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Cedars Sinai
Former President Joe Biden’s announcement that he has advanced prostate cancer brought new attention to the second-most common cancer in men. He is among the 1 in 8 men who will be diagnosed with prostate cancer during their lifetime—but a Cedars-Sinai expert says new approaches for earlier diagnosis and treatment options are advancing.
Robert Figlin, MD, interim director of Cedars-Sinai Cancer and professor of Medicine and Biomedical Sciences at Cedars-Sinai, sat down with the Cedars-Sinai Newsroom to answer common questions about the disease and options for patients.
What does it mean to have stage 4 prostate cancer?
All cancers are diagnosed by stage. Stage 4 is when the disease has spread from the primary area or organ—in this case, the prostate gland—to other areas. The most common place that prostate cancer spreads is to the bone, although it can spread to other organs such as the lungs, lymph nodes or liver.
How is prostate cancer treated?
The standard of care for prostate cancer, by and large, when newly diagnosed, is to turn off the stimulation of the prostate cancer cell by blocking androgens, including testosterone, either where they are made or where they act with the cancer to cause cancer to grow. So, androgen suppression through treatments that reduce testosterone levels is the treatment of choice, primarily for hormone-sensitive prostate cancer. Having said that, recent evidence suggests that you can add chemotherapy to hormone treatment for men with prostate cancer that improves both their progression-free survival and their overall survival.
What is the expected prognosis for a patient with stage 4 prostate cancer?
Prostate cancer, when metastatic, whether it’s aggressive or nonaggressive, is not currently a curable disease. So, what we can expect is that control of the cancer should be easily obtained using hormone ablation. This will certainly improve what’s called progression-free survival, meaning that it’ll slow the growth of the cancer to other areas, it will prolong survival, but it will not be curative.
What are the screening recommendations for prostate cancer?
The standard screening recommendation for men is a digital rectal examination and a PSA blood test on an annual basis. The PSA test measures a hormone called prostate-specific antigen, which may indicate prostate cancer when found at high levels. But currently, it’s not recommended that men beyond the age of 70 have routine screenings, because in population studies, there’s been no evidence that screening elderly men improves overall survival. Having said that, that should still be a discussion between the physician and the patient to see whether screening is appropriate.
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Information Source: Cedars Sinai
