Prostate cancer in men 4. Stage 4 prostate cancer: life expectancy and treatment

When is stage 4 prostate cancer diagnosed? Treatment and prognosis

Stage 4 prostate cancer is diagnosed when the tumor has spread to other organs. Typically these are bones, lungs and liver. With such a diagnosis, the prognosis is extremely unfavorable.

Very rarely, patients live more than three years.

Features of stage 4

Indicators of stage 4 prostate cancer:

  • the tumor has spread outside the organ (to the muscles that control urination, the pelvic wall or rectum); the lymph nodes are affected by cancer cells; distant organs are affected by metastases.

Additional tests to determine the stage of cancer: 1. Radiological bone scan. To determine the location of cancer cells in the bones. It is the bones that are most often affected in stage 4 prostate cancer. Helps determine whether there is damage to the pelvic lymph nodes.3.

Magnetic resonance imaging. Allows you to find out whether the tumor has spread to the bladder and seminal vesicles.4. Radiological scanning of the prostate. With the help of which the area of ​​​​spread of cancer cells is determined.5. Lymph node biopsy. This may be a biopsy during surgery, laparoscopy, or needle aspiration biopsy.

Symptoms of stage 4 prostate cancer

The last stage of prostate cancer is characterized by damage to nearby tissues, lymph nodes and distant organs. Therefore, nonspecific symptoms are observed:

  • pain in the lower back and abdomen, perineal area; urinary incontinence or, conversely, the inability to completely empty the bladder; blood or other impurities in feces or urine; painful urination; stool disorders (if the rectum is affected) - constipation, incontinence, flatulence, involuntary passage of gas; loss of appetite;

Life expectancy and treatment

Most often, stage 4 prostate cancer occurs in men over 60 years of age. The early stages of the disease are difficult to diagnose because patients do not experience significant discomfort and consult a doctor too late.

And only when the process of metastasis begins (and this happens at stages 3 and 4). patients consult a doctor. At stage 4 prostate cancer, the tumor affects neighboring organs The main diagnostic sign of the disease is elevated level acid phosphatase in the blood. The resulting tumor looks like adenocarcinoma (glandular cancer). The main reason for its occurrence is considered to be an imbalance of hormones in a man’s body. This grade 4 disease poses a serious threat to life and the prognosis rarely exceeds 5 years.

Symptoms of late stages of tumor

Most symptoms do not allow a clear diagnosis. They are very similar to those with prostate adenoma. Stage 4 prostate cancer leads to a number of disorders of the urinary system:

  • Urination disorders. Pain, difficulty in passing urine, accumulation in the bladder. Sometimes - incontinence. Hematuria - the appearance of blood in the urine. The appearance of blood in the stool, defecation disorders. Renal failure. Metastasis of the pelvic bones, ribs, lymph nodes, liver, lungs. Sharp pain in the perineum. Swelling of the legs, genitals, perineum. Cachexia (sharp weight loss).

To clarify the diagnosis, a digital examination of the prostate is performed, and if a neoplasm is detected, a histological examination is performed. However, only strong growth of the gland, the appearance of its tuberosity and compaction can be reliable signs of a malignant tumor.

Classification and diagnosis

Stage 4 prostate cancer is classified depending on the direction of tumor cell growth:

  1. T4a – tumor grows to the side Bladder and rectum. T4b - germination occurs through the pelvic bones and anal muscles.

In the later stages of prostate cancer, the prognosis for the patient is usually unfavorable. If metastasis occurs in the bones, then the following may be observed in them:

How to cure stage 4 prostate cancer and what the prognosis may be

Prostate cancer is divided according to the degree of spread and has 4 stages:

prostate cancer image

Stage 1

At the first stage, the tumor is small in size and cannot be determined by standard diagnostic methods. If the disease is detected at this stage and the necessary course of therapy is completed, the patient’s five-year survival rate reaches 100%.

Stage 2

At the second stage, the tumor is in the prostate gland and does not leave its boundaries. It can be detected by transrectal ultrasound. Using a course of therapy at this stage of development, the patient's five-year survival rate reaches 100%.

Stage 3

At the third stage, the tumor extends beyond the borders of the prostate gland into the surrounding tissue. Using therapy at this stage, the patient's five-year survival rate is slightly more than 50%.

Stage 4

In the fourth stage, the tumor spreads to other organs. Metastases usually affect the bones, liver and lungs. If prostate cancer is detected at the last stage, the patient can live from 1 to 3 years, rarely more than 3 years.

Causes

Scientists have not yet come to a conclusion on this matter. unanimous opinion. Doctors are actively researching the molecular processes of the development of the disease, thanks to which a gene has been found that is responsible for the hereditary transmission of the disease. Also, prostate cancer can appear as a result of changes in the activity of certain sections of the DNA that are responsible for suppressing the development of this disease.

Risk factors:

  • Age. This is the main factor. The older a man is, the more likely he is to develop the disease. Race. Representatives of the Negroid race get sick more often than other men. Heredity. If a relative develops this disease at an early age, it can be inherited. Nutrition. Men who eat a lot of fatty foods are more likely to get sick. Smoking. Prostate cancer is caused by cadmium, which is found in cigarette smoke, batteries and welding materials.

Treatment of stage 4 prostate cancer in various ways

prostate cancer stage 4

Treatment depends on the stage. On early stage It is possible to completely recover from this disease. In other cases, and especially when the disease is in its last stage, the prognosis will not be so favorable, but the progression of cancer can be restrained for some time, which will improve the patient’s quality of life and relieve pain. Today, a number of different methods, but it is not yet possible to compare their effectiveness. The doctor chooses a treatment method depending on the stage of the disease, the age of the patient, the presence of chronic diseases, the risk of complications, etc. Today, there are five main methods of treating prostate cancer.

Surgery

Surgery or radical prostatectomy is considered the main treatment option. This method has been used for more than 100 years, but due to the huge number of complications, it was not popular for a long time. Nowadays, modern medicine minimizes the number of complications during surgical treatment.

Radiation therapy

This method helps to destroy malignant tissue as a result of exposure to radioactive radiation. Today, this method is used precisely in the last stages of the disease, when the tumor has metastasized or if surgery is contraindicated for treatment.

Brachytherapy

One type of radiation therapy is brachytherapy for prostate cancer. During brachytherapy, emitters are implanted into the tumor itself, and irradiation occurs from the inside, thereby avoiding many side effects and achieving the most effective radioactive load on the affected organ.

With this treatment method, the tumor is destroyed under the influence of low temperatures. Cryotherapy can be compared in effectiveness to radiation therapy.

