival rate is 95%

Staging, Spread, and Survival Rates

As with all cancers, doctors use the term stage to describe the characteristics of the primary tumor itself, such as its size and how far prostate cancer has spread when it is found.

Staging systems are complicated. The staging system for most cancers, including prostate cancer, uses three different aspects of tumor growth and spread. It's called the TNM system, for tumor, nodes, and metastasis:

T, for tumor (which means a swelling, a growth or mass, and describes the cancer as found in its place of origin) describes the size of the main area of prostate cancer.
N, for nodes, describes whether prostate cancer has spread to any lymph nodes, and how many and in what locations.
M, for metastasis, means distant spread of prostate cancer, for example, to the bones or liver.

Using the TNM system, each man's prostate cancer can be described in detail and compared to other men's prostate cancer. Doctors use this information for studies and to decide on treatments.

As far as survival rates for prostate cancer go, however, the staging system is pretty simple. As we've mentioned, in terms of survival rates, men with prostate cancer can be divided into two groups:

Men with prostate cancer that is localized to the prostate or just nearby. These men have a high long-term survival rate for their prostate cancer. Almost all will survive their prostate cancer for longer than five years -- and well beyond for many men.
Men whose prostate cancer has spread to distant areas, like their bones. These men may need more aggressive treatment for their prostate cancer. about 30% will survive their prostate cancer for more than five years.

How is prostate cancer staged?

Microscopic-level image of prostate cancer cells.

Prostate cancer is one of the most common types of cancer that develops in men and is the second leading cause of cancer deaths in American men, behind lung cancer and just ahead of colorectal cancer. The prognosis for prostate cancer, as with any cancer, depends on how advanced the cancer has become, according to established stage designations.

The prostate gland is a walnut-sized gland present only in men, found in the pelvis below the bladder. The prostate gland wraps around the urethra (the tube through which urine exits the body) and lies in front of the rectum. The prostate gland secretes part of the liquid portion of the semen, or seminal fluid, which carries sperm made by the testes. The fluid is essential to reproduction.

The term to stage a cancer means to describe the evident extent of the cancer in the body at the time that the cancer is first diagnosed.

Clinical staging of prostate cancer is based on the pathology results, physical examination, PSA, and if appropriate, radiologic studies.
The stage of a cancer helps doctors understand the extent of the cancer and plan cancer treatment.
Knowing the overall results of the different treatments of similarly staged prostate cancers can help the doctor and patient make important decisions about choices of treatment to recommend or to accept.

Prostate cancer is comprised nearly always of adenocarcinoma cells -- cells that arise from glandular tissue. Cancer cells are named according to the organ in which they originate no matter where in the body we find such cells.

If prostate cancer cells spread in the body to the bones, it is labeled prostate cancer metastatic to the bones, not bone cancer.
Metastasis is the process of cancer spread through the blood or lymphatic system to other organs/areas throughout the body.
In the late stages of the disease, prostate cancer more commonly metastasizes to lymph nodes in the pelvis and to the bones.

What are the stages of prostate cancer?

Cancer staging is first described using what is called a TNM system. The "T" refers to a description of the size or extent of the primary, or original, tumor. "N" describes the presence or absence of, and extent of spread of cancer to lymph nodes that may be nearby or further from the original tumor. "M" describes the presence or absence of metastases -- usually distant areas elsewhere in the body other than regional (nearby) lymph nodes to which cancer has spread. Cancers with specific TNM characteristics are then grouped into stages, and the stages are then assigned Roman numerals with the numerals used in increasing order as the extent of the cancer being staged increases or the cancer prognosis worsens. Prognosis is finally reflected by considering the patient's PSA score at presentation as well as their Gleason score (the grading system used to determine the aggressiveness of prostate cancer) in assigning a final stage designation.

The American Joint Commission on Cancer (AJCC) system for prostate cancer staging is as follows:

The primary tumor (T)

T designations refer to the characteristics of the prostate cancer primary tumor.
T1 prostate cancers cannot be seen on imaging tests or felt on examination. They may be found incidentally when surgery is done on the prostate for a problem presumed to be benign, or on needle biopsy for an elevated PSA.
T1a means that the cancer cells comprise less than 5% of the tissue removed.
T1b means that cancer cells comprise more than 5% of the tissue removed.
T1c means that the tissue containing cancer was obtained by needle biopsy for an elevated PSA.
T2 prostate cancers are those that can be felt (palpated) on physical examination of the prostate gland (on the digital rectal exam) or that can be visualized with imaging studies such as ultrasound, X-ray, or related studies. The prostate gland is comprised of two halves or lobes. The extent of involvement of those lobes is described here.
T2a means cancer involves one-half of one lobe of the prostate or less.
T2b means cancer involves more than half of one lobe but does not involve the other lobe of the prostate.
T2c means that cancer has grown into or involves both lobes of the prostate.
T3 prostate cancers have grown to the extent that the tumor extends outside of the prostate gland. Adjacent tissues, including the capsule around the prostate gland, the seminal vesicles, as well as the bladder neck, may be involved in T3 tumors.
T3a means that cancer has extended beyond the capsule (the outer edge) of the prostate gland but not into the seminal vesicles.
T3b means that cancer has invaded the seminal vesicles.
T4 prostate cancers have spread outside of the prostate gland and have invaded adjacent tissues or organs. This may be determined by examination, biopsy, or imaging studies. T4 prostate cancer may involve the pelvic floor muscles, the urethral sphincter, the bladder itself, the rectum, or the levator muscles, or the pelvic wall. T4 tumors have become fixed to or invaded adjacent structures other than the seminal vesicles.

