Drugs To Treat Cancer Spread To Bone
If prostate cancer spreads to other parts of the body, it almost always goes to the bones first. These areas of cancer spread can cause pain and weak bones that might break. Medicines that can help strengthen the bones and lower the chance of fracture are bisphosphonates and denosumab. Sometimes, radiation, radiopharmaceuticals, or pain medicines are given for pain control.
Side effects of bone medicines
A serious side effect of bisphosphonates and denosumab is damage to the jaw, also called osteonecrosis of the jaw . Most people will need to get approval from their dentist before starting one of these drugs.
Pain In The Back Or Hips
Many times, prostate cancer pain occurs around the lower spinal cord and hips. This a result of the prostate being in close proximity to these regions.
Cancer in the hips will cause bones to become brittle and weak. The result is consistent soreness, especially when bending over or exercising.
Prostate cancer can also put pressure on the spine. The compression of the nerves causes a dull pain that can become stabbing as the cancer grows.
If youve been experiencing severe pain in the back or hips even without engaging in rigorous activities during the day, its best if you get yourself checked. Aside from being one of the most common signs of prostate cancer, severe pain in the back and hips can take a toll on your daily activities, and prevent you from becoming productive during the day. Pain in the back and hips can also adversely affect your mobility, making it very challenging for you to move.
Can Prostate Cancer Spread
Medically Reviewed by: Dr. BautistaUpdated on: November 18, 2019
Like other cancers, prostate cancer can spread if the cancer cells grow out of control. At ITC, we treat all different types of cancer and know that patients often have a lot of questions surrounding their diagnosis.;
We often are asked what is prostate cancer? Can prostate cancer spread? How is it diagnosed? And more. At Immunity Therapy Center, we know that each diagnosis is unique and every patient is different which is why we focus on a holistic approach to prostate cancer. And we believe that when patients have the knowledge, theyre more likely to take control of their health.
To give you the knowledge to prepare, lets take a closer look at prostate cancer, what symptoms to look for, and how it can spread.
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Bone Loss From Prostate Cancer Treatment
Testosterone, the male sex hormone, fuels the growth of prostate cancer but it also is crucial to bone health. Treatment of prostate cancer with hormone therapy, also called androgen deprivation therapy , blocks the production of testosterone which stops or slows the growth of the cancer. Without testosterone, bones can become weak and break more easily. When a man is on ADT recovery from a bone fracture takes longer than for other men. It is especially important for men taking ADT to speak with their physician about how to plan for and manage the bone loss before a problem arises. Bone strength can also be decreased as a result of radiation and chemotherapy used to treat prostate cancer.
Fortunately there are ways to strengthen and repair your bones including medicines and lifestyle changes.
- Bisphosphonates can prevent the thinning of the bone and help make them stronger
- Oral bisphosphonates include Fosamax and Actonel
- The intravenous bisphosphonate is Zometa
- Strive for a healthy diet and make sure to get enough calcium and vitamin D
- When exercising, include weight bearing and muscle strengthening exercises
- Avoid tobacco and excessive alcohol
Prostate Cancer Risk Groups
In addition to stage, doctors may use other prognostic factors to help plan the best treatment and predict how successful treatment will be. Examples of these include the National Comprehensive Cancer Network risk group categories and the Cancer of the Prostate Risk Assessment risk score from University of California, San Francisco.
Information about the cancers stage and other prognostic factors will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.
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What About Other Treatments I Hear About
When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.
Urinary Problems After Surgery
Most men cant control their bladder properly when their catheter is first removed. This is because surgery can damage the muscles and nerves that control when you urinate.You might just leak a few drops if you exercise, cough or sneeze . Or you might leak more and need to wear absorbent pads, especially in the weeks after your surgery.Leaking urine usually improves with time. Most men start to see an improvement one to six months after surgery. Some men leak urine for a year or more and others never fully recover, but there are;things that can help;and;ways you can manage it.
A few men may find it difficult to urinate after surgery . This can be caused by scarring around the opening of the bladder or the urethra .Some men find they suddenly and painfully cant urinate. This is called acute urine retention and it needs treating quickly to prevent further problems. If this happens, call your doctor or nurse, or go to your nearest accident and emergency department.