Hormone therapy

This is an effective method of treating patients in the final stages. This technique is used mainly when it is not possible to use other methods of treatment. There are many options for hormonal therapy, but they all involve suppressing the synthesis of testosterone in the body or preventing its effect on prostate tissue. This method cannot completely cure the patient, but is one of the components in complex therapy.

Chemotherapy

In the later stages of the disease, when surgery and radiation do not produce results, and the effectiveness of hormonal therapy begins to decline, and the tumor does not stop its growth, the patient is prescribed chemotherapy. Chemotherapy is also prescribed to treat metastases, which usually occur in the bones, liver, lungs. Chemotherapy is prescribed to stop their spread and reduce pain.

Forecast

With stage 1 prostate cancer, there is a 100% five-year survival rate, but with stage 4 prostate cancer the prognosis will no longer be so optimistic. An accurate diagnosis for this disease will make it possible to correctly select the most effective course of treatment. Every year there are more and more cases of this disease in the world. To diagnose the disease, laboratory tests are used, the main of which is the determination of PSA. If a man is diagnosed with grade 4 prostate cancer, the prognosis in terms of life expectancy can be called extremely unfavorable.

At this stage, modern medicine can no longer completely cure the patient. Life expectancy is determined by the stage, as well as the course of treatment. The earlier the disease is detected, the longer the patient will live.

If the disease has metastasized to nearby and distant organs, it becomes difficult to treat and control. If the patient is diagnosed with stage 4 prostate cancer, then the average life expectancy is up to five years. Doctors promise such patients about three years of life, after which this prognosis is increased by another two years under favorable conditions. In addition to treatment, a man’s mental and physical health affects life expectancy.

The support of loved ones and positive emotions have a beneficial effect. It happens that people with stage 4 cancer live for 8 years. However, there are some points that can negatively affect life expectancy.

These include the patient’s mature age, African-American race, prostate cancer in close relatives, excess weight. Approximately 30% of patients live more than five years. Of course, the prognosis for patients with stage 4 cancer is not very encouraging, but every patient must remember that his life can go beyond the average statistical data.

Attention! Do not try to self-medicate. A consultation with a doctor and an examination in a clinic are required.

Prostate cancer stage 4: life expectancy

Prostate cancer stage 4 and the exact life expectancy with such a diagnosis. This is what worries the man and his family most in this case. The fourth stage of malignant neoplasm is the most severe. with the most unfavorable prognosis. A neoplasm discovered at the fourth stage does not have the best prognosis: life expectancy is from one to three years.

How to protect yourself, what do you need to know?

A prostate tumor goes through four stages of development:

  • At stage 1 it is practically impossible to detect it. A tumor detected at stage 1 gives a 100% recovery, in contrast to the diagnosis of "prostate cancer in grade 4", in which life expectancy is low. At grade 2, the prostate tumor becomes larger, but it is still located within the prostate glands. Its increased size can actually be detected using ultrasound. If therapy is started at stage 2, survival is guaranteed. Stage 3 of development is characterized by the rapid spread of malignant cells beyond the borders of the prostate with the transition to neighboring tissues. Treatment gives only 50% successful results. In the case of prostate cancer of the 4th degree, the tumor grows, it quickly metastasizes to other organs. Prostate cancer in the 4th degree gives a low life expectancy.

Differences between benign and malignant forms

The key difference between benign education and cancerous tumor prostate adenoma is classified as benign, in contrast to cancer in the prostate gland. A malignant tumor tends to metastasize through the bloodstream and lymph to other organs.

Stage 4 prostate cancer gives a low life expectancy. The main difference between these two types of tumors is related to the direction of growth: crustacean cells always grow outward.

Clinical picture

How to suspect cancer? The following signs may indicate a diagnosis of stage 4 prostate cancer:

  • Frequent trips to the toilet. Intermittent and painful urination, weak stream pressure. Blood in the urine, burning sensation. Acute urinary retention. Pain in the pelvic area, radiating to the back, ribs, perineum, weight loss and poor appetite (all this indicates tumor metastasis). False urge to urinate.

All these signs are quite common among older people and indicate problems with the prostate gland. The diagnosis of cancer can only be made by a doctor.

Timely examination allows you to prevent the disease from progressing to the last stage and begin treatment. In the last stages of cancer in the prostate gland, grade 4 gives a low life expectancy. In old age, you need to be especially attentive to alarming symptoms, since there is a high risk of developing cancer.

Features of therapy

The main disease of men. BPH, which, if treatment rules are not followed, usually develops into a malignant neoplasm. The most dangerous stage is the fourth. Today, there are three methods of complex prostate therapy:

  • Surgical intervention by a surgeon. Radiation. Chemotherapy.

The first method is usually prescribed when the time limit for cancer treatment has passed and surgery is necessary to reduce the severity of symptoms. In one case, the surgeon removes only the prostate gland itself. this is done when the tumor affects this particular area.

The operation is performed on elderly men who have not reached the age of seventy. In the second case, in order to avoid the growth of the prostate pathology, the testicles are surgically removed.

They are responsible for the release of testosterone, which, in turn, is one of the reasons for the increase in tumor growth and the development of cancer cells. Radiation is used to destroy cancer cells, which directly inhibits their development and prevents their proliferation, preventing metastasis to other vital organs.

Radiation may be prescribed separately, and if the result is positive, treatment is limited to this. But sometimes it is necessary to combine irradiation with surgery. The most gentle method of control. is chemotherapy that allows medicines slow down the growth of the tumor process.

Such drugs include Taxotere, Mitoxantrone, Estramustine. They stop the body's production of testosterone, thereby slowing down the development of cancer cells. As a result, human life is significantly extended. Radiation therapy is an effective method for destroying cancer cells.

What to expect

If a man is diagnosed with prostate cancer at the first stage of development, then, as statistics show, 100% of such patients live for the first five years. But already at the fourth stage of such a disease, the prognosis will be much more pessimistic; treatment is not always effective.

To make a correct diagnosis in a timely manner, special tests are used. The main test is PSA determination. When diagnosed with stage 4 prostate cancer, the patient has very little chance of living long.

Main. detect the disease at the very first stages of development. Life expectancy will directly depend on this.

But if the cancer has already metastasized to other organs, then in this case it is very difficult to carry out effective treatment, the prognosis for the patient is unfavorable, and life expectancy is low. Life expectancy is affected not only by medical treatment, but also by psychological and physical state sick.

The support of relatives and friends is important for a successful fight. There are factors that negatively affect life expectancy with this disease.

These include advanced age, African-American race, similar diseases in close relatives, and excess weight. In such cases, according to statistics, only 30% of patients live more than five years. Despite the above, every patient should remember that this is just a statistical forecast and life without aggravating symptoms may go beyond the numerical data.

