The fourth stage of prostate cancer means that a tumor is beyond the capsule and grows to the neighboring organ or organs.

If a patient has prostate cancer stage 4, it does not mean that prognosis is poor.

In case of prostate cancer stage 4, the possibility of 10-year survival rate is 30%.

A tumor can be big, but operable. A decision about surgical treatment is made individually.

Classification of prostate cancer stage 4

Metastasizing can be rapid because each new population of cancer cells divides and spreads faster than previous one (at stage 4 a process is really fast).

Prostate cancer stage T4-A can become T4-B (inoperable tumor) for 3-4 days. If you are suggested a surgery in case of prostate cancer stage 4 - agree immediately, do not postpone a surgery.

Т4-А

(with substage - T4N0M0)

ОTumor metastases in the bladder and the rectum. A surgery supposes prostatectomy and plastic. This substage includes T4N0M0 condition when a patient does not have metastases. After a surgery, such patients recover completely.

Т4-В

Cancer effects pelvic muscles, bones and other organs.




Metastases spread through blood and lymphatic duct. In some cases, doctors detect them by accident.

General symptoms of prostate cancer stage 4

Severe dysuria disorders. A tumor compresses urinary tracts that can lead to urinary incontinence, painful urination, inflammatory and infectious diseases of the bladder and urethra (urine is cloudy and with putrefactive smell).

Doctors cannot estimate an advancement of the disease according to the intensity of dysuria disorders - they point only the size of tumor body (T). Life prognosis is made according to the other criterion - invasiveness of tumor cells (1-10 Gleason scale).

Tumor destruction is accompanied by blood in urine and sperm. Patients can see it by themselves, or specialists in the laboratory conditions. Because of the oncological process, regeneration of the vascular wall is compromised. Hidden bleeding can manifest itself with decrease of hemoglobin, weakness, and dizziness.

A patient with the advanced process can notice weight loss, fatigue, drowsiness, and other signs of intoxication.

Symptoms caused by prostate cancer metastases

  • pain in the pubis region, in the bones (most often in the lower back), rectum, perineum;
  • frequent fractures (due to the activity of the tumor, osteoporosis begins), disturbances in synosteosis, a change in gait. Metastases most often affect the sacrum, are also found in the thoracic and cervical vertebrae, cranial bones, ribs, in the neck of the femur;
  • swelling of the lower extremities, scrotum, penis;
  • with metastasis in the testicles, in 35% of patients gynecomastia (swelling of the mammary glands) and impotence develop;
  • paralysis and paresis of the lower extremities due to the compression of the spinal cord by a secondary tumor. For the same reason, there may be disorders of the pelvic organs, uncontrolled defecation;
  • a disorder of consciousness occurs with metastases in the brain;
  • jaundice develops upon the formation of a large metastasis in the liver;
  • a hemoptysis - in case of lung damage.

Treatment of prostate cancer stage 4

  • Extended prostatectomy. The prostate, lymph nodes and parts of affected. Doctors perform surgery at stage 4 after agreement with a patient. Criterion - no more than 1 metastasis (T4N0M0, T4NxM0-1);
  • radiosurgical methods (iMRT, etc.). Tumor cells are destroyed without surgery; it is possible to act on multiple metastases at one time;
  • chemotherapy and hormone therapy. Cytostatics and hormones are prescribed to suppress tumor growth;
  • cytokine therapy - a destruction of distant metastases by immunological means (antibodies, interleukins, etc.).

For the improvement of health condition at stage 4:

  • doctors install cava filters (prevention of thrombosis);
  • restore the patency of the urinary tract (stenting);
  • remove the affected lymph nodes;
  • prescribe plasmapheresis, transfusion of blood components and other palliative methods.