The life expectancy of a patient with stage 4 prostate cancer is, of course, an estimate based on studying the clinical course of many patients.

Each patient is unique. There are many different factors which affect the overall survival data even among patients with the same stage of disease. 

About 1 in 3 (30%) patients with advanced prostate cancer will live for more than five years after diagnosis. On average, patients with metastatic prostate cancer may see some response to treatment for about 12 to 18 months. Average survival after that is about another two years.

Researchers are continuing to refine prognostic models for patients with metastatic prostate cancer.

In one study, 10  independent prognostic factors other than treatment group were identified in multivariate analysis. These factors were:

 (a) presence of liver metastases [hazard ratio (HR), 1.66; P = 0.019];

 (b) number of metastatic sites (HR, 1.63 if > or =2 sites; P = 0.001);

 (c) clinically significant pain (HR, 1.48; P < 0.0001);

 (d) Karnofsky performance status (HR, 1.39 if < or =70; P = 0.016);

 (e) type of progression (HR, 1.37 for measurable disease progression and 1.29 for bone scan progression; P = 0.005 and 0.01, respectively);

 (f) pretreatment prostate-specific antigen (PSA) doubling time (HR, 1.19 if <55 days; P = 0.066);

 (g) PSA (HR, 1.17 per log rise; P < 0.0001);

 (h) tumor grade (HR, 1.18 for high grade; P = 0.069);

 (i) alkaline phosphatase (HR, 1.27 per log rise; P < 0.0001);

 (j) hemoglobin (HR, 1.11 per unit decline; P = 0.004).



A nomogram was developed based on this multivariate model and validated internally.

Further testing with other patient populations may support the further use of this normogram.


It is important to remember that statistics always lag to a certain degree the current reality. By the time results are published, treatments may have advanced and the statistics may have improved somewhat.




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