Stage 4 prostate cancer has spread to other areas of the body and is generally incurable, but treatments can slow growth and improve quality of life. Hormone therapy is the first line of treatment, and radiation therapy may be used in combination. Surgery is usually not effective. Pain management and counseling are important.
Stage 4 prostate cancer is advanced cancer of the male prostate gland that has spread, or metastasized, to other areas of the body. Prostate cancer is more common in men over 55, and risk is influenced by advancing age, genetic predisposition, and a high-calorie diet. It is generally considered incurable in this advanced stage, although many treatments are available that slow the growth of the cancer, prolong life, and improve overall quality of life.
Prostate cancer is classified by stages, ranging from stage 1 to stage 4. Stage 1 prostate cancer involves small tumors in the prostate gland that are thought to be unlikely to spread aggressively, and stage 2 involves larger tumors or more aggressive ones that still remain inside the prostate gland. Cancer classified as stage 3 has spread to grow through the capsule around the prostate and possibly into the seminal vesicles. Stage 4 prostate cancer has spread further than stage 3 to another organ or body structure such as the lymph nodes, bladder, or bones.
Treatment options for stage 4 prostate cancer are different than for earlier stages of the disease. Surgery to remove the prostate, which is common for earlier stage cancers, is usually not effective in stage 4. It is only used if the cancers are causing problems such as obstructing urine flow. Most patients with stage 4 prostate cancer are treated with several methods of treatment, and some participate in experimental clinical trials of new treatments.
Hormone therapy is the first line of treatment for stage 4 prostate cancer. It involves blocking or removing the male hormones needed for prostate tumors to grow, either through medications or surgery to remove the testicles. Radiation therapy, which involves the use of beams of radiation to destroy cancer cells, is often used as a treatment in combination with hormone therapy. Most prostate cancers eventually continue to grow even after hormone therapy and may therefore require chemotherapy.
Treatment side effects can vary widely in severity. It is important to weigh the risks and benefits of each treatment. Very old men and men with other serious illnesses may choose to refuse treatment unless they experience symptoms such as pain, as side effects of treating these patients with hormones, radiation, or chemotherapy can cause significant problems.
Pain is more likely to be a problem for patients with stage 4 prostate cancer than patients with earlier stage cancer, particularly if the cancer has affected the bones. Pain management is an important part of caring for these patients. Counseling for the patient and their family is likely to be beneficial for general well-being and quality of life.
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