Traditionally, advanced prostate cancer was defined as a disease that had widely metastasized beyond the prostate, the surrounding tissue, and the pelvic lymph nodes and was incurable. However, a more contemporary definition includes patients with the lower-grade disease with an increased risk of progression and/or death from prostate cancer in addition to those with widely metastatic disease.

The National Cancer Institute and the National Comprehensive Cancer Network (NCCN) guidelines on prostate cancer version 2.2017 indicate the following:

CT scan is used for the initial staging in select patients including

T3 or T4 disease, and
T1 or T2 disease and nomogram probability of lymph node involvement > 10% may be candidates for pelvic CT. A nomogram is a predictive tool that takes a set of information (data) and makes a prediction about outcomes.
Standard MRI techniques can be considered for the initial evaluation of high-risk patients including
T3 or T4 disease, and
T1 or T2 disease and nomogram indicating the probability of lymph node involvement > 10% may be candidates for pelvic MRI.

Bone scan is recommended in the initial evaluation of patients at high risk for skeletal metastases including

T1 disease with PSA > 20, T2 disease and PSA > 10, Gleason score > 8 or T3/T4 disease; and
any stage disease with symptoms of bone metastases (for example, bone pain).

The regional lymph nodes (N)

N designations refer to the presence or absence of prostate cancer in nearby lymph nodes, including what is referred to as the hypogastric, obturator, internal and external iliac, and sacral nodes.

N0 means that there is no prostate cancer evident in the nearby nodes.
N1 means that there is evidence of prostate cancer in the nearby nodes.
NX means that the lymph nodes cannot or have not been assessed.

The distant metastasis (M)

M designations refer to the presence or absence of prostate cancer cells in distant lymph nodes or other organs. Prostate cancer that has spread through the bloodstream most often first spreads into the bones, then into the lungs and liver.

M0 means that there is no evidence of the spread of prostate cancer into distant tissues or organs.
M1a means that there is a spread of prostate cancer into distant lymph nodes.
M1b means that there is evidence that prostate cancer has spread into bones.
M1c means that prostate cancer has spread into other distant organs in addition to or instead of into the bones.

IMAGES

Prostate Illustrion Browse through our medical image collection to see illustrations of human anatomy and physiology See Images

Stratifying prostate cancer by risk

The NCCN guidelines stratify prostate cancer by risk. The risk groups are based on the staging of prostate cancer, the Gleason score, PSA, and the number and extent of biopsy cores positive for cancer. The risk stratification may help decide what treatment option is best for each individual.

Very low risk: stage T1c, Gleason score ≤ 6, Gleason grade group 1, PSA < 10 ng/mL, < 3 prostate biopsy cores positive for cancer, < 50% cancer in any core, PSA density < 0.15 ng/mL/g
Low risk: stage T1-T2a, Gleason score ≤ 6, Gleason grade group 1, PSA < 10 ng/mL
Intermediate risk: stage T2b-T2c, Gleason score 3+4 = 7, Gleason grade group 2 or Gleason score 4+3=7, Gleason grade group 3, or PSA 10-20 ng/mL
High risk: stage T3a or Gleason score 8, Gleason grade group 4, or Gleason 9-10, Gleason grade group 5, PSA > 20 ng/mL
Very high risk: stage T3b-T4, primary Gleason pattern 5, Gleason grade group 5 or > 4 cores with Gleason 8-10, Gleason grade group 4-5

Health News

What are prostate cancer survival rates by stage?

Staging evaluation is essential for the planning of treatment for prostate cancer.

A basic staging evaluation includes the patient examination, blood tests, and the prostate biopsy including ultrasound images of the prostate.
Further testing and calculations may be performed to best estimate a patient's prognosis and help the doctor and patient decide upon treatment options.

Prognosis refers to the likelihood that cancer can be cured by treatment, and what the patient's life expectancy is likely to be as a consequence of having had a prostate cancer diagnosis.

