Prostate cancer grows relatively slowly. When it is localized, it takes two or three years to double in size. And the confounding fact is that cancer can stay in the prostate indefinitely. It takes a long time and many steps involving subde genetic changes before a normal cell, which is designed to live and die, becomes a cancer cell—before some switch is activated that makes the cell think it’s immortal—and before such cells start dividing endlessly. (In high-risk men, some of these steps may be shortened.
If localized prostate cancer is found in a 65-year-old man, for example, it could stay localized for years and he may die with prostate cancer, not of it. This is what happens to hundreds of thousands of men, and it’s one of the factors that can make treatment decisions so cloudy.
But—and this is the crux of the issue—once it escapes the prostate, cancer’s growth is relentless. It can no longer be cured. Once the cancer has spread to bone, the average life expectancy for a man is about three years.
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