Materiały źródłowe

• #1 Prostate Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/prost.html

  Estimated New Cases in 2025 313,780 […] Estimated Deaths in 2025 35,770 […] Prostate cancer represents 15.4% of all new cancer cases in the U.S. […] In 2025, it is estimated that there will be 313,780 new cases of prostate cancer and an estimated 35,770 people will die of this disease. […] The rate of new cases of prostate cancer was 120.2 per 100,000 men per year based on 20182022 cases, age-adjusted. […] Prostate cancer is most frequently diagnosed among men aged 6574. […] Because we have screening for prostate cancer, most of the time it is caught before it spreads to other parts of the body. […] In general prostate cancer has excellent survival rates, but death rates are higher in non-Hispanic Black men, men who have advanced stage cancer, and men who are between the ages of 75 and 84.

• #2 Prostate Cancer – Uroweb

  https://uroweb.org/guidelines/prostate-cancer/chapter/epidemiology-and-aetiology

  Prostate cancer (PCa) is the second most commonly diagnosed cancer in men, with an estimated 1.4 million diagnoses and 375,000 deaths worldwide in 2020. In more than half of the countries of the world it is the most frequently diagnosed cancer in men and PCa is the leading cause of death among men in a quarter of all countries. In Europe, it is the most frequently diagnosed cancer in men and the third cancer-related cause of death in men. […] A SR of autopsy studies reported a prevalence of PCa at age 30 years of 5%, increasing with age, to a prevalence of 59% by age 79 years. There is variation in the frequency of autopsy-detected PCa between men with different ethnical backgrounds and geographical areas. Regarding incidence of PCa diagnosis, the variation is even more pronounced between different geographical areas, partly driven by rate of prostate-specific antigen (PSA) testing and influenced by (inter)national organisations recommendations on screening. It is highest in Australia/New Zealand and Northern America, and in Western and Northern Europe. The incidence is low in Eastern and South-Central Asia, but rising. Rates in Eastern and Southern Europe were low but have also shown a steady increase. Other reasons for variation in PCa incidence include the age of the population, ethnicity and dietary factors.

• #3 Incidence and mortality trends of metastatic prostate cancer: Surveillance, Epidemiology, and End Results database analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8631846/

  Incidence rates of metastatic prostate cancer increased by 18% from 2008-2009 to 2014-2016 (incidence rate ratio [IRR]=1.18, 95% confidence interval [CI] 1.14-1.21). […] This trend was observed across multiple subgroups but was greatest in non-Hispanic Whites and patients living in counties 0-10% below poverty level. […] Despite trends of decreased risk of prostate cancer-specific mortality, we found certain populations experienced increases in mortality risk. […] Prostate cancer is the most common cancer in men in the U.S., with an estimated 191,000 new cases diagnosed in 2020. […] Despite a five-year relative survival rate of greater than 99% for localized disease, metastatic prostate cancer (mPCa) remains the second leading cause of cancer-related death in men, with a five-year relative survival rate of 30.2%.

• #4

  https://cuaj.ca/index.php/journal/article/view/7173

  Incidence rates of metastatic prostate cancer increased by 18% from 2008-2009 to 2014-2016 (incidence rate ratio [IRR]=1.18, 95% confidence interval [CI] 1.14-1.21). […] This trend was observed across multiple subgroups but was greatest in non-Hispanic Whites and patients living in counties 0-10% below poverty level. […] There was an overall decreased risk of all-cause and prostate cancer-specific mortality, but unmarried men and men living in counties 20% below poverty level showed statistically significant increased risk of prostate cancer-specific mortality. […] Non-Hispanic Whites and the wealthiest subgroups had the largest increase in incidence of metastatic prostate cancer since 2008. […] Despite trends of decreased risk of prostate cancer-specific mortality, we found certain populations experienced increases in mortality risk.

• #5 Metastatic and Advanced Prostate Cancer: Overview, Epidemiology of Advanced Prostate Cancer, Presentation of Advanced Prostate Cancer

  https://emedicine.medscape.com/article/454114-overview

  A review of almost 800,000 cases of prostate cancer diagnosed from 2004-2013 found that although the incidence of low-risk prostate cancer decreased by 37% from 2004 to 2007-2013, the annual incidence of metastatic prostate cancer during those years increased by 72%. The increase in metastatic prostate cancer was greatest (92%) in men aged 55-69 years. […] At diagnosis, 69% of prostate cancer cases are localized; in 13%, the cancer has spread to regional lymph nodes, and 8% have distant metastasis. The 5-year relative survival rate for localized and regional prostate cancer is 100%, compared with 34.1% for metastatic cases. […] Since the early 1990s, prostate cancer death rates have been decreasing in men of all races and ethnicities. However, they remain more than twice as high in Blacks as in any other group. Prostate cancer tends to not only be more aggressive and progressive in Black men, leading to advanced disease, but to also be of a higher grade at diagnosis. […] Death rates are also higher in men who have advanced-stage cancer, and men who are 75 to 84 years of age.