Watch;Paulâs story for one manâs experience of managing urinary problems after surgery below.
Sexual problems after surgery
Change in penis size and shape
Changes to orgasm
The seminal vesicles, which make some of the fluid in semen, are removed during surgery. This means you wont ejaculate any more. You may have a dry orgasm instead where you feel the sensation of orgasm but dont ejaculate. This may feel different to the orgasms youre used to.
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What Are Bone Metastases With Prostate Cancer
The ACS describes bone metastases as areas of bone containing cancer cells that have spread from another place in the body. In the case of prostate cancer, the cells have spread beyond the prostate gland. Since the cancer cells originated in the prostate gland, the cancer is referred to as metastatic prostate cancer.
The cancer cells spread to the bones by breaking away from the prostate gland and escaping attack from your immune system as they travel to your bones.
These cancer cells then grow new tumors in your bones. Cancer can spread to any bone in the body, but the spine is most often affected. Other areas cancer cells commonly travel to, according to the ACS, include the pelvis, upper legs and arms, and the ribs.
Treatments To Help Manage Symptoms
Advanced prostate cancer can cause symptoms, such as bone pain. Speak to your doctor or nurse if you have symptoms there are treatments available to help manage them. The treatments above may help to delay or relieve some symptoms. There are also specific treatments to help manage symptoms you may hear these called palliative treatments. They include:
This is the team of health professionals involved in your care. It is likely to include:
- a specialist nurse
- a chemotherapy nurse
- a urologist
- an oncologist
- a diagnostic radiographer
- a therapeutic radiographer
- a radiologist
- other health professionals, such as a dietitian or physiotherapist.
Your MDT will meet to discuss your diagnosis and treatment options. You might not meet all the health professionals straight away.
Your main point of contact might be called your key worker. This is usually your clinical nurse specialist , but might be someone else. The key worker will co-ordinate your care and help you get information and support. You may also have close contact with your GP and the practice nurses at your GP surgery.
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What Questions Should I Ask My Healthcare Provider
If you have prostate cancer, you may want to ask your healthcare provider:
- Why did I get prostate cancer?
- What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
- Has the cancer spread outside of the prostate gland?
- What is the best treatment for the stage of prostate cancer I have?
- If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
- What are the treatment risks and side effects?
- Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
- Am I at risk for other types of cancer?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.
Faqs About Prostate Cancer That Has Spread To The Bones
Learn what this diagnosis means for your health and your future, and what you can do to feel strong and well supported.
The prostate is a gland the size of a golf ball that sits below the bladder and in front of the rectum. Its responsible for making the fluid that forms semen. Many men develop cancer of the prostate gland; its the second most common cancer among men in the United States. There are several stages of prostate cancer the earliest, when the cancer is still limited to the prostate gland itself, is the easiest to treat.
When the cancer has spread, or metastasized, beyond the prostate gland, its considered advanced, according to the American Cancer Society . When it spreads, its common for cancer cells to reach the bones first. Nine out of 10 men with advanced prostate cancer also have it in their bones.
At this advanced stage, the cancer cant be cured, says Scott T. Tagawa, MD, a medical oncologist at Weill Cornell Medicine and New York-Presbyterian Hospital in New York City. But with treatment, many men can live a long time. There are men Ive been treating for advanced prostate cancer for 10 or 20 years.
Arm yourself with the facts about what happens when prostate cancer spreads to the bones and what you can do to help manage it.
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Gleason Score For Grading Prostate Cancer
Prostate cancer is also given a grade called a Gleason score. This score is based on how much the cancer looks like healthy tissue when viewed under a microscope. Less aggressive tumors generally look more like healthy tissue. Tumors that are more aggressive are likely to grow and spread to other parts of the body. They look less like healthy tissue.
The Gleason scoring system is the most common prostate cancer grading system used. The pathologist looks at how the cancer cells are arranged in the prostate and assigns a score on a scale of 3 to 5 from 2 different locations. Cancer cells that look similar to healthy cells receive a low score. Cancer cells that look less like healthy cells or look more aggressive receive a higher score. To assign the numbers, the pathologist determines the main pattern of cell growth, which is the area where the cancer is most obvious, and then looks for another area of growth. The doctor then gives each area a score from 3 to 5. The scores are added together to come up with an overall score between 6 and 10.