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Today, among malignant prostate tumors, doctors distinguish five degrees of prostate cancer. During the study of a neoplasm, oncologists not only identify the diagnosis as accurately as possible, but also formulate prognoses for treatment, selecting effective therapeutic tactics. Almost all malignant neoplasms of the prostate gland are detected before they spread beyond the area of ​​this gland.

In that case, if the disease is not detected at the last stage, 99 percent of patients will be able to live more than 5 years. Of course, if this tumor has already metastasized to other organs, the survival prognosis is significantly worse. If, a year after treatment, prostate cancer makes itself known again, then a relapse has occurred.

Usually the disease recurs in the prostate gland, but sometimes it spreads to other organs or bones. Typically, recurrence is treated with other methods that have not previously been used to treat the original tumor.

Prognosis and treatment of prostate cancer

If metastases are detected at the 3rd or 4th stage of cancer, emergency treatment is required, and the prognosis worsens. Treatment methods for detecting metastases

  • The prostate gland and regional lymph nodes are remotely irradiated, and hormonal therapy is prescribed. Medical or surgical castration. In the first case, there will be a reverse effect after stopping the drug. If there are metastases at an early stage of cancer, chemotherapy may be added.

In advanced forms of cancer with metastases that are present in the bones or internal organs beyond the pelvic area, symptomatic treatment is prescribed. Radiation and hormonal therapy are usually used to prolong the life of patients. The prognosis of treatment will directly depend on the aggressiveness of the tumor, the degree of the oncological process and the selection of effective therapy.

Prognosis of stage 1 prostate cancer With visual examination and x-ray cannot detect a tumor. Cancer cells are found in tissue samples that are taken during surgery for gland hyperplasia. They can also be detected during a biopsy, the reason for which is an increased content of prostate-specific antigen in the blood.

  • If cancer cells are found in less than five percent of the tissue, a Gleason score of less than seven is assigned. If such cells are found in more than five percent of the tissue, a score of greater than seven is given. Cancer cells may be found in tissue taken by puncture.

At this stage, the cancer is isolated, the disease is localized only in the prostate region. The tumor grows exclusively on the surface of the organ, without penetrating into its tissue. The survival rate for 10 years is high - about 95-100 percent. The resulting tumor can be felt, it does not go beyond the area of ​​the capsule that has grown around the gland.

  • A neoplasm may occupy less than 50 percent of one half of the gland. Occupies more than 50 percent of one half of the gland. It is located on two halves of the prostate gland.

At the second stage, the cancer is isolated, it is localized in the region of the gland, while the tumor has already penetrated deeply into the tissue. Over 10 years, the survival rate is 60.

Forecast of prostate cancer of the 3rd degree In this case can't do without surgery . radiation and hormone therapy. Treatment is aimed at reducing the growth of the malignant process and at alleviating painful symptoms.

When selecting effective treatment oncologists take into account the individual characteristics of the organism. The prognosis of survival will depend on the stage of the disease and the type of tumor. Unfortunately, at the 3rd stage, such a prognosis is unfavorable, for 5 years the survival rate is 50-60. It is impossible to completely exclude the development of the disease.

To determine cancer at an early stage, after the age of 45, it is recommended to undergo a preventive examination once a year. Thus, you can get a chance for a successful cure.

Screening includes examination of the gland by the rectal method, ultrasound and detection of PSA levels. At the third stage the disease gives metastases to the pelvic organs, which also spread to regional lymph nodes. The average survival rate is less than 60 percent.

Prognosis of grade 4 and 5 prostate cancer At stages 4 and 5 of the disease, metastases appear very quickly, in about a few days, and this is perhaps the only clinical sign of cancer. Malignant cells spread through the blood and lymphatic system. The hypogastric, iliac and obturator lymph nodes are affected.

Due to the growth of metastases, swelling of the genital organs and lower extremities can be observed. If metastases have penetrated the bone tissue, severe pain appears, which signals the presence of cancer.

The femur, cranial, pelvic, vertebral and costal bones are often affected. When metastases affect internal organs, the adrenal glands, liver and lungs are the first to suffer. If the wrong treatment is selected, the survival rate is less than 50 to 5 years. In the case when a man is diagnosed with stage four or five prostate cancer, the prognosis regarding life expectancy is extremely unfavorable. It is not possible to completely cure a patient using modern medical methods. Life expectancy will be determined by the stage of development of the disease and the course of its treatment. The earlier cancer is diagnosed, the greater the chance of complete or partial cure. If, during the development of cancer, metastases form in close or distant organs, it is much more difficult to treat and control the disease.

Prostate cancer stage 4 - unlike adenoma, is a severe pathology, manifested by uncontrolled division and spread of cancer cells of the primary tumor throughout the body. According to the frequency of occurrence, prostate cancer can be considered folk disease, among men he is consistently included in the list of leaders. According to the methodology of the World Cancer Organization, stage 4 includes a condition when the tumor rapidly progresses and metastasizes to the liver, lungs, kidneys, and other organs and tissues. The prognosis for this course of the disease is extremely negative, especially if the symptoms indicate damage to bone tissue.

Features of the last stage of prostate cancer

Stage 4 prostate cancer manifests itself with the following symptoms:

  • The tumor leaves its capsule and spreads to neighboring organs and tissues;
  • Damage to rectal tissue;
  • Tumor growth into the bladder;
  • Spread to tissues and organs in the pelvis and anus;
  • Metastases.

Unfortunately, this tumor is very secretive and begins to manifest itself only when the process is very advanced. More than 50% of prostate cancer cases are detected at the last stage, when almost the entire body is affected by metastases, right down to the skeletal tissues. In this case, the forecasts are disappointing.

Symptoms of late stage prostate cancer

Symptoms of this oncology appear late and often like an avalanche. Literally within a month, and sometimes even a week, the following arise:

  • Disturbances in urination - frequent urge, delayed onset of the process, intermittency, incomplete emptying, blood spots appear. Urination is accompanied by colic and pain;
  • Pain in the groin area appears and intensifies. At times, the pain covers the entire lumbar region, with clear radiation to the kidneys.

The process develops at an accelerating pace, cancer cells spread through the lymphatic channels and affect the entire body. The first to suffer are the iliac and obturator lymph nodes. At the same time, swelling of the lower extremities and genital organs occurs. When metastasizing to skeletal tissue, the disease manifests itself in severe bone pain, which is difficult to relieve. In most cases, the bones of the pelvis, spine, hips and ribs are the first to suffer from metastases. Of the internal organs, the parenchymal organs are primarily affected - most often the oven, somewhat less often the lungs. Symptoms of advanced metastasis appear:

  • Severe nagging pain in the bones, fever;
  • Predisposition to atypical compression type fractures. The spine is most often affected;
  • Dystrophy of the hip bones and, as a result, lameness;
  • Pathological metabolic disorders;
  • The emergence of a persistent aversion to certain foods;
  • In especially severe cases, modifications of consciousness of varying severity are possible - from nervousness to severe delirium and complete loss of self-awareness.

