Prostate Cancer Survival Rates and Statistics

Generally, prostate cancer survival rates are very good with a five-year survival rate of 98%.

There are, however, a number of factors that can influence survival rates, particularly for men with advanced prostate cancer. These can include:

• Stage of cancer
• Race
• Age
  
• Disease progression
• Tumor grade
• Disease recurrence
• Smoking

Survival by Stage

The stage of prostate cancer can be described by doctors using the tumor, node, metastasis (TNM) system. The TNM system was developed by the American Joint Committee on Cancer. Under this system, doctors use scans and results from diagnostic tests to determine the following values:

• Tumor (T): How large is the tumor and where is it located?
• Node (N): Has the tumor spread to the lymph nodes and if so where and how?
• Metastasis (M): Has the cancer spread to other parts of the body and if so where and how much has it spread?

These values are then combined to determine the cancer stage on a five-stage scale ranging from stage 0 (zero) to stage four. Here is how it breaks down:

• In localized prostate cancer, the cancer has not yet spread from the prostate to other parts of the body. This would equate to stage I and II on the TNM scale.
• In regional prostate cancer, the cancer has spread from the prostate to nearby structures or lymph nodes. This would equate to stage III on the TNM scale.
• In distant prostate cancer, the cancer has spread far from the prostate to other organs like the liver or lungs. This would equate to stage IV on the TNM scale.

Outcomes for prostate cancer are measured using a five-year survival rate. This compares those with the same type and stage of cancer to those in the general population.

Survival by Race

Race can impact survival due to disparities in healthcare access which can, in turn, lead to late diagnoses.

Compared to non-Hispanic white men Black men are more likely to be diagnosed with prostate cancer and are nearly 2.5 times more likely to die from prostate cancer.

Black men have the highest incidence of prostate cancer among all racial/ethnic groups in the United States.

Social inequalities contribute to worse outcomes for Black men with prostate cancer compared to white men.

A 2019 study found that the risk of dying from low-grade prostate cancers for black men was double the risk of white men. The same study found doctors may underestimate the risk of low-grade cancers in black men.

According to the Centers for Disease Control and Prevention (CDC), five-year survival at all stages of prostate cancer was higher for white men than Black or Hispanic men.

Survival by Age

Unlike some other cancers, age is less of a factor in survival rates for prostate cancer. This is partially due to the fact that men are more likely to be diagnosed with prostate cancer after the age of 70.

Roughly six in 10 cases are diagnosed in men who are 65 years or older. The average age at diagnosis is 66 and diagnosis under age 40 is rare.

An exception to this is for men with stage IV prostate cancer. In this group, the 10-year mortality rate for prostate cancer is highest for men between the ages of 60 to 64.

Men aged less than 49 and more than 80 years old have the lowest 10-year survival rate. Those aged less than 49 years old had a 95.6% 10-year survival rate, while those aged more than 80 years old had an 82.7% 10-year survival rate.

Survival by Disease Progression

The extent prostate cancer has progressed can influence survival rates.

Prostate-specific antigen (PSA) is a protein produced by cells of the prostate gland by normal and malignant cells. In men with prostate cancer, blood levels of PSA are often elevated.

Doctors can use PSA as a marker to better understand the progression of prostate cancer and the resulting prognosis.

One way doctors assess the progression of the disease is through PSA doubling time. This refers to the number of months it takes for PSA to double.

One study suggests a short doubling time means a poorer prognosis for patients with stage IV prostate cancer. Median survival was 16.5 months for those with a PSA doubling time lower than 45 days compared with 26 months for patients with a longer PSA doubling time.

Whether or not the cancer has metastasized and spread to other areas of the body outside the prostate can also influence survival. In distant or stage IV prostate cancer, when cancer has spread from the prostate to other organs like the liver or lungs, the five-year survival rate is 31% compared with localized (stage I and II) cancer, which has a five-year survival rate of nearly 100%.

Survival by Tumor Grade

One way cancer is staged is by looking at the grade of cancer. Grade refers to how cancer cells look like under a microscope.

Traditionally for prostate cancer, this has been done using the Gleason Score, which was developed in the 1960s. Under this system, cancerous cells are categorized on a scale from 1 to 5. Grade 1 cells are considered normal prostate tissues, while cells in the grade 5 range have mutated to such an extent they no longer resemble normal cells.

In determining a Gleason score, a pathologist will examine a biopsy sample under a microscope and give a Gleason grade using the above scale to the most predominant pattern displayed, then a second grade to the pattern that is the second most predominant. Those two grades are then added to form the overall Gleason score (eg a 3 grade + a 4 grade = a 7 on the Gleason score).

In theory, Gleason scores could range from 2 to 10, but pathologists today rarely give a score between 2 and 5 and are more likely to be in the range of 6 to 10 with 6 being the lowest grade of prostate cancer.

Under the Gleason Score system, a 6 is considered low grade, 7 is intermediate and scores of 8, 9, or 10 are considered high-grade cancers.

The higher the Gleason score, the more likely it is the prostate cancer will grow and spread quickly.

However, there have been some issues with the Gleason system, and a new grading system, to act as an extension of the Gleason system, has been developed.

Under this system Gleason scores are now categorized into grade groups:

• Grade Group 1 = Gleason 6 (or less)
• Grade Group 2 = Gleason 3+4=7
• Grade Group 3 = Gleason 4+3=7
• Grade Group 4 = Gleason 8
• Grade Group 5 = Gleason 9-10

According to the American Cancer Society, this system may eventually replace the Gleason system, but currently, they are reported together.

Survival by Disease Recurrence

If a man develops an elevated PSA level (greater than 0.2ng/ml) after cancer surgery, then the disease is viewed as recurrent.

The number of lymph nodes at the time of prostatectomy can influence the risk of recurrence. One study suggests the removal of a large number of nodes is associated with an improvement in odds of recurrence, but this doesn't appear to impact overall survival.

But disease recurrence doesn't always influence survival times. If a recurrence does occur, the 15-year survival rate at the time of diagnosis may be as high as 94% in those with low-risk recurrence.  

The main factors influencing survival rates are:

• The Gleason score
• The PSA doubling time
• Whether the recurrence occurred within three years or after three years

A recurrence that occurs within three years reduces survival rates by anywhere from 15 to 20%—and even more, if the doubling time is short.

Smoking

Smoking is the one factor that influences survival rates in almost every cancer, including prostate cancer. Current smokers have a significantly poorer chance of survival from prostate cancer, and from recurrence than nonsmokers. Ceasing smoking can improve survival rates.

A Word From Verywell

Overall survival rates from prostate cancer are good, with a five-year survival rate of 98%. Even with stage IV prostate cancer, improvements in treatments have increased survival times and have led to a significant reduction in deaths related to prostate cancer.