What is the prognosis for prostate cancer that has spread to the spine

How We Treat Prostate Cancer

The prognosis for metastatic prostate cancer can be discouraging, but some treatment centers—like the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancer—specialize in innovative, individualized therapy with the potential to improve outcomes.

Long-Term Prognosis

Because most prostate cancers are diagnosed with early screening measures and are curable, the average long-term prognosis for prostate cancer is quite encouraging. The figures below, provided by the American Cancer Society, represent the average relative survival rate of all men with prostate cancer. They represent a patient’s chances of survival after a specified number of years as compared with the larger population’s chances of survival during that same timeframe. Since these numbers include all stages of prostate cancer, they will not accurately predict an individual man’s prognosis.

• 5-year relative survival rate of nearly 100 percent: Five years after diagnosis, the average prostate cancer patient is about as likely as a man without prostate cancer to still be living.
• 10-year relative survival rate of 98 percent: Ten years after diagnosis, the average prostate cancer patient is just 2 percent less likely to survive than a man without prostate cancer.
• 15-year relative survival rate of 95 percent: Fifteen years after diagnosis, the average prostate cancer patient is 5 percent less likely to survive than a man without prostate cancer.

Recurrence

Even if your cancer was treated with an initial primary therapy (surgery or radiation), there is always a possibility that the cancer will reoccur. About 20 percent to-30 percent of men will relapse (have the cancer detected by a PSA blood test) after the five-year mark, following the initial therapy. The likelihood of recurrence depends on the extent and aggressiveness of the cancer.

Several online tools have been assembled to help predict the likelihood of recurrence. Try inputting your own information into the Han Tables prediction tool.

The Role of PSA

Prostate cancer recurrence is determined by rising PSA levels following treatment. Use the following guide to gauge recurrence:

Clinicians use the change in PSA over time as a marker for the aggressiveness of the recurrence. After a certain amount of time, the cancer will become visible radiographically (e.g., via CT scans or bone scans). Prostate cancer can recur locally in the pelvis or elsewhere in the body. The location of the recurrence is determined by these radiographic scans.

• After surgery, PSA levels should drop to zero. When PSA levels rise above 0.2 ng/mL, the cancer is considered recurrent.
• After treatment with radiation, PSA levels rarely drops completely to zero. However, the PSA should level out at a low number, which is called the nadir. When PSA rises 2 points from its lowest value, the cancer is considered recurrent.

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