• #6 Prostate Cancer Incidence and Survival, by Stage and Race/Ethnicity — United States, 2001–2017 | MMWR

  https://www.cdc.gov/mmwr/volumes/69/wr/mm6941a1.htm

  Among U.S. men, prostate cancer is the second leading cause of cancer-related death. The incidence of distant stage prostate cancer (signifying spread to parts of the body remote from the primary tumor) has increased since 2010. […] Additional years of data show continued increases in the incidence of distant stage prostate cancer in the United States. The percentage of distant stage prostate cancer increased from 4% in 2003 to 8% in 2017. […] Five-year survival for distant stage prostate cancer improved from 28.7% during 2001-2005 to 32.3% during 2011-2016; for the period 2001-2016, 5-year survival was highest among Asian/Pacific Islanders (42.0%), followed by Hispanics (37.2%), American Indian/Alaska Natives (32.2%), Black men (31.6%), and White men (29.1%). […] Understanding the disease trends of distant stage prostate cancer and disparities in prostate cancer survival by stage, race/ethnicity, and age can guide public health planning related to screening, treatment, and survivor care.

• #7 Changing Incidence of Metastatic Prostate Cancerlogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na54746/2022/03/15/changing-incidence-metastatic-prostate-cancer

  Changing Incidence of Metastatic Prostate Cancer […] Increasing incidence from 2010 to 2018 might reflect changes in U.S. screening recommendations — or not. […] Of 836,000 total cases of prostate cancer, 3.2% and 2.5% were cases of distant metastatic cancer in middle-aged (age range, 45–74) and older men (age, ≥75), respectively. In analyses that translated these findings into population-based rates, the incidence of metastatic cancer for middle-aged men was stable from 2004 to 2010 and then increased between 2010 and 2018 (from 12 to 17 cases/100,000 men). For older men, the incidence decreased from 2004 to 2011 (from 67 to 58 cases/100,000 men) and then increased to 89 cases per 100,000 men by 2018. […] At first glance, one might attribute these findings to USPSTF recommendations against screening in 2008 and 2012, as the authors do; however, the results could be explained by more-accurate or more-aggressive diagnostic strategies.

• #8 Estimating the Number of Men Living with Metastatic Prostate Cancer in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36716178/

  Metastatic prostate cancer (MPC) includes metastases detected at diagnosis (de novo) and those occurring after diagnosis with early-stage disease (recurrent). Cancer registries collect data only on de novo MPC, providing a partial picture of the burden of MPC. We use cancer registry data to estimate the number of men living with MPC in the United States including both de novo and recurrent cases. […] On January 1, 2018, we estimated 120,400 U.S. men living with MPC (45% de novo, 55% recurrent). The age-adjusted prevalence in 2018 for Black men was over double that of White men (137.1 vs. 62.2 per 100,000 men). By 2030, 192,500 men are expected to be living with MPC, with the increase being driven by population growth projections. […] The number of men living with MPC in the United States exceeds 100,000 and represents a small fraction of the 3 million men living with a prior diagnosis of prostate cancer. […] Relatively similar fractions of de novo and recurrent MPC among prevalent cases highlight opportunities for management of localized disease in reducing the MPC burden. Changes in diagnostic technologies could lead to greater growth in MPC cases in the United States than projected.

• #9 Epidemiology of metastatic castration-resistant prostate cancer: A first estimate of incidence and prevalence using the French nationwide healthcare database.

  https://urotoday.review/recent-abstracts/urologic-oncology/prostate-cancer/125393-epidemiology-of-metastatic-castration-resistant-prostate-cancer-a-first-estimate-of-incidence-and-prevalence-using-the-french-nationwide-healthcare-database.html

  There is a lack of information about the burden of metastatic castration-resistant prostate cancer (mCRPC). The present work aims to estimate the incidence and prevalence of mCRPC in 2014 using the French nationwide healthcare database (SNDS). […] Prevalence and incidence of mCRPC were estimated as, respectively, 62 and 21 cases per 100 000 men in 2014. Less than one mCRPC case per 100 000 was observed in men aged 40-49. Maximum mCRPC incidence was in men aged 80-89 (175 per 100 000). […] The good performances of the algorithm for mCRPC identification and the consistency of the generated results with the existing data highlight the robustness of these first estimates of mCRPC prevalence and incidence. Future updates will call for algorithm adjustment as practices evolve over time. These first real-life data will serve for future follow-up of the impact of changes in the management of prostate cancer.

• #10 Incidence and mortality trends of metastatic prostate cancer: Surveillance, Epidemiology, and End Results database analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8631846/

  Previous reports have shown that the incidence of mPCa increased after 2007, which may be partially attributed to the 2008 USPSTF recommendation against screening in those 75 and older. […] We found that there was a significant increase in incidence among certain groups, most notably those who were non-Hispanic White, those who were 0-10% below federal poverty level, and those 75-84 years old. […] Our results show that despite increases in mPCa incidence over time, the risk of prostate cancer-specific mortality decreased in later time intervals. […] The overall incidence of mPCa increased from 2008 to 2016. […] We also demonstrated that despite decreased prostate cancer-specific mortality in recent years, perhaps due to the advances in treatment and access to care, certain demographic subgroups saw an increase in risk of prostate cancer-specific mortality.