Gleason scores of 5 or lower are not used. The lowest Gleason score is 6, which is a low-grade cancer. A Gleason score of 7 is a medium-grade cancer, and a score of 8, 9, or 10 is a high-grade cancer. A lower-grade cancer grows more slowly and is less likely to spread than a high-grade cancer.
Types Of Imaging Studies
If your doctor suspects your cancer might be spreading, they will likely order more imaging tests. A common imaging workup may include a;bone scan;and a;CT scan;of the abdomen and pelvis. An;MRI;might be done as well. Some research centers are also using magnetic MRIs or PET scans to further refine the staging of prostate cancer.
Prostate Cancer Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
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Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
Chances Of Developing Metastatic Prostate Cancer
About 50% of men diagnosed with local prostate cancer will get metastatic cancer during their lifetime. Finding cancer early and treating it can lower that rate.
A small percentage of men aren’t diagnosed with prostate cancer until it has become metastatic. Doctors can find out if it’s metastatic cancer when they take a small sample of the tissue and study the cells.
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Newly Diagnosed With Prostate Cancer Why Choose Robotic Prostatectomy
When first diagnosed with prostate cancer, its common for men to wonder what the future will hold. Certainly, a prostate cancer cure is a top priority, but then what?
Dr. David Samadi understands that men want to know:
Will I have sex after prostate cancer?
How will sex after prostate cancer be different?
For many men, prostate cancer treatment choice determines these answers.
If you select robotic prostate surgery your chances of enjoying sex after prostate surgery are very high. Robotic prostatectomy is a minimally invasive prostate removal. It is considered one of the best treatment options for prostate cancer due to its success rate and fast recovery rate.
The da Vinci robotic prostate cancer surgery system enables the surgeon to make precise movements. This ensures cancer-removal efficiency and sparing of the nerves and muscles that are responsible for the sexual function.
However, it is absolutely critical to choose a robotic surgeon with a high case volume and extensive prostate surgery experience. The robot does not perform the surgery and technology is no guarantee of success.
Dr. Samadi explains how the preservation of sexual function is possible:
If my only responsibility was to remove the cancerous prostate, my job would be much easier, he acknowledges, But patients deserve much more than that. It was paramount that I find a way to remove the prostate gland without damaging functions critical to a comfortable and enjoyable life after recovery.
Ask Your Doctor About Solutions
Patients should not be shy about discussing intimacy issues;with their doctor. He or she may be able to prescribe medications to help. Certain medicationssuch as sildenafil , tadalafil or vardenafil are typically tried first. But these drugs may not help men achieve an erection if the nerves responsible are not healthy. In fact, the medications only work for a small percentage of men in the first few months after surgery, according to a 2017 study published in the International Journal of Sexual Health.
Besides oral medications for erectile dysfunction, there are other options available to men with ED after prostate cancer treatment, says Dr. Shelfo. These include penile injection therapy, which involves injecting a small amount of medication directly into the base of the penis. That has helped many men achieve erections. Another option is an intraurethral suppository of medication, an external vacuum erection device, or surgery may be performed to implant a penile prosthesis.
While regaining erectile function is not possible for all men treated for prostate cancer, it is important to remember that an erection is just one aspect of a satisfying sex life.;Intimacy;is another major component, one that may become more important as sexual relationships become more difficult after cancer treatment.
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How Important Is Early Diagnosis And What Happens When Prostate Cancer Spreads To The Bones
There are no two cases of prostate cancer that are the same. Some grow slowly while others progress rapidly. Without treatment, slow-growing cancer can spread only slightly over time, but aggressive prostate cancer can overwhelm the prostate, cause unpleasant symptoms, or even metastasize.
Metastatic growth occurs when cancer spreads from one part of the body to another when cancer cells separate from one tumor and travel to a nearby lymph node or blood vessel. From that point, it can attach to another part of the body such as a bone or organ and grow to form a second tumor. Prostate cancer most commonly spreads to the bones and lymph nodes.
The five-year survival rate for men with local prostate cancer that has not spread to other areas is nearly 100%. The five-year survival rate for men with metastatic prostate cancer is about 30%a steep decline that underscores the importance of detecting prostate cancer before it spreads to the bones and other areas of the body.