If cancer is cured, your life expectancy is what it would have been had you never been diagnosed with prostate cancer. If cancer cannot be cured due to it recurring in distant locations as metastases, or recurs either locally (where it started) or in an area no longer able to be treated in a curative manner, then estimates can be made of what is likely to be your survival-based again on group statistics for people who have been in the same situation.

Nomograms are charts or computer-based tools that use complex math from the analysis of many patients' treatment results.

They help to estimate the likelihood of a patient surviving free of recurrence after treatment.
They also can determine the likelihood of a cancer being found confined to the prostate or spread beyond the prostate, or into the nearby lymph glands.
Your doctor will likely input the data from your staging evaluation into a nomogram in order to best counsel you regarding your treatment options.

The prognosis for prostate cancer varies widely and depends on many factors, including the age and health of the patient, the stage of the tumor when it was diagnosed, the aggressiveness of the tumor, and cancer's responsiveness to treatment, among other factors.

The 5-year survival rate for most men with local or regional prostate cancer is 100%.
Ninety-eight percent are alive at 10 years.
For men diagnosed with prostate cancer that has spread to other parts of the body, the 5-year survival rate is 30%.

The 5 and 10-year survival rate of prostate cancer chart

Stage and 5-Year Survival	Survival rate (%), 5 and 10 year
Localized or Regional prostate cancer	Approaches 100% 5 and 10-year for most
5 to 10-Year Survival	98% for most prostate cancers, unless spread
Spread to Other Parts of the Body	30% for 5 years only

IMAGES

Prostate Illustrion Browse through our medical image collection to see illustrations of human anatomy and physiology See Images

Coping with prostate cancer

The diagnosis of cancer can cause great anxiety to the individual and his family and friends. At times, one may have troubles coping with the diagnosis, the disease, and its treatment. Searching online for information may prove overwhelming also and may not be the best resource. Ask your physician or local hospital about local resources. Often, there are local prostate cancer support groups which may help you cope with your feelings and provide local resources for more knowledge.

You may consider contacting one or more of the following organizations:

US Prostate Cancer Foundation,
American Urological Association Foundation,
Centers for Disease Control and Prevention (CDC),
American Cancer Society, and
Patient Advocates for Advanced (Prostate) Cancer Treatment.

The Internet has provided access to a number of sites focusing on prostate cancer treatment and outcomes. The National Cancer Institute and the National Comprehensive Cancer Network (NCCN) have patient information, as well as the American Urological Association.

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Medically Reviewed on 11/16/2021

References

Ahlering, T., et al. "Unintended consequences of decreased PSA-based prostate cancer screening." World J Urol 37.3 March 2019: 489-496.

American Cancer Society (ACS). <http://www.cancer.org/cancer/prostatecancer/index>.

American Urological Association. "Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline." 2017. <http://www.auanet.org/guidelines/clinically-localized-prostate-cancer-new-(aua/astro/suo-guideline-2017)>.

Byrd, E.S., et al. AJCC Cancer Staging Manual, 7th Ed. New York, NY: Springer, 2009.

The James Buchanan Brady Urological Institute. Johns Hopkins Medicine.

Lu-Yao, G.L., P.C. Albertson, D.F. Moore, et al. "Fifteen-year outcomes following conservative management among men aged 65 years or older with localized prostate cancer." Eur Urol 68.5 (2015): 805-811.

Mottet, Nicolas, et al. "Updated Guidelines for Metastatic Hormone-Sensitive Prostate Cancer: Abiraterone Acetate Combined With Castration Is Another Standard." European Urology 73 (2018): 316-321.

National Comprehensive Cancer Network

"Prostate Cancer." Memorial Sloan Kettering Cancer Center.

https://www.cancer.net/cancer-types/prostate-cancer/statistics

What is the life expectancy with a Gleason score of 10?

Maximum estimated lost life expectancy for men with Gleason score 5 to 7 tumors was 4 to 5 years and for men with Gleason score 8 to 10 tumors was 6 to 8 years. Tumor histologic findings and patient comorbidities were powerful independent predictors of survival.

Can a man live 10 years with metastatic prostate cancer?

Survival for all stages of prostate cancer more than 95 out of 100 (more than 95%) will survive their cancer for 1 year or more. more than 85 out of 100 (more than 85%) will survive their cancer for 5 years or more. almost 80 out of 100 (almost 80%) will survive their cancer for 10 years or more.

How long can a man live with metastatic prostate cancer?

A decade ago, a man with metastatic prostate cancer would typically have a life expectancy of two to three years. Today, life expectancy for men with the same advanced disease is likely to be five to six years.

What is the survival rate for Stage 4 metastatic prostate cancer?

Stage IV Prostate Cancer Prognosis Prostate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate.

metastatic prostate cancer gleason score life expectancy