Prostate Cancer High Risk

What High Risk Means

Stage T3a OR Gleason 8–10 OR PSA >20 ng/mL

Treatment Approach for High Risk

Definitive therapy + ADT. EBRT – 24–36 months ADT preferred if fit. Consider adding docetaxel in high-grade disease. Surgery if candidate and node-negative on imaging.

Survival Rates and Prognosis

The 5-year survival rate for prostate cancer at High Risk is approximately 88%–93% (10-yr: 75%–85%). Survival rates are statistical averages drawn from large patient populations and may not reflect your individual outcome. Factors that influence your specific prognosis include your age, overall health, tumour biology, and how well the cancer responds to treatment.

Important: These numbers are drawn from historical data. Newer treatments available today may improve outcomes beyond what published statistics show. Discuss your individual prognosis with your oncologist.

How Other Stages Compare

Stage	5-Year Survival	Treatment
Very Low Risk	99%+ (10-yr: 98%+)	Active surveillance preferred. Annual PSA, DRE, repeat biopsy in 1–2…
Low Risk	98%+ (10-yr: 95%)	Active surveillance or definitive therapy (RARP or radiation). Discuss 10-year…
Intermediate Risk	95% (10-yr: 88%–92%)	Definitive therapy: RARP with or without pelvic lymph node dissection, or EBRT…
Very High Risk	70%–85% (10-yr: 55%–75%)	Aggressive systemic therapy. EBRT – 36+ months ADT with or without…
Metastatic Hormone-Sensitive (mHSPC)	40%–60% (10-yr: 10%–25%)	Upfront ADT + docetaxel (STAMPEDE/CHAARTED trials showed docetaxel improves…
Metastatic Castration-Resistant (mCRPC)	15%–30% (10-yr: <10%)	Sequence of hormone therapies (abiraterone, enzalutamide, apalutamide) or…