• #11

  https://www.healio.com/news/hematology-oncology/20220316/rise-in-metastatic-prostate-cancer-incidence-coincides-with-screening-guideline-changes

  Increases in metastatic prostate cancer incidence may be temporally associated with changes in clinical policy following U.S. Preventive Services Task Force recommendations, according to a study in JAMA Network Open. […] Our study of the recently released 2004-2018 SEER data set confirms a rising incidence rate of metastatic prostate cancer coinciding with the 2008 and 2012 USPSTF recommendations against PSA-based prostate cancer screening. […] Cacciamani and colleagues said concern followed that the recommendation could contribute to an increase in the incidence of metastatic prostate cancer. […] The increased metastatic prostate cancer incidence rates occurred despite a significant concurrent reduction in the overall incidence of prostate cancer diagnosis, Cacciamani said. […] Cacciamani noted the stark contrast between the increased incidence rates observed in the study and the decreases prior to the USPSTF recommendations.

• #12 Metastatic and Advanced Prostate Cancer: Overview, Epidemiology of Advanced Prostate Cancer, Presentation of Advanced Prostate Cancer

  https://emedicine.medscape.com/article/454114-overview

  Prostate cancer is the most commonly diagnosed cancer in men in the United States, and the second leading cause of cancer-related deaths. Approximately 12.9% of men will develop prostate cancer in their lifetime, with the likelihood increasing with age; prostate cancer is most often diagnosed in men age 65 to 74 years, and the median age at diagnosis is 67 years. Since the advent of prostate-specific antigen (PSA) screening, prostate cancer is being detected and treated earlier. […] Overall, incidence rates of prostate cancer began declining in 2000. From 2007 to 2014, rates declined sharply, coinciding with less PSA testing because of changes in screening recommendations. Since 2014, however, the overall incidence has increased by 3% per year, and diagnoses of advanced-stage prostate cancer have increased by about 5% per year.

• #13 Metastatic prostate cancer on the rise since decrease in cancer screenings

  https://news.keckmedicine.org/metastatic-prostate-cancer-on-the-rise-since-decrease-in-cancer-screenings/

  Keck Medicine of USC study shows that the incidence rate of metastatic prostate cancer rose as much as 43% in men 75 and older and 41% in men 45-74 after routine prostate cancer screenings were no longer recommended. […] A new study from Keck Medicine of USC finds that the incidence rate of metastatic prostate cancer has significantly increased for men 45 and older and coincides with recommendations against routine prostate cancer screenings. […] Among the 45-74 age group, the incidence rate of metastatic prostate cancer remained stable during 2004-2010, then increased 41% during 2010-2018. For men 75 and older, the incidence rate decreased in 2004-2011, then increased 43% from 2011-2018. For both age groups, the increases were across all races. […] The researchers note that these increases stand in contrast to the decreasing trends in incidence of metastatic prostate cancer between 2004-2009, before the USPSTF stopped recommending routine PSA screenings for men.

• #14 Prostate Cancer: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/1967731-overview

  In the United States, the incidence rate of prostate cancer is 70% higher in Black versus White men, and the prostate cancer mortality rate in Black men is 2-4 times higher than in every other racial and ethnic group. […] Well-established risk factors for prostate include ethnicity, age, and country of residence. Additional risk factors include family history and genetic predisposition. […] Discovery of these mutations has led to recommendations for the consideration of genetic testing for men with family histories that strongly suggest the presence of these mutations and men with metastatic castrate-resistant prostate cancer. […] An examination of cancer histories of 198 Lynch syndrome families, including probands and their first- through fourth-degree relatives, found that men with Lynch syndrome have a 2-fold higher risk of prostate cancer compared with the general population.

• #15 Metastatic and Advanced Prostate Cancer: Overview, Epidemiology of Advanced Prostate Cancer, Presentation of Advanced Prostate Cancer

  https://emedicine.medscape.com/article/454114-overview

  A review of almost 800,000 cases of prostate cancer diagnosed from 2004-2013 found that although the incidence of low-risk prostate cancer decreased by 37% from 2004 to 2007-2013, the annual incidence of metastatic prostate cancer during those years increased by 72%. The increase in metastatic prostate cancer was greatest (92%) in men aged 55-69 years. […] At diagnosis, 69% of prostate cancer cases are localized; in 13%, the cancer has spread to regional lymph nodes, and 8% have distant metastasis. The 5-year relative survival rate for localized and regional prostate cancer is 100%, compared with 34.1% for metastatic cases. […] Since the early 1990s, prostate cancer death rates have been decreasing in men of all races and ethnicities. However, they remain more than twice as high in Blacks as in any other group. Prostate cancer tends to not only be more aggressive and progressive in Black men, leading to advanced disease, but to also be of a higher grade at diagnosis. […] Death rates are also higher in men who have advanced-stage cancer, and men who are 75 to 84 years of age.

