Prostate cancer experts say that former President Joseph R. Biden’s diagnosis is serious. Announced on Sunday by his office, the cancer has spread to his bones. And it is Stage 4, the most deadly of stages for the illness. It cannot be cured.

前列腺癌专家表示，前总统约瑟夫·R·拜登的诊断结果很严重。根据其办公室周日发布的消息，癌症已经扩散到了骨骼，并且已达到四期——这一疾病中最致命的阶段。该病无法治愈。

But the good news, prostate cancer specialists said, is that recent advances in diagnosing and treating prostate cancer — based in large part on research sponsored by the National Institutes of Health and the Defense Department — have changed what was once an exceedingly grim picture for men with advanced disease.

但好消息是，前列腺癌专科医生表示，近年来在诊断和治疗前列腺癌方面取得的进展——这在很大程度上得益于美国国立卫生研究院和国防部资助的研究——意味着晚期患者不用再面对如此严峻的前景。

“Life is measured in years now, not months,” said Dr. Daniel W. Lin, a prostate cancer specialist at the University of Washington.

“现在以年为单位来衡量他们的剩余寿命，而不是以月，”华盛顿大学的前列腺癌专家丹尼尔·W·林博士说。

Dr. Judd Moul, a prostate cancer expert at Duke University, said that men whose prostate cancer has spread to their bones, “can live 5, 7, 10 or more years” with current treatments. A man like Mr. Biden, in his 80s, “could hopefully pass away from natural causes and not from prostate cancer,” he said.

杜克大学的前列腺癌专家贾德·莫尔博士表示，前列腺癌已经扩散到骨骼的男性在目前的治疗条件下“可以活五年、七年、10年甚至更久”。他说，像拜登这样年过80的男性，“有望因自然原因去世，而不是死于前列腺癌。”

Mr. Biden’s office said the former president had urinary symptoms, which led him to seek medical attention.

拜登的办公室表示，这位前总统出现了泌尿系统症状，因此寻求了医疗帮助。

But, Dr. Lin said, “I highly doubt his symptoms were due to cancer.”

但林表示：“我非常怀疑他的症状是由癌症引起的。”

Instead, he said, the most likely scenario is that a doctor did an exam, noticed a nodule on Mr. Biden’s prostate and did a blood test, the prostate-specific antigen test. The PSA test looks for a protein released by cancer cells, and can be followed up by an M.R.I. The blood test and the M.R.I. would have pointed to the cancer.

他表示，更可能的情况是，医生在检查时发现拜登的前列腺上有一个结节，于是进行了血液检测——前列腺特异性抗原测试。该测试是用来检测由癌细胞释放的蛋白质，接下来还可以进行核磁共振检查。血液检测和核磁共振检查最终发现了癌症。

In this moment, patients like Mr. Biden and others who develop metastatic prostate cancer diagnoses are more fortunate than patients in the past. There are about 10 new treatments for the disease, and they have markedly changed the picture.

在当下，像拜登以及其他被诊断为转移性前列腺癌的患者比过去的患者要幸运得多。目前已有大约10种该病的新疗法，这些治疗方法显著改变了治疗前景。

The first line of attack is to cut off the testosterone that feeds prostate cancer. When Dr. Moul was starting out as a urologist in the 1980s, that was done by removing a man’s testicles. Today, men have a choice of two drugs given by injection that block the testicles from making testosterone, or a pill that does the same thing.

前列腺癌的首要治疗方式是切断其赖以生存的睾酮来源。在莫尔上世纪80年代刚成为泌尿科医生时，需要通过切除男性的睾丸来实现这一点。而如今，男性可以选择两种注射药物中的一种，这些药物能阻止睾丸产生睾酮，或者选择一种具有相同效果的口服药物。

But those drugs alone are not sufficient. So, doctors add any of three or four so-called androgen blockers that block testosterone that still manages to be produced in the testicles.

但仅靠这些药物是不够的。因此，医生会再加入三种或四种所谓的雄激素阻断剂之一，以阻断那些仍然在睾丸中产生的睾酮。

Some men, depending on how much cancer is in their bones, where the cancer tends to go, also have additional treatment, with chemotherapy or radiation.

根据骨骼中癌症的扩散程度——因为癌细胞往往会转移到骨骼——一些男性还需要额外的治疗，如化疗或放疗。

There have also been improvements in diagnosis.

诊断方法也有所改进。

Until recently, doctors determined how much cancer was in the bones with scans that looked for inflammation. Now they have a more precise scan, called a prostate-specific membrane antigen (PSMA) PET scan. It uses a radioactive tracer that attaches to a marker on the surface of prostate cells. It allows doctors to spot the cancer much earlier, which means men with prostate cancer cells in their bones often have a much better prognosis — because they can be treated earlier — than men who had bone scans of just a few years ago.

医生曾经需要通过扫描寻找炎症来判断骨骼中癌症的扩散程度，这一点近年得到改观。现在，他们有了一种更精确的扫描方法，叫做前列腺特异性膜抗原PET扫描。这种扫描使用一种放射性示踪剂，能附着在前列腺细胞表面的标记物上。这使得医生能够更早发现癌症，因此骨骼中有前列腺癌细胞的男性，通常会比几年前仅做骨扫描的男性有更好的预后——因为他们可以更早接受治疗。

Finally, if the medications that block testosterone, and the chemotherapy and radiation therapy, stop working, there are other drugs that can be used to quell the cancer.

最后，如果阻止睾酮的药物、化疗和放疗失效，还有其他药物可以用来抑制癌症。

Dr. Lin noted that the infusion of federal research money, with Mr. Biden’s cancer moonshot effort, in large part led to this progress. Mr. Biden, he said, “was one of the first presidents to put cancer on the forefront.”

林指出，联邦研究资金的注入，尤其是拜登发起的目标远大的抗癌计划，在很大程度上推动了这一进展。他说，拜登“是最早将癌症提到优先位置的总统之一”。

As for Dr. Moul, he said he sees men Mr. Biden’s age with Stage 4 prostate cancers on a regular basis and is much more optimistic now than ever before.

而莫尔则表示，他经常见到像拜登这个年龄、患有四期前列腺癌的男性，而现在他比以往任何时候都更加乐观。

“We have a lot more tools in our toolbox,” Dr. Moul said. “Survival rates have almost tripled in the last decade. I can’t fathom how much change has taken place.”

“我们现在有了更多的治疗手段，”他说。“生存率在过去十年里几乎翻了三倍。我简直无法想象发生了如此巨大的变化。”