Diagnosis
Prostate cancer often presents no symptoms. Many times it is detected through routine physicals at the physician's office. Once cancer is confirmed, it will be staged to determine how far the cancer has spread and graded to measure how aggressive the cancer is. Staging is ranked from stage I through stage IV. Grading is based on the Gleason Grading System which applies a numerical number to cancer cells observed under a microscope. Scores range from 2 to 7, the lower the better. The final stages of prostate cancer fall into the stage IV category. At this point, the cancer has spread to lymph nodes and other organs. The Gleason score, however, may still be low. Life expectancy and treatment options depend on a combination of the stage involved and the Gleason score.
Prognosis
If a man is diagnosed at a stage IV prostate cancer, immediate interventions usually involve external radiation with hormone therapy. Once the cancer is at stage IV, it is referred to as metastatic prostate cancer. Hormone treatments may alleviate symptoms such as urinary problems, difficulty in maintaining an erection,and painful urination or ejaculation. If the bones are not yet affected, hormonal treatments can delay the spread of the cancer for two to three years. The physician sometimes prescribes a course of chemotherapy as an adjunct to radiation and hormones. If the cancer has spread to the bones, a patient may be prescribed medications that strengthen the bones and limit bone mass losses, thus reducing fractures and pain. Radiation also can be effective in address bone pain in patients whose cancer has spread. Unfortunately, many of these measures serve as a palliative intervention. Statistically, only one-third of men diagnosed with stage IV prostate cancer will survive for five years post diagnosis, but prostate cancer survival rates are improving annually.
Hospice Decision
There may come a time when all interventions have failed and a patient is facing the terminal stages of prostate cancer. Hospice care may be appropriate for a patient in this situation. The goal of hospice care takes a shift from treatment of the disease to treatment of the person. Pain relief, dignity and spiritual fulfillment are priorities under hospice care. Supportive care is extended to family members to help all involved cope with the disease and the dying process.
Tags: prostate cancer, cancer spread, Gleason score, hospice care, Once cancer, stage prostate, stage prostate cancer