• #16 Metastatic and Advanced Prostate Cancer: Overview, Epidemiology of Advanced Prostate Cancer, Presentation of Advanced Prostate Cancer

  https://emedicine.medscape.com/article/454114-overview

  A review of almost 800,000 cases of prostate cancer diagnosed from 2004-2013 found that although the incidence of low-risk prostate cancer decreased by 37% from 2004 to 2007-2013, the annual incidence of metastatic prostate cancer during those years increased by 72%. The increase in metastatic prostate cancer was greatest (92%) in men aged 55-69 years. […] At diagnosis, 69% of prostate cancer cases are localized; in 13%, the cancer has spread to regional lymph nodes, and 8% have distant metastasis. The 5-year relative survival rate for localized and regional prostate cancer is 100%, compared with 34.1% for metastatic cases. […] Since the early 1990s, prostate cancer death rates have been decreasing in men of all races and ethnicities. However, they remain more than twice as high in Blacks as in any other group. Prostate cancer tends to not only be more aggressive and progressive in Black men, leading to advanced disease, but to also be of a higher grade at diagnosis. […] Death rates are also higher in men who have advanced-stage cancer, and men who are 75 to 84 years of age.

• #17 Journal of Urologic Oncology

  https://www.e-juo.org/m/journal/view.php?number=532

  The incidence of prostate cancer (PCa) has increased worldwide in recent years along with the recommendation for prostate-specific antigen testing, and mortality has been declining owing to advances in fragmented and simplified access to treatment care. […] The incidence of PCa is 7.3% of the total cancer incidence (developed countries: 3%15%, developing countries: 3%4%). […] The incidence of PCa has been increasing, especially in developed countries since the 1990s when prostate-specific antigen (PSA) testing was approved. […] Asian countries have the lowest incidence of PCa in the world. […] According to the GLOBOCAN 2020 database, the incidence tends to be higher in Northern Europe (age-standardized rate [ASR], 83.4), Western Europe (ASR, 77.6), the Caribbean (ASR, 75.8), Australia and New Zealand (ASR, 75.8), and North America (ASR, 73.0). In contrast, the lowest regions were Asia including South-Central Asia (ASR, 6.3), Southeast Asia (ASR, 13.5), East Asia (ASR, 16.8), and Western Asia (ASR, 28.6).

• #18 The Silent Burden of De Novo Metastatic Prostate Cancer in the Middle East: A Call for Region-Specific Screening Guidelines

  https://www.mdpi.com/2563-6499/6/1/4

  The Silent Burden of De Novo Metastatic Prostate Cancer in the Middle East: A Call for Region-Specific Screening Guidelines […] Background: Prostate cancer is a significant global health concern, with rising incidence and disease burden in the Middle East (ME). This review aims to explore the current state of prostate cancer epidemiology in the ME, particularly in low- to middle-income settings, investigating trends in incidence and mortality, assessing challenges related to de novo metastatic prostate cancer, and evaluating the need for region-specific screening guidelines. […] The ME exhibits a rising trend in prostate cancer incidence, with a mortality-to-incidence ratio of 0.3–0.4, compared to 0.1 in the United States, reflecting significant differences in healthcare access and quality that contribute to poorer outcomes. […] De novo metastatic prostate cancer is also more prevalent in the ME, often exceeding 20–30%, with a value of 23% reported in Lebanon and reaching 54% in a study including six Middle Eastern countries, compared to 4–14% in the United States. […] Our review identified a critical need for enhanced screening and early detection efforts tailored to the ME’s unique epidemiological and socio-cultural factors. […] The substantial burden of de novo metastatic prostate cancer in the ME underscores the need for region-specific screening guidelines. […] Prostate cancer represents a significant global health burden, characterized by its high incidence and associated morbidity and mortality. […] In the Middle East (ME), the burden of prostate cancer is alarming, especially in low- and lower-middle-income countries. […] De novo metastatic prostate cancer, defined by the presence of distant metastases at initial diagnosis, poses a substantial challenge in the ME due to its aggressive nature and poor prognosis. […] The percentage of prostate cancer cases that are metastatic at diagnosis varies significantly by region. In the United States, this percentage typically ranges from 4 to 14%. In contrast, the ME experiences much higher rates, often exceeding 20–30%. […] A retrospective analysis of 559 patients diagnosed with prostate cancer and treated at a tertiary center in Lebanon, a lower-middle-income country, revealed 23% of patients with stage IV disease. […] To address the high burden of de novo metastatic prostate cancer in the ME, especially given the low to middle socio-economic status of many countries in the region, tailored guidelines for treatment have been developed. […] Data on de novo metastatic prostate cancer in the ME are scarce, highlighting a critical need for further investigation. […] Implementing national prostate cancer screening programs in the ME could increase the detection of localized and early-stage disease. […] Addressing these barriers through targeted awareness campaigns, improving physician education, strengthening primary care systems, and establishing regional collaboration and incentive programs that support the training and retention of healthcare professionals in low-income countries can significantly improve early detection and outcomes for prostate cancer patients in the ME. […] Active surveillance is now increasingly recognized as the preferred management strategy for low-risk prostate cancer.

• #19 Prostate Cancer Statistics for 2024

  https://www.cancertherapyadvisor.com/factsheets/prostate-cancer-statistics/

  Black men are more likely to have prostate cancer, more likely to be diagnosed at an earlier age, and more likely to die from prostate cancer. […] The incidence of prostate cancer is approximately 70% higher in Black men than in White men. […] Prostate cancer is the second leading cause of cancer death in men. […] Approximately 1 in 44 men in the US will die from prostate cancer. […] In 2024, an estimated 35,250 men will die from prostate cancer. […] However, mortality rates are higher in men who are Black, those who are older, and those who have distant metastasis. […] For men diagnosed with localized or regional prostate cancer, the 5-year relative survival rate is approximately 100%, but the rate declines to 36.6% for patients diagnosed with distant disease. […] As a result of earlier detection through PSA testing and improved treatments, the prostate cancer mortality rate declined from a height of 39.3 deaths per 100,000 men in 1993 to 18.8 deaths per 100,000 men in 2017.

