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Prostate Cancer Prognosis

Doctors will help you develop your prognosis - the potential outcomes of the treatment options available to you.

In this section: Decisions Overview Build Your Team Prostate Cancer Grade Prostate Cancer Stage Prognosis Treatment Option Tools Questions to Ask

Your prognosis should take into account your PSA level, grade and stage, as well as your age, race, health, and personal and family medical history.

It helps to understand some common terms used to talk about prognosis, before you talk to your doctor.

Developing Your Prognosis

Prognostic Charts and Statistical Models (nomograms) are developed by teams of doctors who look at a large number of patients, compare their PSA levels, Gleason scores, staging, and other indicators with the results of their treatment, and then create charts showing how likely it is that patients with a certain set of indicators will have a certain treatment outcome.

The Treatment Option Decision Tool in this section uses statistical models to suggest treatment options based on the medical information you provide. Decision tools and statistical models are meant to support your decision making process, not make the decision for you. They are useful, but they do not give you certainties, only odds. You and your doctor will have to figure out what these odds mean for you.

Terms to Know:

Survival Rates the percentage of patients with a certain stage of cancer who are still alive a specific period of time after their diagnosis.

Median Survival Length in patients with a certain level of the disease or a certain regimen of treatment, the median survival rate refers to the length of time where half of those patients live longer than that time and half live shorter.

5 Year Survival Rate survival rate 5 years after diagnosis. 5 and 10 year survival rates are used as standards for comparison.

Relative Survival Rates when people refer to survival rates, they usually mean relative survival rates - how many people survive some years after diagnosis relative to how many people would have survived the same number of years without the disease. That is, they don’t include those who would have died anyway from something other than the disease.

Recurrence when the disease comes back after the initial period of treatment. Likelihood of recurrence refers to the percentage of a certain category of patient whose cancer comes back after a certain kind of treatment.

(Cancer) Progression refers to a bad kind of “progress” that is, progress being made by the cancer, not the patient. Progression is often measured in the rate of change of PSA level, or PSA velocity, after treatment, a very strong indicator of whether prostate cancer has been stopped or continues to grow, or an observable change in the cancer mass through exam or imaging.

Progression-Free Survival Rates instead of measuring the percentage of patients still alive at some time past diagnosis, this measures the percentage of patients still alive and free of signs that the disease is progressing at that amount of time past diagnosis.

Partin Tables Dr. Alan W. Partin’s research team analyzed treatment and results for patients who had undergone radical prostatectomy, or complete surgical removal of the prostate. Then he developed charts predicting the outcome of surgery for others, based on the patient’s PSA, Gleason score, and clinical stage prior to surgery.

Other prognostic tools predict other odds, such as the likelihood of relapse for patients who have undergone surgery or different kinds of radiation. Some can be used to predict how those odds might change if they added hormone therapy. Others predict the risk of spread to lymph nodes. Your doctor will probably use a number of these tools, depending on your situation.