From the Guidelines
The 10-year survival rate for high-grade prostate cancer is approximately 45% for patients with a Gleason score of 8-10, as indicated by the RTOG 92-02 trial and other studies 1. This rate can vary significantly based on individual factors such as the stage of cancer at diagnosis, age, overall health, and treatment approach. Early detection and aggressive treatment are crucial for improving long-term survival. Standard treatment for high-grade prostate cancer typically involves a multimodal approach, including:
- Radical prostatectomy (surgical removal of the prostate)
- Radiation therapy
- Androgen deprivation therapy (ADT) For instance, a common ADT regimen might involve leuprolide (Lupron) injections every 3-6 months, combined with daily oral antiandrogens like bicalutamide (Casodex), as recommended by the AUA/ASTRO/SUO guideline 1. Newer treatments that have shown promise in improving survival rates include:
- Abiraterone acetate (Zytiga) or enzalutamide (Xtandi) for metastatic cases
- Chemotherapy with docetaxel, especially when started early in the treatment course
- Immunotherapy options like sipuleucel-T (Provenge) for certain cases It's essential to note that regular PSA monitoring and follow-up imaging are crucial for early detection of recurrence or progression, as emphasized in the NCCN clinical practice guidelines in oncology: prostate cancer 1. Lifestyle factors such as maintaining a healthy diet, regular exercise, and avoiding smoking can also contribute to better overall outcomes. The relatively high survival rate is due to advancements in treatment options and early detection methods, as discussed in the Journal of the National Comprehensive Cancer Network: JNCCN 1. However, high-grade prostate cancer is still considered aggressive, and immediate, comprehensive treatment is necessary to achieve the best possible outcomes. Radical prostatectomy or radiotherapy plus ADT is recommended as standard treatment options for patients with high-risk localized prostate cancer, as stated in the AUA/ASTRO/SUO guideline 1. Clinicians should not recommend active surveillance for patients with high-risk localized prostate cancer, and watchful waiting should only be considered in asymptomatic men with limited life expectancy (£5 years) 1.
From the Research
10-Year Survival Rate for High-Grade Prostate Cancer
- The 10-year survival rate for high-grade prostate cancer varies depending on the treatment and patient characteristics.
- A study published in the Journal of Urology in 2002 found that the 10-year cancer-specific survival rate for patients with pathological Gleason score 8 or greater prostate cancer was 85% 2.
- Another study published in the World Journal of Urology in 2014 found that the 10-year cancer-specific survival rate for patients with Gleason 8-10 prostate adenocarcinoma who underwent radical prostatectomy was 89.5% 3.
- A study published in Urology in 2016 found that aggressive treatment was associated with significantly lower risk of cancer mortality for patients with high-grade prostate cancer, with a 10-year absolute risk reduction in cancer mortality of 11.3% for men with Charlson scores of 0 4.
- A study published in the International Journal of Radiation Oncology, Biology, Physics in 2018 found that the 10-year overall survival rate for patients with Gleason score 10 prostate adenocarcinoma was around 80-83% depending on the treatment 5.
- A study published in European Urology in 2016 found that the 10-year prostate cancer-specific mortality rate for patients with nonmetastatic locally advanced or aggressive intermediate prostate cancer who received lifelong endocrine treatment alone or combined with radiotherapy was 34% and 17%, respectively 6.