• #20 Prostate Cancer: Epidemiology, Diagnosis, and Treatment | MedPage Today

  https://www.medpagetoday.com/medical-journeys/prostate-cancer/105268

  Prostate cancer mortality has been trending down. The death rate peaked in 1993 (39.3 per 100,000 men) and was cut in half by 2013 (19.3 per 100,000 men), largely due to earlier detection through PSA testing and advances in treatment. […] Many patients simply require careful monitoring of the disease (active surveillance) — particularly patients with early-stage disease and less aggressive tumors, and those who are older. […] Bone metastases occur in 85-90% of metastatic cases.

• #21 Key Statistics for Prostate Cancer | Prostate Cancer Facts | American Cancer Society

  https://www.cancer.org/cancer/types/prostate-cancer/about/key-statistics.html

  Other than skin cancer, prostate cancer is the most common cancer in men in the United States. […] The American Cancer Societys estimates for prostate cancer in the United States for 2025 are: About 313,780 new cases of prostate cancer. […] About 35,770 deaths from prostate cancer. […] The number of prostate cancers diagnosed each year declined sharply from 2007 to 2014, coinciding with fewer men being screened because of changes in screening recommendations. Since 2014, however, the incidence rate has increased by 3% per year. […] Prostate cancer is the second-leading cause of cancer death in American men, behind only lung cancer. About 1 in 44 men will die of prostate cancer. […] The prostate cancer death rate declined by about half from 1993 to 2022, most likely due to earlier detection and advances in treatment. In recent years, the decline in the death rate has slowed, likely reflecting the rise in cancers being found at an advanced stage.

• #22 Prostate Cancer: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/1967731-overview

  In 2015-2019, incidence rates for regional and distant prostate cancer increased by 4-6% per year. […] Prostate cancer mortality rates began to decline in the early 1990s, in all racial and ethnic populations, decreasing from 39.3 per 100,000 persons in 1991 to 18.6 per 100,000 in 2020. […] However, in 2015-2019, the decline in death rates slowed for Black and Hispanic men and ceased for White and Asian American/Pacific Islander men. […] Prostate cancer incidence increases as men age; as many as 60% of men over 65 years of age may be diagnosed with prostate cancer. […] Prostate cancer is most often diagnosed in men aged 65-74 years; median age at diagnosis is 66 years. […] However, men as young as 17 years are experiencing an increasing incidence of prostate cancer in much of the world, including the United States, according to data from the Surveillance, Epidemiology, and End Results (SEER) program and the Institute for Health Metrics and Evaluation (IHME) Global Burden of Disease (GBD) database.

• #23 Metastatic and Advanced Prostate Cancer: Overview, Epidemiology of Advanced Prostate Cancer, Presentation of Advanced Prostate Cancer

  https://emedicine.medscape.com/article/454114-overview

  A review of almost 800,000 cases of prostate cancer diagnosed from 2004-2013 found that although the incidence of low-risk prostate cancer decreased by 37% from 2004 to 2007-2013, the annual incidence of metastatic prostate cancer during those years increased by 72%. The increase in metastatic prostate cancer was greatest (92%) in men aged 55-69 years. […] At diagnosis, 69% of prostate cancer cases are localized; in 13%, the cancer has spread to regional lymph nodes, and 8% have distant metastasis. The 5-year relative survival rate for localized and regional prostate cancer is 100%, compared with 34.1% for metastatic cases. […] Since the early 1990s, prostate cancer death rates have been decreasing in men of all races and ethnicities. However, they remain more than twice as high in Blacks as in any other group. Prostate cancer tends to not only be more aggressive and progressive in Black men, leading to advanced disease, but to also be of a higher grade at diagnosis. […] Death rates are also higher in men who have advanced-stage cancer, and men who are 75 to 84 years of age.

• #24 Metastatic Prostate Cancer: Treatment Options & Prognosis | ZERO Prostate Cancer

  https://zerocancer.org/stages-and-grades/metastatic-prostate-cancer

  While metastatic prostate cancer is not curable, many factors influence a patient’s prognosis and life expectancy. […] Factors that impact metastatic prostate cancer prognosis include: Extent of metastasis: The number and location of metastatic sites can affect prognosis. Patients with fewer metastases or metastases confined to the bones may have a better prognosis than those with widespread metastases or visceral involvement (such as liver or lung metastases). […] Survival rates for metastatic prostate cancer can vary widely depending on individual factors. According to the American Cancer Society, the 5-year relative survival rate for distant (metastatic) prostate cancer is about 34%. However, this statistic doesn’t account for individual variations and advancements in treatment. […] Remember, while metastatic prostate cancer is a serious diagnosis, many patients can live for several years with appropriate treatment and support. Advances in therapies like hormone therapy, chemotherapy, immunotherapy, and targeted agents continue to improve outcomes and quality of life for men with advanced prostate cancer.

