Prognosis For 44 Year Old Man With Stage 4 Metastatic Prostate Cancer


Asked by Julie

Prognosis For 44 Year Old Man With Stage 4 Metastatic Prostate Cancer

My huband has been diagnosed with Stage IV Metastatic Prostate cancer. Since he was 43 when diagnosed (it took them awhile since prostate cancer usually strikes older men) and the cancer has spread to his bones, bladder, liver and lymph nodes. After 2 rounds of chemo and one hormone shot, the lymph nodes have shrunck some and the bone lesions have lessened some. The doctors now want to do another 2 rounds of chemo and localized radiation. My husband is unwilling to take another hormone shot due to the side effects and his age. He would actually like us to have a baby. Can you tell me his prognosis? Would another baby even be possible?


Metastatic prostate cancer is associated with a very poor prognosis. The survival data that you are seeking is a function of what chemotherapy protocol your husband is currently on. The fact that he has had a partial response is promising but long-term survival is not common in patients with advanced metastatic disease.

A recent study from Columbia University cites median survival of 16 months with progression of disease being delayed for twice as long in patients treated with docetaxel and estramustine (Petrylak et al).

The Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute cites a 5-year survival rate of less than 40% for distant disease.

Conception is typically not advised while undergoing chemotherapy; however, this should be discussed in greater detail with his oncologist who is familiar with the exact treatment protocol that he is on.

Answered by Jay Motola, M.D.