In the latter case, the disease cannot be cured and patients die.

Treatment

Unlike prostate cancer of the 2nd degree and even 3rd, which are quite successfully treated with modern therapeutic agents, with stage 4 cancer, especially with extensive metastases, there is almost no chance of complete healing. In this situation, we can only talk about prolonging the patient's life as much as possible, reducing his suffering and, if possible, improving his remaining life. Palliative therapy serves these tasks. About her below.

Palliative care

The vast majority of patients at the final stage of prostate cancer are susceptible to compression fractures of the vertebrae, entrapment of the spinal substance and, as a result, severe pain. To relieve these effects, drugs based on zoledronic acid - bisphosphonates - are successfully used. The use of these agents is also justified in the case of multiple metastases. Most patients treated with bisphosphonate therapy experience significant pain relief and improvement in their general condition. To relieve pain, you can also use folk remedies, for example, hemlock tincture.

External and local radiation therapy, the use of powerful analgesics and glucocorticoids help to overcome pain caused by bone metastases.

In case of problems with compression injuries of the spinal column, radiation therapy and glucocorticoids are also applicable. Treatment with hormonal drugs copes well with the situation. In severe situations, sometimes it is necessary to resort to surgical decompression of the spine.

Radiological therapy

The ionizing effect of radiation helps to slow down the growth rate of tumor formations and, thereby, control pain. More than 75% of patients report a decrease in pain after using targeted radiation therapy. The course of treatment is 10 sessions of external irradiation, over 14–21 days. In cases where the patient has multiple metastases, it is preferable to use the method of targeted administration of radioactive elements. At the same time, approximately 50% of patients experience some (short-term) relief.

Along with pain relief, this treatment causes side effects– leukopenia and thrombocytopenia, therefore the frequency and intensity of such therapy are limited. If there is a significant increase in leukocytes and platelets in the blood, therapy is stopped and rehabilitation measures are carried out, including the use of drugs traditional medicine.

Bisphosphonate therapy

This method uses drugs based on acids - clodronic and aledronic, which help to some extent restore the level of minerals in bone tissue. The method has proven itself to be effective in treating bone metastases with myeloma tumors. Therapy is often used in conjunction with hormonal treatment.

Complications associated with prostate cancer

Treatment for stage 4 prostate cancer does not occur without significant complications. Without adequate treatment, it is impossible to talk about any way of life acceptable for the patient. The most serious and dangerous complications are spinal compression injuries, anemia, ureteral obstruction and, of course, severe pain, especially in the bones.

Pain

Stage 4 prostate cancer almost always occurs with metastases to bone tissue. In this case, the patient experiences severe pain in the pelvis and spine. Sometimes this condition even leads to pathological fractures. Most often, the bones of the hip - its neck - are broken.

To stabilize a significantly damaged bone, or in the case of a high probability of such a scenario, surgical treatment is performed.

Spinal cord compression

The thoracic spine and the upper third of the lumbar spine are most susceptible to this pathology. The compression state occurs for 2 reasons - infringement of brain tissue by a growing metastasis or due to a fracture of a vertebral area. This shows up:

  • Motor retardation;
  • Increase in temperature;
  • Reduced skin sensitivity;
  • Radiculitis-type pain;
  • Dysfunction of the ureters and bladder.

Symptoms can be chronic or develop like an avalanche, with the emergence and development of paralysis.

The compression condition is treated:

  • Antiandrogen therapy - administration of glucocorticoids;
  • Surgical decompression;
  • By means of radiotherapy.

The last two methods are sometimes combined - first, radiation therapy is used, and if it does not bring the desired result, surgical methods are used.

Infravesical obstruction

There are two types of this condition - chronic obstruction and acute. Treatment is carried out with hormonal agents - antiandrogens, or surgically. 70% of patients experience relief after treatment, but during therapy, artificial drainage of the bladder has to be arranged for about 3 months.

The operation is performed in exceptional cases, since the risk of developing urinary incontinence is high and only if:

  • Low effectiveness of hormonal treatment;
  • Heavy bleeding into the prostate or its neck.

Anemia

This condition, even at the last stage of prostate cancer, is not often observed. The impact of metastases on bone erythropoiesis tissue plays a role in its occurrence. Anemia does not cause significant inconvenience for most patients, but sometimes treatment is necessary. To normalize the condition, the diet is adjusted and iron supplements, erythropoietins and vitamins are additionally administered. Blood transfusion also has a positive effect.

Folk remedies

Traditional treatment includes herbal infusions, serums, and propolis. Its effectiveness is very doubtful and is aimed primarily at increasing general immunity.

Nutrition

A properly chosen diet not only strengthens the body, but also to some extent helps it fight pathology. For example, a diet with an emphasis on fresh vegetables and fruits strengthens the immune system and increases hope for an improved outlook. Let's say more - normalization of the diet is the basis of any traditional medicine. Any folk remedy will not be effective without healthy image life, the first criterion of which is a healthy diet.

Forecasts

As with other oncopathologies, the treatment of stage 4 prostate cancer is difficult to reliably predict. Its results are influenced by a huge number of factors, many of which cannot be clearly defined and classified, therefore accurate forecasts impossible. And yet, statistics inexorably indicate a fairly low survival rate for patients with this form of cancer. Even the world's leading clinics, subject to the application modern methods therapy, predict a small survival of such patients. The answer to the question of how long people live with this disease is, unfortunately, disappointing. More than two thirds of patients with stage 4 prostate cancer die within five years.

Video on the topic

Prostate cancer (PCa) is one of the most common cancer pathologies detected in men over 50 years of age. This diagnosis is in second place among cancer causes of death in men. About 25% of newly diagnosed prostate cancer is the fourth stage of the disease.

Despite the fact that this is the last and incurable stage, modern medicine has ways to stabilize the process, transforming it into a chronic course that can be controlled. Stage 4 prostate cancer can and should be treated; life expectancy is significantly increased by several years.

Criteria for Stage 4 PCa

  • Local spread index T4, that is, tumor invasion beyond the boundaries of the glandular capsule and its growth into surrounding structures: bladder, seminal vesicles, rectum, anal sphincter, pelvic diaphragm (T4N0M0).
  • Any form of T, but with screening in nearby lymph nodes (T1-4N1M0).
  • Existing malignant screenings in other organs, regardless of the local spread of the tumor (T1-4N0-1M1).

