Advanced Prostate Cancer

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Advanced Prostate Cancer?

Advanced prostate cancer (stage III-IV or metastatic) originates in the prostate gland and spreads to bones, lymph nodes, lungs, or liver. It’s initially hormone-sensitive but may progress to castration-resistant prostate cancer (CRPC). In 2025, it’s the second most common cancer in men, with 1 in 8 diagnosed, but advances in therapy extend survival significantly.

Symptoms

Symptoms include difficulty urinating, frequent urination, blood in urine/semen, erectile dysfunction, pelvic pain, and fatigue. Metastatic disease causes bone pain (spine, hips), weight loss, leg swelling (lymphoedema), and shortness of breath (lung metastases). CRPC may present with systemic symptoms like weakness or neurological issues if spinal cord is affected.

Causes

Risk factors include age (over 65), family history, African descent, and genetic mutations (BRCA1/2, ATM). Androgen signaling drives tumor growth, with lifestyle factors (high-fat diet, obesity) contributing. In 2025, genomic profiling reveals how DNA repair defects and androgen receptor mutations promote progression to CRPC.

Diagnosis

Diagnosis uses prostate-specific antigen (PSA) testing, digital rectal exam (DRE), and prostate biopsy with Gleason scoring. Imaging (MRI, PSMA PET, bone scans) detects metastases. Molecular testing for BRCA or AR mutations guides therapy. In 2025, PSMA PET scans achieve 90% sensitivity for detecting small metastases, improving staging accuracy.

Treatment

Hormone-sensitive disease is treated with androgen deprivation therapy (ADT) via surgical or medical castration (e.g., leuprolide). Advanced cases add chemotherapy (docetaxel, cabazitaxel), next-generation AR inhibitors (enzalutamide, apalutamide), or PARP inhibitors (olaparib for BRCA mutations). Radiation targets bone metastases, and PSMA-targeted radioligand therapy (e.g., lutetium-177) shows 50% response rates in 2025. Palliative care addresses pain and quality of life.

Future Outlook

In 2025, 5-year survival for metastatic prostate cancer is 30-50%, with combination therapies (ADT + abiraterone) extending life by 18-24 months. Research focuses on PSMA-targeted therapies, immunotherapy, and AI-driven risk models. By 2030, novel combinations and early ctDNA monitoring could achieve 60% survival, with emphasis on delaying CRPC.

Sources

The information for advanced prostate cancer is sourced from NCI’s “Prostate Cancer Treatment (PDQ®)” for treatment and prognosis details; Cleveland Clinic’s “Prostate Cancer” for symptoms and diagnostic methods; Mayo Clinic’s “Prostate Cancer” for causes and symptoms; JAMA Oncology’s “Precision Oncology in Prostate Cancer” for 2025 treatment advancements; and PMC’s “Genomic Drivers of CRPC” for causes and future therapeutic directions.