• #25 Prostate Cancer Incidence and Survival, by Stage and Race/Ethnicity — United States, 2001–2017 | MMWR

  https://www.cdc.gov/mmwr/volumes/69/wr/mm6941a1.htm

  Among U.S. men, prostate cancer is the second leading cause of cancer-related death. The incidence of distant stage prostate cancer (signifying spread to parts of the body remote from the primary tumor) has increased since 2010. […] Additional years of data show continued increases in the incidence of distant stage prostate cancer in the United States. The percentage of distant stage prostate cancer increased from 4% in 2003 to 8% in 2017. […] Five-year survival for distant stage prostate cancer improved from 28.7% during 2001-2005 to 32.3% during 2011-2016; for the period 2001-2016, 5-year survival was highest among Asian/Pacific Islanders (42.0%), followed by Hispanics (37.2%), American Indian/Alaska Natives (32.2%), Black men (31.6%), and White men (29.1%). […] Understanding the disease trends of distant stage prostate cancer and disparities in prostate cancer survival by stage, race/ethnicity, and age can guide public health planning related to screening, treatment, and survivor care.

• #26 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  Clinicians should assess the extent of metastatic disease (lymph node, bone, and visceral metastases) in newly diagnosed mHSPC patients. […] In newly diagnosed mHSPC patients, clinicians should assess the extent of metastatic disease (low- versus high-volume). High-volume is defined as greater than or equal to four bone metastases with at least one metastasis outside of the spine/pelvis and/or the presence of visceral metastases. […] Clinicians should assess if a newly diagnosed mHSPC patient is experiencing symptoms from metastatic disease at the time of presentation to guide discussions of prognosis and further disease management. […] Clinicians should obtain a baseline PSA and serial PSAs at three- to six-month intervals after initiation of ADT in mHSPC patients and consider periodic conventional imaging.

• #27 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  In mCRPC patients, clinicians should obtain baseline labs (e.g., PSA, testosterone, LDH, Hgb, alkaline phosphatase level) and review location of metastatic disease (lymph node, bone, visceral), disease-related symptoms, and performance status to inform discussions of prognosis and treatment decision-making. […] In mCRPC patients without PSA progression or new symptoms, clinicians should perform imaging at least annually. […] In mCRPC patients with disease progression (PSA or radiographic progression or new disease-related symptoms) having previously received docetaxel and androgen pathway inhibitor, who are considering 177Lu-PSMA-617, clinicians should order PSMA PET imaging. […] In patients with mCRPC, clinicians should offer germline (if not already performed) and somatic genetic testing to identify DNA repair deficiency, MSI status, tumor mutational burden, and other potential mutations that may inform prognosis and familial cancer risk as well as direct potential targeted therapies.

• #28 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  In mCRPC patients, clinicians should obtain baseline labs (e.g., PSA, testosterone, LDH, Hgb, alkaline phosphatase level) and review location of metastatic disease (lymph node, bone, visceral), disease-related symptoms, and performance status to inform discussions of prognosis and treatment decision-making. […] In mCRPC patients without PSA progression or new symptoms, clinicians should perform imaging at least annually. […] In mCRPC patients with disease progression (PSA or radiographic progression or new disease-related symptoms) having previously received docetaxel and androgen pathway inhibitor, who are considering 177Lu-PSMA-617, clinicians should order PSMA PET imaging. […] In patients with mCRPC, clinicians should offer germline (if not already performed) and somatic genetic testing to identify DNA repair deficiency, MSI status, tumor mutational burden, and other potential mutations that may inform prognosis and familial cancer risk as well as direct potential targeted therapies.

• #29 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  In mCRPC patients, clinicians should obtain baseline labs (e.g., PSA, testosterone, LDH, Hgb, alkaline phosphatase level) and review location of metastatic disease (lymph node, bone, visceral), disease-related symptoms, and performance status to inform discussions of prognosis and treatment decision-making. […] In mCRPC patients without PSA progression or new symptoms, clinicians should perform imaging at least annually. […] In mCRPC patients with disease progression (PSA or radiographic progression or new disease-related symptoms) having previously received docetaxel and androgen pathway inhibitor, who are considering 177Lu-PSMA-617, clinicians should order PSMA PET imaging. […] In patients with mCRPC, clinicians should offer germline (if not already performed) and somatic genetic testing to identify DNA repair deficiency, MSI status, tumor mutational burden, and other potential mutations that may inform prognosis and familial cancer risk as well as direct potential targeted therapies.

• #30 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  In mCRPC patients, clinicians should obtain baseline labs (e.g., PSA, testosterone, LDH, Hgb, alkaline phosphatase level) and review location of metastatic disease (lymph node, bone, visceral), disease-related symptoms, and performance status to inform discussions of prognosis and treatment decision-making. […] In mCRPC patients without PSA progression or new symptoms, clinicians should perform imaging at least annually. […] In mCRPC patients with disease progression (PSA or radiographic progression or new disease-related symptoms) having previously received docetaxel and androgen pathway inhibitor, who are considering 177Lu-PSMA-617, clinicians should order PSMA PET imaging. […] In patients with mCRPC, clinicians should offer germline (if not already performed) and somatic genetic testing to identify DNA repair deficiency, MSI status, tumor mutational burden, and other potential mutations that may inform prognosis and familial cancer risk as well as direct potential targeted therapies.

