Prostate cancer is the fourth most commonly diagnosed cancer worldwide, and the second most common cancer among men. The good news is that prostate cancer is highly treatable, depending on the cancer’s stage at diagnosis, the person’s age and general health, and how well treatment works. In addition, prostate cancer often progresses slowly and has one of the highest survival rates among all types of cancer.
What Prostate Cancer Survival Rates Tell Us
A five-year prostate cancer survival rate tells us the percentage of people with the same stage of cancer that are alive five years after diagnosis. A 10-year survival rate tells us the percentage of people with the same stage of cancer that are alive 10 years after diagnosis.
Remember that every case is different and the numbers are just guidelines. It’s important to know that these statistics don’t estimate prostate cancer life expectancy. In other words, they don’t tell you how long you’ll live, but they can give you an idea of how successful treatment might be based on how advanced the cancer is.
Overall, the five-year relative survival rate for prostate cancer in the United States is close to 100 percent. But the survival rate for an individual diagnosed with prostate cancer will vary depending on how advanced the cancer is.
The American Cancer Society estimates five-year survival rates using the SEER (Surveillance, Epidemiology, and End Results) database from the National Cancer Institute to group prostate cancer into three stages: localized, regional, and distant, based on how far the cancer has spread.
Localized There is no sign that the cancer has spread outside the prostate. The five-year survival rate is greater than 99 percent.
Regional The cancer has spread to nearby structures or lymph nodes. The five-year survival rate remains greater than 99 percent.
Distant The cancer has spread to parts of the body far from the prostate (lungs, liver, bones). The five-year survival rate is 37 percent.
The estimates apply only to the stage of cancer when it is diagnosed. These numbers also don’t say how long you can live with stage 4 prostate cancer, with or without treatment. Every case is unique, and life expectancy with prostate cancer is affected by many factors, such as age, overall health, and how well the body responds to treatment.
Importantly, survival estimates are “backwards looking,” meaning they are based on previous outcomes of people with prostate cancer, and they might not be predictive for someone who is diagnosed today. That could be good news when considering the five-year survival rate for prostate cancer that has spread to distant parts of the body.
According to William Dahut, MD, chief scientific officer of the American Cancer Society, there are newer therapies that could improve prostate cancer survival at this distant stage. “Over the last 10 or 15 years, we’ve developed better hormonal therapy, more potent combination therapy for advanced disease, mutation-driven hormonal therapy, and immunotherapy for select patients that can prolong life,” he says.
Can Prostate Cancer Be Cured?
Dr. Dahut says that the chancers that are most curable are ones that come on very intensely. “If you treat them, you can eradicate them,” he says.
However, metastatic or stage 4 advanced prostate cancer is not considered curable. Dahut cautions that even in the curable earlier stages of prostate cancer, recurrence — specifically cancer that comes back in other parts of the body — is possible (though still treatable) after cancer is eliminated from the prostate.
“Cancers like prostate cancer and even breast cancer have the ability to come back years after diagnosis, even when patients are in remission for localized disease,” he says.
Screening and Early Detection Lead to Better Survival
It’s important to get screened for prostate cancer, especially if you’re at high risk, to identify cancer early and have a better chance of long-term survival. Some screening tools are:
Digital rectal exam, where the doctor inserts a gloved finger in the rectum to feel for abnormalities
Prostate-specific antigen (PSA) blood test
Imaging tests, including computed tomography (CT) and magnetic resonance imaging (MRI) scans
Biopsy, to remove some cancerous tissue. A Gleason Score is used to determine how likely it is for the cancer to spread based on how the tissue looks under the microscope.
Bone scans, which are performed if there is suspicion that the cancer has spread to the bones
The American Cancer Society recommends discussing the benefits of prostate cancer screening and your possible risk of developing prostate cancer with your doctor at the following ages:
Age 40 This is for men at highest risk of developing prostate cancer. That means more than one close relative (father or brother) diagnosed with prostate cancer at a young age (before age 65).
Age 45 This is for men at high risk, meaning that one close relative was diagnosed with prostate cancer at a young age (before age 65). Black American men are also at high risk of prostate cancer compared with other populations and have a higher death rate from prostate cancer than white men.
Age 50 This is for all other men who don’t meet the above criteria.
If you and your doctor agree to screen for prostate cancer, a PSA blood test will typically be performed. There is conflicting advice about PSA testing. The reason for this is that sometimes PSA levels may be elevated even if cancer isn’t present. The screening may also find cancers that don’t need immediate treatment, or won’t grow aggressively. Receiving treatment in these instances may be more harmful than good.
A doctor can help you weigh the risks and other factors before determining if a PSA test is necessary. The U.S. Preventive Services Task Force’s most current recommendation from 2018 advises doctors to discuss the benefits and risks of PSA testing with men 55 through 69 years old so you can make an informed, individual decision. They do not recommend this screening for men over 70. The reason is that many tumors found through the PSA test are slow growing and unlikely to be life-threatening, and the risks associated with screening may outweigh the benefits. This recommendation is currently being updated.
If your doctor doesn’t bring up screening for prostate cancer and you haven’t been screened in the past, it may be a good idea to open the discussion.
The Takeaway
The five-year survival rates for localized and regional prostate cancer stages is greater than 99 percent. The rate drops to 37 percent for prostate cancer that has spread to distant parts of the body.
Survival rates are not an indication of life expectancy, but can give an idea of how successful treatments might be depending on the stage of cancer at diagnosis.
Treatments for prostate cancer have greatly improved over the past few decades, and so have survival rates with better understanding of the disease.
If you haven’t been screened for prostate cancer, it may be a good idea to speak to your doctor to determine what’s best for you.
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Christopher Wolter, MD, is an assistant professor in urology at Mayo Clinic in Phoenix, Arizona. He has been in practice since 2008, specializing in the areas of urinary incontinence, pelvic organ prolapse, urologic reconstruction, urologic prosthetics, post prostate cancer survivorship, erectile dysfunction, neurourology and neuromodulation, and overall functional considerations of urogenital health.
Dr. Wolter has been heavily involved in urologic education. He spent the last 12 years heavily involved in resident education and leadership for his department, including the last eight years as urology residency program director. He currently serves as the director of urologic education for the preclinical and clinical rotations for the Mayo Clinic Alix School of Medicine Phoenix, Arizona, campus.
Wolter completed his undergraduate and medical education at the University of Illinois. He then completed his urology residency at Tulane University in New Orleans, followed by a fellowship in female pelvic medicine and reconstructive urology at Vanderbilt University in Nashville, Tennessee.
A multimedia journalist and author, Larry Buhl is a longtime contributor to Positively Aware, TheBodyPro and Capital & Main. He has also contributed to KQED, Marketplace, Distillations, The New Republic, A&U, Salon, Fast Company, the BBC and others. He's based in Los Angeles.