In establishing the 4th stage, only the above criteria are taken into account. PSA level and Gleason grade are not important here. Another name for this stage is generalized prostate cancer.

Reasons for late detection

  • Asymptomatic course of the disease in the initial stages.
  • Low information content of screening studies and lack of clear recommendations for early detection of prostate cancer.
  • The reluctance of many older men to be regularly monitored and undergo prescribed examinations as part of a “wait-and-see approach.”

Clinical picture of metastatic prostate cancer

Symptoms of stage 4 prostate cancer can be divided into several groups:

Symptoms of bladder outlet obstruction

Narrowing of the urethra exiting the bladder due to compression by a growing tumor:

  • Difficulty in urination.
  • Feeling of dissatisfaction after visiting the toilet, inability to completely empty the bladder.
  • Sluggish stream of urine.
  • Ishuria is a constant leakage of urine when the bladder is full.
  • Acute or chronic urinary retention, the appearance of renal failure against this background.

Symptoms associated with tumor invasion into surrounding organs

  • Hematuria is the appearance of blood in the urine when it spreads to the walls of the urethra and bladder.
  • Blood in sperm – with invasion of the seminal vesicles and ejaculatory ducts.
  • Pain in the perineum. If nearby nerve trunks are involved, it can radiate to the penis, scrotum, and inner thigh.
  • The appearance of blood in the stool, tenesmus when the tumor affects the walls of the rectum, and the development of intestinal obstruction is possible.
  • Swelling of the lower extremities with damage to the pelvic lymph nodes and blockage of lymphatic drainage. Edema is characterized by density, asymmetry, and lack of response to diuretics.
  • When the ureters become obstructed by tumor growth, lower back pain appears and renal failure begins to develop.

Paraneoplastic symptoms

Caused by the toxic effect of tumor metabolites on the entire body.

  • Anemia is a decrease in the concentration of hemoglobin and red blood cells in the blood.
  • Loss of body weight.
  • Loss of appetite.
  • General weakness, asthenia.
  • Polyarthritis.
  • Polyneuropathy – loss of sensitivity, decreased strength in the limbs.

Metastases in prostate cancer: clinical picture in the pathology of distant organ complexes

  • Bone metastases in prostate cancer are most often localized in lumbar region spine and pelvic bones. The pain increases over time, gets worse at night, does not correlate with the intensity of the exercise, and is poorly relieved by available analgesics and NSAIDs.
  • Spontaneous vertebral fractures, against this background there may be compression of the spinal cord: impaired movement, urinary and fecal incontinence.
  • Cough, hemoptysis, shortness of breath, chest pain with metastases in the lungs.
  • Symptoms of brain damage are migraine-like pain, nausea, convulsions, paralysis and paresis of the limbs.
  • Jaundice, ascites, bleeding, itching – in the presence of liver metastases.

Stage 4 cancer may first manifest itself with local symptoms followed by the development of a clinical picture characteristic of damage to other organs, but quite often there are situations when symptoms, due to distant metastases in prostate cancer, become the first signs of the disease. That is, prostate cancer may first manifest itself as a vertebral fracture, metastatic pneumonia or jaundice.

Diagnostics

Inspection and instrumental methods

  • Digital rectal examination (DRE). In most cases, the prostate gland can already be palpated through the wall of the rectum. Prostate cancer, especially at stage 4, is enlarged in size, dense, immobile, its surface is uneven, lumpy, the tumor can protrude strongly into the lumen of the rectum. Sometimes the edges of the gland cannot be palpated; it is defined as a dense diffuse infiltrate. The intestinal wall is fused with the tumor, and ulceration and bleeding are possible.
  • TRUSY. Transrectal ultrasound examination. This examination reveals the tumor itself - a nodular formation, with uneven contours, of a heterogeneous structure. Ultrasound can show germination of the gland capsule, expansion of the tumor into neighboring organs, and damage to regional lymph nodes.
  • Prostate biopsy. Necessary for an accurate diagnosis and degree of malignancy of the tumor. It is carried out under the control of a transrectal ultrasound sensor: biopsy needles are inserted through the perineum. Columns of tissue (from 8–12 points) are collected into the needle and sent for histological examination.
  • The morphological type is determined (in 90% - prostate adenocarcinoma) and the level of Gleason differentiation. The higher the score on this scale, the more malignant the tumor and the more unfavorable the prognosis.
  • CT or MRI of the pelvis. These examinations are necessary to accurately determine the stage of the disease. These imaging methods allow you to assess the size, spread of the tumor, damage to nearby organs and lymph nodes. MRI in these cases is more informative than CT.
  • Osteostigraphy. The study is based on the ability of metastatic foci in bone tissue to intensively accumulate a radioactive isotope, which is detected during subsequent scanning. Prostate cancer spreads to the skeleton in 50–65% of cases. Most often these are the pelvic bones and lumbar vertebrae. Generalized skeletal damage is possible.
  • X-ray or computed tomography of the chest. Detects metastases in the lungs. It is performed on all patients, regardless of the presence of bronchopulmonary symptoms. CT is preferable; it allows visualization of lesions as small as 5 mm.
  • CT abdominal cavity and brain. It is prescribed to detect metastases in the liver, other organs, and brain.
  • Pelvic lymphadenectomy. A surgical intervention that has diagnostic and therapeutic purposes in addition to therapeutic ones. It is carried out when there is doubt about damage to the pelvic lymph nodes to accurately determine the stage of the disease and develop treatment tactics.
  • PET CT. Newest method examinations combining radionuclide and radiation diagnostics. Allows you to examine the entire body and see even the smallest screenings of a malignant tumor. The method is informative, but is not yet widely available and is carried out only in large specialized centers.

Laboratory methods

  • A general blood test usually diagnoses a decrease in hemoglobin and red blood cells, possible leukocytosis and an increase in ESR.
  • A general urine test reveals hematuria (blood cells), proteinuria (protein).
  • Biochemical analysis reveals an increase in creatinine and urea levels with a complication such as kidney failure. An increase in alkaline phosphatase concentration is an indirect criterion for bone metastasis.
  • PSA (prostate-specific antigen) is a glycoprotein produced by the secretory cells of the prostate. It is a tissue marker, a small amount of it is determined in the blood serum. Increases with malignant tumors of the organ, benign adenomas, prostatitis. There is a correlation between the size of the carcinoma and the PSA level. In stage 4 cancer, the PSA concentration is almost always greater than 20 ng/ml. A figure > 100 ng/ml is considered a reliable criterion for the presence of distant lesions.