• #31 Prostate Cancer – Uroweb

  https://uroweb.org/guidelines/prostate-cancer/chapter/epidemiology-and-aetiology

  Pathogenic germline mutations in the BRCA2 and HOXB13 genes, but also in the genes CHEK2, BRCA1, ATM, NBS1, and genes involved in Lynch syndrome, have been suggested to increase the risk of PCa. Data from UK, on over 21,000 men without a PCa diagnosis, suggest that 1.6 % carry a pathogenic mutation in at least one of the genes BRCA2, HOXB13 or CHEK2. Even though germline mutations leading to PCa are relatively rare, the impact on PCa risk is quite strong, and the prevalence in patients with advanced PCa is high. Among men with metastatic PCa, an incidence of 11.8% was found for germline mutations in genes mediating DNA-repair processes, and for patients diagnosed with metastatic castrate-resistant PCa (mCRPC) the incidence was 16.2%. […] Prostate cancer is a major health concern in men, with incidence mainly dependent on age and extent of PSA testing. Genetic factors are associated with risk of (aggressive) PCa. A variety of dietary/exogenous/environmental factors have been associated with PCa incidence and prognosis. In hypogonadal men, testosterone supplements do not increase the risk of PCa. No conclusive data exist which could support specific preventive or dietary measures aimed at reducing the risk of developing PCa.

• #32 Active surveillance shown to be an effective management strategy for prostate cancer patients | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/news/releases/2024/05/active-surveillance-shown-to-be-an-effective-management-strategy.html

  Active surveillance for prostate cancer patients with a low risk of progression is an effective alternative to immediate surgery or radiation to manage the disease. […] 10 years after diagnosis, 49% of men using active surveillance remained free of treatment or progression. Less than 2% developed metastatic disease and less than 1% died of prostate cancer. […] Patients who were treated after several years of active surveillance had the same rates of poor outcomes, such as adverse pathology or metastasis, as those treated immediately following a confirmatory biopsy, validating active surveillance as a safe initial management strategy for low-risk prostate cancers. […] The goal of active surveillance for prostate cancer is to reduce unnecessary treatments and side effects among those diagnosed with lower risk cancer while avoiding undertreatment of aggressive disease.

• #33 Active surveillance shown to be an effective management strategy for prostate cancer patients | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/news/releases/2024/05/active-surveillance-shown-to-be-an-effective-management-strategy.html

  Active surveillance for prostate cancer patients with a low risk of progression is an effective alternative to immediate surgery or radiation to manage the disease. […] 10 years after diagnosis, 49% of men using active surveillance remained free of treatment or progression. Less than 2% developed metastatic disease and less than 1% died of prostate cancer. […] Patients who were treated after several years of active surveillance had the same rates of poor outcomes, such as adverse pathology or metastasis, as those treated immediately following a confirmatory biopsy, validating active surveillance as a safe initial management strategy for low-risk prostate cancers. […] The goal of active surveillance for prostate cancer is to reduce unnecessary treatments and side effects among those diagnosed with lower risk cancer while avoiding undertreatment of aggressive disease.

• #34 Metastasis Rates Among Men on Active Surveillance for Prostate Cancer

  https://www.pharmacytimes.com/view/metastasis-rates-among-men-on-active-surveillance-for-prostate-cancer

  Active surveillance seems to be safe in patients who are low risk, and certain patients at intermediate risk. […] Approximately 3% of men on active surveillance for prostate cancer were found to have metastasis by a median of 7 years after diagnosis, a recent study found. […] Of the 980 participants, 3% developed metastasis. Additionally, 11 patients were found to be living with metastases at the end of the study, while 15 patients died from prostate cancer and 4 died from a different cause. […] The reported rate of 3% is a best case scenario and it is likely that many more men have metastatic disease, said researcher Joel B. Nelson, MD. […] There were 60% of patients who had metastases develop in the bone, while 43% saw development in the lymph nodes. In patients with GS 7 disease, the risk for metastasis increased to 10% in 13 of 133 patents.

• #35 Prostate Cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/prostate-cancer.html

  On average, metastatic prostate cancer takes 2 to 3 years to become castration-resistant, but it could be longer or shorter depending on the features of the cancer. […] There is a lot of exciting research happening right now. […] In 2022, the Food and Drug Administration (FDA) approved a targeted nuclear medicine therapy called lutetium Lu 177 vipivotide tetraxetan to treat prostate-specific membrane antigen (PSMA) metastatic castration-resistant prostate cancer. […] At MD Anderson, we’re also conducting clinical trials to study how immunotherapy can help treat prostate cancer. […] If you have been diagnosed with prostate cancer, specifically metastatic prostate cancer, I strongly encourage you to ask your oncologist about clinical trials. […] We haven’t cured metastatic prostate cancer yet. But we’re moving in the right direction.

