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Prostate cancer treatment as recommended helps most men survive the disease
Last reviewed: 15.07.2025
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Most men who are treated for prostate cancer according to current guidelines have good survival rates, and most of them die from causes unrelated to prostate cancer, according to a new study from Uppsala University published in the Journal of the National Comprehensive Cancer Network.
"We were surprised by how much life expectancy affected the prognosis. This shows how important it is to carefully assess the general health of a man with newly diagnosed prostate cancer. The patient's life expectancy has a significant impact on the choice of an appropriate treatment strategy," says Marcus Westerberg, a researcher at the Department of Surgical Sciences at Uppsala University who led the study.
In the case of prostate cancer, disease progression often takes decades, and the risk of dying from prostate cancer depends on both the characteristics of the tumor and life expectancy, which is based on the man’s age and other medical conditions at diagnosis. Recommendations in clinical guidelines and treatment programs are also based on both tumor characteristics and life expectancy. This means that recommended initial treatment can range from active surveillance for low risk to a combination of local and systemic treatments for high risk.
High average age at diagnosis
Because the average age at diagnosis of prostate cancer is often high and the disease usually progresses very slowly, it is especially important to know the long-term risk of dying from prostate cancer in order to choose the best treatment for a patient. Little was previously known about this.
“We wanted to fill this knowledge gap, so we analyzed outcomes for 30 years after diagnosis. In all cases, we had information on tumor characteristics, treatment, and the patient’s life expectancy based on age and comorbidities,” Westerberg explained.
The researchers used data from the Prostate Cancer Database Sweden (PCBase), which contains information from the National Prostate Cancer Registry (NPCR) and other medical registries. They focused on men who had received recommended treatment for prostate cancer that had not spread. Using statistical modeling, the researchers estimated the lifetime risk of dying from prostate cancer and other causes.
11 percent risk of dying from cancer
In men with low-risk prostate cancer and a short life expectancy (less than 10 years), the risk of death from prostate cancer was 11% and the risk of death from all causes was 89% within 30 years of diagnosis.
In men with high-risk prostate cancer (eg, stage T3, PSA 30 ng/mL, and Gleason score 8) and a long life expectancy (more than 15 years), the risk of death from prostate cancer was 34% and the risk of death from other causes was 55% within 30 years of diagnosis.
"We hope that our results will be used to form a realistic picture of the prognosis for men with prostate cancer. Our study shows that most men who receive the recommended treatment have a good prognosis," Westerberg concluded.
Life expectancy was calculated based on age and comorbidities. Examples of low-risk cancers: stage T1, PSA 5 ng/mL, and Gleason score 6. Examples of high-risk cancers: stage T3, PSA 30 ng/mL, and Gleason score 8.