Treatment

The fourth stage of prostate cancer includes both prostate cancer with regional metastases, and with distant ones. Accordingly, treatment tactics for these groups of patients will be different. If we talk about locally advanced cancer (T4N0M0 or T1-4N1M0), then following methods treatment:

  1. In patients with resectable tumors - radical prostatectomy (RP) + adjuvant radiation therapy + hormonal therapy.
  2. External beam radiation + hormone treatment.
  3. Isolated hormone therapy.

If we are talking about prostate cancer with distant metastases (a generalized form of cancer, which is mainly associated with the fourth stage in everyone), then the only effective method treatment is hormonal therapy - androgen deprivation.

Stage 4 prostate cancer with metastases is radically incurable. Impact on it is considered palliative and has the following goals:

  • Elimination or reduction of symptoms.
  • Slowing tumor growth.
  • Prevention of further metastasis.
  • Improving the patient's quality and life expectancy.

Hormone therapy

PCa is a hormone-dependent carcinoma. It has been proven that the male sex hormone testosterone and its more active form, dihydrotestosterone, stimulate the growth of glandular tissue cells of the organ, both malignant and benign. And if the production of androgens is sharply reduced, the growth of the tumor slows down or stops, in some cases there is even a regression of the existing malignant foci. Main types of hormone therapy:

  • Bilateral orchiectomy – surgical castration. The simplest, most accessible and effective method reduce the amount of testosterone in the body. Hormone levels drop within a few hours after surgery. This intervention is simple and can be performed under local anesthesia and in elderly and debilitated patients. There are almost no contraindications for it. The only difficulty is that you need to overcome the patient’s psychological resistance, since the very concept of “castration” causes a sharp negative reaction. But in this case we are talking about extending life by an average of 2–3 years, sometimes more, which should motivate patients to agree.
  • Medical castration. An antiandrogenic effect can also be achieved with the help of medications. They belong to the group of luteinizing hormone releasing hormone (LHRH) agonists. Goserelin, Triptorelin, Leuprorelin or Buserelin are used. They need to be administered once every 28 days. There are deposited forms that last 3-6 months. Treatment is carried out for life or until tumor resistance is achieved.
  • LHRH antagonist. The most studied drug is Degarelix, which is also administered once a month. Unlike the previous group, it does not cause a “flash” effect.
  • Antiandrogens are drugs that block male sex hormones. They are used both independently and in combination with surgical or medical castration (maximum androgen blockade - MAB). They are also prescribed in the first weeks after the start of treatment with LHRH agonists - to prevent the "flare" effect. The most used are Bicalutamide, Flutamide, Cyproterone acetate.
  • Estrogens. By mechanism type feedback indirectly block the production of androgens. Historically, these are the very first drugs that began to be used for hormonal therapy for prostate cancer. However, estrogens also have the most pronounced side effects (cardiotoxicity, thromboembolic complications), so they are not currently used as first-line drugs.

The main side effects of hormone therapy:

  • Impotence.
  • Tides.
  • Swelling and tenderness of the mammary glands.
  • Osteoporosis (decrease in bone density) and a tendency to spontaneous fractures.
  • Gastrointestinal disorders (diarrhea, nausea).
  • Atherosclerosis and cardiovascular complications.

Chemotherapy

As a drug for the treatment of prostate cancer in patients with a high prevalence of the process, Docetaxel is used intravenously every 21 days (up to 6 courses). A study has been conducted that the combination of castration (surgical or medical) with chemotherapy significantly increases the survival of patients compared with hormonal therapy alone. But this treatment is less well tolerated.

Hormone resistance of prostate cancer and second line of treatment

During HT, the tumor inevitably becomes refractory to castration. After a certain period (on average 2 years), it begins to progress, despite the continuing low level of testosterone. Progression is recorded by the increasing concentration of PSA, the growth of the primary focus, and the increase in the number of metastases.

The appearance of signs of tumor resistance is a signal for a review of treatment. There are many treatment options for patients with advanced prostate cancer due to HT:

  • Cancellation of antiandrogens in patients receiving them leads to an improvement in performance in 1/3 of cases.
  • Substitution of one drug for another (for example, flutamide is replaced by bicalutamide and vice versa).
  • Prescription of ketoconazole. It is an antifungal drug with the effect of suppressing the production of androgens by the adrenal glands.
  • Use of estrogens. Contraindicated for cardiovascular diseases.
  • Adding chemotherapy. If progression occurs after docetaxel, cabazitaxel, abiraterone, or enzalutamide are given in combination with prednisolone.

Palliative care methods

This treatment is designed to reduce symptoms and improve quality of life. Unlike hormonal therapy, it does not affect the tumor itself and overall survival.

  • Bisphosphonates (zoledronic acid) in combination with calcium and vitamin D preparations. They are used for bone metastases, promote the repair of foci of destruction and reduce pain.
  • Radiation therapy for screening bone metastases. Introduction of radioactive strontium Sr-89 or samarium Sa153.
  • Use of bone cement for fractures.
  • Adequate pain relief. NSAIDs and non-narcotic analgesics are prescribed, and opioids may also be needed. Often, once palliative radiation therapy or bisphosphonates begin to work, the need for pain relief decreases.
  • Transurethral resection (TUR) as a method of eliminating urinary problems.
  • Epicystostomy in case of refusal or impossibility of performing TUR.
  • If signs of spinal cord compression appear, decompression surgery may be performed. The alternative is high doses of corticosteroids and radiation therapy.
  • Antidepressants for appropriate indications.

Observation

After starting HT, follow-up examinations should be performed every 3–6 months. Deadlines are usually set individually. The goal is to record the moment of development of castration resistance and the beginning of disease progression, as well as to neutralize the side effects of HT.

Minimum examinations:

  • Questioning (increasing symptoms).
  • General clinical tests.
  • PSA level (increases with progression).
  • According to indications - ultrasound, osteoscintigraphy, CT or MRI, PET CT.

Forecast

Stage 4 prostate cancer has a poor prognosis. It depends on the degree of tumor spread at the time of its detection, the Gleason score (the higher, the shorter the life expectancy), the initial PSA concentration, the intensity of its growth, as well as the presence of distant malignant foci.

Hormone therapy is the main treatment method for metastatic prostate cancer. On average, it slows down and stabilizes the disease for 24–36 months. 7% of patients live 10 years or more after starting HT.

Stage 4 prostate cancer is increasingly becoming a cause of death in men over 70–75 years of age.

Disappointing medical statistics force specialists to look for new methods early diagnosis cancer and its prevention.

The peculiarities of the formation and growth of the tumor, the almost complete absence of warning symptoms, lead to the fact that a man is already diagnosed with stage 4 prostate cancer. The prognosis at this stage is far from comforting - the process ends in death. However, carrying out therapeutic measures makes it possible to somewhat delay the sad outcome of the disease.