• #36 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  In newly diagnosed mCRPC patients, who have not received prior androgen receptor pathway inhibitors, clinicians should offer continued ADT with abiraterone acetate plus prednisone, docetaxel, or enzalutamide. […] In mCRPC patients who are asymptomatic or minimally symptomatic, clinicians may offer sipuleucel-T. […] Clinicians should offer radium-223 to patients with symptoms from bony metastases from mCRPC and without known visceral disease or lymphadenopathy 3cm. […] Clinicians should offer 177Lu-PSMA-617 to patients with progressive mCRPC having previously received docetaxel and androgen pathway inhibitor with a positive PSMA PET imaging study. […] In mCRPC patients who received prior docetaxel chemotherapy and abiraterone acetate plus prednisone or enzalutamide, clinicians should recommend cabazitaxel rather than an alternative androgen pathway directed therapy.

• #37 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  In newly diagnosed mCRPC patients, who have not received prior androgen receptor pathway inhibitors, clinicians should offer continued ADT with abiraterone acetate plus prednisone, docetaxel, or enzalutamide. […] In mCRPC patients who are asymptomatic or minimally symptomatic, clinicians may offer sipuleucel-T. […] Clinicians should offer radium-223 to patients with symptoms from bony metastases from mCRPC and without known visceral disease or lymphadenopathy 3cm. […] Clinicians should offer 177Lu-PSMA-617 to patients with progressive mCRPC having previously received docetaxel and androgen pathway inhibitor with a positive PSMA PET imaging study. […] In mCRPC patients who received prior docetaxel chemotherapy and abiraterone acetate plus prednisone or enzalutamide, clinicians should recommend cabazitaxel rather than an alternative androgen pathway directed therapy.

• #38 Prostate Cancer – Uroweb

  https://uroweb.org/guidelines/prostate-cancer

  1.4.2. Summary of changes […] For the 2025 PCa Guidelines new and relevant evidence was identified, collated and appraised through a structured assessment of the literature for all sections of the Guidelines. Key changes include: […] […] […] Section 6.6.4 Combination therapies for management of metastatic PCa has been restructured. […] […] […] New recommendation on use of darolutamide in section 6.6.8 – Recommendations for the first-line treatment of hormone-sensitive metastatic disease. […] […] […] New recommendation on discussing all patients with hormone-sensitive metastatic disease in a multidisciplinary team in section 6.6.8 – Recommendations for the first-line treatment of hormone-sensitive metastatic disease. […] […] […] New recommendation on offering bone protective agents to men on long-term androgen deprivation therapy plus/minus ARPI in the supportive care recommendations in section 6.6.9 related to hormone-sensitive metastatic disease. […] […] […] New recommendation in section 7.4.6 for follow-up during hormonal treatment. […] […] […] Expansion and update of section 8.2.5 Androgen deprivation therapy with section 8 Quality of life outcomes in PCa.

• #39 Metastatic Prostate Cancer: Investigators Ponder New Path to Improve Survival – Renal and Urology News

  https://www.renalandurologynews.com/features/metastatic-prostate-cancer-investigators-ponder-new-path-to-improve-survival/

  Overall survival also improved among men with mCSPC after the introduction of docetaxel and novel hormonal therapies (abiraterone, enzalutamide, apalutamide) for treating that disease state, according to study findings presented at the European Society for Medical Oncology 2022 Congress. […] Despite the positive trend, however, improvements in survival have been marginal, according to the findings of a population-based study published in Cancer Medicine. […] The median survival for men presenting with metastatic disease is still around 3 years, so there is still room for improvement before we consider this a chronic disease state for most advanced prostate cancer patients. […] In a study of SEER data, Mihir M. Desai, MD, MPH, of University of Southern California’s Keck School of Medicine in Los Angeles, and colleagues found no statistically significant increase in the incidence of metastatic prostate cancer from 2004 to 2010 among men aged 45 to 75 years, but the incidence increased 41% from 2010 to 2018.

• #40 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  In patients with mismatch repair deficient or MSI-H mCRPC, clinicians should offer pembrolizumab. […] Clinicians should discuss the risk of osteoporosis associated with ADT and should assess the risk of fragility fracture in patients with advanced prostate cancer. […] Clinicians should recommend preventative treatment for fractures and skeletal-related events, including supplemental calcium, vitamin D, smoking cessation, and weight-bearing exercise, to advanced prostate cancer patients on ADT. […] In advanced prostate cancer patients at high fracture risk due to bone loss, clinicians should recommend preventative treatments with bisphosphonates or denosumab and referral to physicians who have familiarity with the management of osteoporosis when appropriate. […] Clinicians should prescribe a bone-protective agent (denosumab or zoledronic acid) for mCRPC patients with bony metastases to prevent skeletal-related events.

• #41 Metastatic Prostate Cancer: Investigators Ponder New Path to Improve Survival – Renal and Urology News

  https://www.renalandurologynews.com/features/metastatic-prostate-cancer-investigators-ponder-new-path-to-improve-survival/

  Prostate cancer care already is moving toward earlier use of newer agents, as the FDA approvals of abiraterone, enzalutamide, apalutamide, and darolutamide for use in mCSPC suggest. […] The ARASENS trial showed significant improvement in overall survival when darolutamide was added to docetaxel and ADT and delayed the need for additional treatments. […] Treatments that prolong the lives of men with metastatic prostate cancer could mean increasing the likelihood of dying from something else. […] Although metastatic prostate cancer remains incurable despite the best that state-of-the-art medical science has to offer, the therapeutics and imaging techniques now available, as well as encouraging developments on the horizon, offer the promise of reducing that number in the years ahead.

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