Features of stage 4 prostate cancer and prognosis

Stage 4 prostate cancer will be characterized by tumor growth into neighboring tissues and organs, as well as the presence of metastases in distant parts of the man’s body. The bladder, intestinal loops, and pelvic bones are most often attacked by cancer cells.

A diagnosis of stage 4 prostate cancer is given to a man based on the following criteria:

  • the tumor has spread beyond the organ;
  • multiplicity of primary foci, or the huge size of a single tumor;
  • rapid tumor growth rates;
  • aggressiveness of negative symptoms;
  • steady deterioration in the man’s well-being;
  • severe difficulty urinating;
  • the presence of constant pain impulses in the pelvis;
  • confirmation by instrumental studies of distant foci of cancer in organs - metastasis.

With prostate cancer at the 4th stage of its course, a man is already worried about weight loss and disorders in the sexual sphere - libido is completely suppressed. The tumor occupies almost the entire small pelvis, with a pronounced disruption of the activity of the organs present in it. The pain is so severe that to suppress it it is necessary to take powerful analgesics, most often narcotic ones.

Treatment tactics boil down to maintaining an acceptable standard of living for the man, since it is no longer possible to eliminate the tumor by surgical excision of the tumor or by administering chemotherapy. The prognosis is extremely negative - men die from prostate cancer by the end of the first or second year from the moment the diagnosis is confirmed.

Symptoms of stage 4 prostate cancer

The fourth stage of the course of a tumor in the structures of the prostate gland in men is accompanied by such a characteristic clinical picture that diagnosis is not difficult for an experienced doctor.

The main symptoms of prostate cancer during this period:

  • dysuric disorders - frequent urge to empty the bladder, with a minimal volume of urine coming out, delayed onset of urination, intermittency and weakness of the stream;
  • the presence of drops or streaks of blood, sperm, or purulent masses in the urine;
  • the process of emptying the bladder and rectum is accompanied by painful sensations, discomfort.

Since cancer cells spread with the blood and lymph throughout the man’s body, with the formation of secondary tumors, the symptoms of the organ in which metastasis occurred are added:

  • in bone structures - pain appears first in the sacral spine, in the pelvic bones, then in the ribs and limbs;
  • cancer four with tumors in digestive system will be manifested by a deterioration in appetite, weight loss, changes in skin color, and difficulties with bowel movements;
  • The main sign of metastasis to the lungs is a prolonged paroxysmal non-productive cough, as well as an increase in shortness of breath, which is not amenable to ongoing therapeutic measures.

The terminal stage of cancer in the prostate parenchyma is a combination of decompensation of the activity of almost all organs and systems. Therefore, the prognosis for men is extremely negative – the five-year survival rate does not exceed 1–2%.

Impact of diagnosis on prognosis

Of course, stage 4 prostate cancer is a failure to carry out diagnostic measures in a timely manner due to a man’s failure to seek medical help, or a diagnostician’s error in assessing the information from the studies performed.

Modern instrumental and laboratory techniques that allow diagnosing a tumor in the structures of the prostate:

  • transrectal ultrasound – visualization of the tumor, nodes in the prostate, their size and location;
  • CT, MRI - allow you to examine the cancer focus in more detail, literally in layer-by-layer sections;
  • concentration of prostate specific antigen in men - PSA blood test.

However, a biopsy finally puts everything in its place - a cytological study of organ cells, identifying cancer cells in the biomaterial. The degree of their malignancy and the structure of the tumor are assessed. Life expectancy directly depends on what form of prostate cancer has formed. Thus, adenocarcinoma is characterized by aggressiveness and rapid growth, as well as early metastasis.

Thus, if the diagnostic procedures performed show that the tumor has a single primary focus and a small number of secondary metastases in nearby organs, the prognosis is somewhat better. Then, as multiple lesions of distant organs of a man are diagnosed - cancer cells from the prostate have moved in large quantities, aggravating the situation. The duration of death is minimal.

Treatment tactics and prognosis

Since it is no longer possible to treat mature prostate cancer at stage 4 of its course - many secondary tumors do not allow for their complete elimination from the organs, the actions of specialists are aimed exclusively at making the man feel better.

Treatment of stage 4 prostate cancer comes down to slowing the rate of tumor growth as much as possible - radiation and chemotherapy. Surgery can be performed to reduce cancer intoxication. Its volume and possibility of implementation are determined by a specialist individually. However, surgical intervention has virtually no effect on the prognosis of five-year survival.

Additionally, in the complex treatment of cancer, men are recommended to take hepatoprotectors, vitamin complexes, sedatives and sleeping pills, as well as the most modern and powerful analgesics. All these medications help support and improve the functioning of internal organs and help them fight cancer intoxication.

chances of recovery

The life span of a man with cancer in the prostate structures will depend on the initial state of his body, as well as his age. Thus, in the absence of severe chronic pathologies - cardiovascular, digestive or genitourinary systems, even at stage 4 of a prostate tumor, men can live another 5-7 years. Whereas with decompensation of diseases and general exhaustion of a man’s body, the amount of time allotted to him is significantly reduced.

The chances of recovery for stage 4 cancer tend to zero. The explanation is the pronounced metastasis of the tumor, a significant depletion of the functional capabilities of the male body. However, experts urge not to give up and fight - advances in the antitumor field can significantly prolong life even with the terminal stage of cancer.

Malignant neoplasms of the prostate claim thousands of lives every year. Stage 4 prostate cancer (carcinoma) ranks second in terms of the number of deaths among all types of tumors. The disease mainly affects men over 60 years of age.

Stage 4 prostate cancer - what is the patient’s prognosis, and how long do they live at the last stage? These are the first most important questions that irritate a man and his relatives.

Stage 4 prostate cancer occurs when the malignant tumor is already in the bones and neighboring organs

When stage 4 of prostate cancer occurs, the malignant formation is already fixed in the bones and neighboring organs, which are initially healthy. The diagnosis usually carries an extremely unfavorable prognosis, and very few patients manage to live beyond three years after this. But sometimes patients live four or five years, depending on what factors are involved in life and how the therapy works on the progression of the disease.

Characteristic 4 stages

Stage 4 prostate cancer is classified into three substages:

  • T4 – the tumor has crossed the borders of the prostate and is already penetrating into nearby organs and tissues.
  • T4A – the tumor has spread through the rectum and bladder.
  • T4B – the tumor has already spread to the bones, pelvis and anus.

A malignant prostate tumor can form metastases in a matter of days. This will be the only sign of an ongoing disease. Cancer cells penetrate into the blood and affect the following types of lymph nodes: obturator, iliac and hypogastric. Swelling of the legs and genitals appears. If bones begin to ache during prostate cancer, this is often a harbinger of a tumor that has spread into them through hematogenous means. In most cases, the following types of bones are affected:

  • pelvic;
  • cranial;
  • rib;
  • vertebrates;
  • femoral

A malignant prostate tumor can form metastases in a matter of days

The first organs affected are the adrenal glands, lungs and liver.

Late stage symptoms

Many clinical manifestations of stage 4 prostate cancer are similar to the clinical picture of prostate adenoma (benign prostate tumor), and do not allow the doctor to make an accurate diagnosis without an in-depth examination of the patient. The fourth stage has the following symptoms, which cannot be used to accurately judge the presence of a progressive tumor:

  • problems with the outflow of urine;
  • frequent urge to urinate;
  • sharp, unexpected urges due to little need;
  • discomfort during and after urination.

However, stage 4 prostate cancer also has significant differences, which together can accurately indicate the presence this disease at the patient. Metastases choose foci in the liver, lungs and bones. That is why, at the last stage of the disease, a man’s usual lifestyle changes for the worse. Inconveniences and peculiar pains appear that disturb the patient’s normal sleep. Among the symptoms:

  • hematuria (blood in the urine);
  • sharp pain in the perineum, in the bones;
  • visible changes in gait (metastases have penetrated the femur);
  • disturbed metabolism;
  • impaired consciousness;
  • cachexia (rapid weight loss);
  • non-union of broken bones in the affected areas;
  • deterioration of immunity, susceptibility to colds and viruses;
  • bowel problems (severe constipation, mucus clots and blood in the stool);
  • swelling of the genitals, legs;
  • chronic fatigue;
  • nausea, sudden vomiting, sudden loss of appetite;
  • impotence, lack of desire;
  • sputum with blood, continuous cough;
  • kidney problems;
  • pain in the lower abdomen.

It is usually impossible to completely cure stage 4 cancer.

Symptoms of prostate cancer do not cause suspicion in men until the fourth stage, since they usually do not manifest themselves in any way. As a result, patients come to the hospital too late medical institution. In such a situation, the prognosis cannot be positive, and the patient can only count on a slight prolongation of life. It is usually impossible to completely cure stage 4 cancer.

Outcome of the disease

Before you perceive information about how people die from prostate cancer, it is necessary to realize that the fourth stage of the disease represents an irreversible change in the body and its functions. Everything that happens to the patient is a gradual decline leading to death.

Refusal of water and food is a harbinger of the onset of last days life of a patient with stage 4 prostate cancer. Force feeding causes vomiting. The patient is too weak and no longer needs much food and energy to maintain vital functions. Breathing slows down, the depth of inspiration decreases. If metastases are present in the lungs, they further inhibit the breathing process.

The man is lethargic, apathetic, and often sleeps. With mental problems, the moral state of the patient may be inadequate, reactions are unpredictable. Many people whose relatives have died from prostate cancer advise spending as much time as possible with the sick, talking, joking with them, and remembering the best periods of life. This will somewhat ease the patient’s moral burden and distract him from negative thoughts.

As soon as the patient enters preagonia, the prognosis for life will be 1-2 days. During this short period, the man will be especially pale, lethargic, reflexes will be impaired, arterial pressure will drop sharply to critical levels. This will be followed by agony - a condition that lasts up to 3 hours (sometimes the patient “burns out” in a few minutes). In these moments, oxygen ceases to flow rhythmically to the tissues, complete depression of breathing and circulation begins, and as a result, clinical death. Within 6 minutes the patient can be resuscitated, but biological death will occur in any case, since the body is no longer able to function.

Treatment

It will no longer be possible to stop developing grade 4 prostate cancer and increase life expectancy through surgery. Patients are considered inoperable and receive the following supportive treatment:

  • hormonal;
  • chemical;
  • radial

Chemotherapy at stage 4 is prescribed if the tumor is hormone-resistant

Hormone therapy

The growth of a prostate tumor is directly related to male sex hormones (androgens), in particular, testosterone. Therefore, the treatment of stage 4 prostate cancer is aimed at suppressing the level of male sex hormones, which contributes to the “inhibition” of cancer. But the effect occurs if the tumor is hormone sensitive. It is possible to suppress androgens by the following actions:

  1. Orchiectomy – removal of the testicles. After surgery, hormone levels decrease immediately.
  2. Estrogen therapy is the introduction of female hormones into the body of a man, which counteracts androgens. Currently, estrogen therapy has been replaced by innovative methods of non-surgical intervention.
  3. LHRH analogues (LHRH antagonists) are substances that suppress the production of male hormones in the body. The action occurs at the level of the hypothalamus.
  4. Steroid and non-steroidal antiandrogens. The effect is not on the level of hormones in the blood, but on the receptors that accept androgens.

Chemotherapy

Chemotherapy for stage 4 cancer is prescribed if the tumor is hormone-resistant. Special chemicals are administered to patients into a vein or received subcutaneously (through the lymph), as well as through the gastrointestinal tract. They poison and destroy cancer cells, preventing them from reproducing. Regression occurs.

Stage 4 prostate cancer with metastases, as a rule, cannot be cured; it is only possible to prolong the patient’s life. Chemical substances, as a rule, affect healthy cells of the body, but there is no choice here.

Radiation therapy

At the last stage of cancer, radiation therapy is used as an auxiliary method of complex therapy. Exposure of the lesions to the rays significantly relieves the patient’s pain symptoms. Similar to chemotherapy, radiation therapy inhibits the division of abnormal cells and destroys them.

In Germany, they practice an innovative method of treating prostate cancer - a radioactive substance is injected into the patient’s veins, which subsequently accumulates in bone and soft tissues. But such therapy is carried out when all other types of treatment no longer work.

The choice of therapy is selected by the oncologist, having studied the characteristics of the course of the disease and the general picture of the patient’s condition. Only after a complete diagnosis of the body is it possible to optimally create a therapeutic program using one or several types of therapy.

Since treatment at the last stage of prostate cancer is ineffective, many depressed patients refuse any type of therapy. Metastases act quickly and the chances of long life are very low. But medicine knows of cases where patients at the last stage of cancer lived up to ten years after intensive therapy. There are only 20% of them, but this already means that every patient can get a more encouraging prognosis with a 1 in 5 chance.

Who said that it is impossible to cure prostatitis?

DO YOU HAVE PROSTATITIS? Have you already tried many remedies and nothing helped? These symptoms are familiar to you firsthand:

  • constant pain in the lower abdomen, scrotum;
  • difficulty urinating;
  • sexual dysfunction.

The only way is surgery? Wait, and do not act with radical methods. Prostatitis is POSSIBLE to cure! Follow the link and find out how the Specialist recommends treating prostatitis...

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