Lung Was The Most Frequent Site Of Synchronous Metastases
Our study shows that in PCa patients with bone metastases, approximately 10% of patients have synchronous distant metastases at other sites. Among these sites, the lung was the most frequently involved extra-skeletal organ, followed by the liver, whereas brain metastasis was relatively uncommon. These results are in line with those of former studies . A previous autopsy study of 1589 PCa patients also demonstrated that lung was the second most frequent site of involvement, following bone . However, there is very few published researches on the mechanisms of lung metastasis in prostate cancer. Several biological processes, such as hemodynamics, bone-specific signaling interactions, and the seed and soil hypothesis, were attributable to the bone metastasis of PCa . Lung metastasis of breast cancer, another primary of high incidence and metastatic rate, is often explained by the seed and soil hypothesis . To elucidate the mechanism of lung metastasis from PCa remains a challenge, which need further study to understand its pathogenesis and prognosis.
What Are The Symptoms Of Bph And Prostate Cancer
BPH and prostate cancer have similar symptoms, so its sometimes hard to tell the two conditions apart. As the prostate grows for any reason, it squeezes the urethra. This pressure prevents urine from getting down your urethra and out of your body. Prostate cancer symptoms often dont start until the cancer has grown large enough to put pressure on the urethra.
Symptoms of both BPH and prostate cancer include:
- an urgent need to urinate
- feeling the urge to urinate many times during the day and night
- trouble starting to urinate or having to push to release urine
- weak or dribbling urine stream
- urine flow that stops and starts
- feeling like your bladder is never fully empty
If you have prostate cancer, you might also notice these symptoms:
- painful or burning urination
Prostate cancer is a cancer that develops in the prostate gland in men and it is one of the most common types of cancer. It is usually seen in men over the age of 50. The prostate is a small walnut-shaped gland in men, which produces seminal fluid required to nourish and transport the sperm. Prostate cancer is a slow-growing cancer and, more often, it is confined to the prostate gland, requiring minimal or no treatment.
In some cases, it can take up to eight years to spread from the prostate to other parts of the body , typically the bones. In many cases, prostate cancer does not affect the mans natural life span.
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
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Staging Of Prostate Cancer
- Stage I : The Gleason score is 6 or less, and the PSA level is less than 10. Cancer at this stage is normally not detectable in an ultrasound test or in a DRE test, as the tumor is very small. It is within the prostate and has not spread to nearby lymph nodes. It is usually discovered accidentally during a surgery carried out for another purpose. Prostate ultrasound and biopsy can be performed after detection of elevated blood PSA levels.
- Stage II : From this stage onwards, the Gleason score and the PSA level may vary from person to person. As the tumor grows in size, it can be detected in a DRE test or sonogram, but the tumor is still confined to the prostate gland. It is in one half or less of only one side of the prostate. It hasnt spread to lymph nodes and nearby organs, or it has spread to nearby lymph nodes, but has not invaded nearby organs.
- Stage III : The cancerous cells spread out from the original site and invade the seminal vesicles. They do not spread to nearby lymph nodes or to nearby organs in the body.
- Stage IV : The cancer moves out of the seminal vesicles and invades the lymph nodes. The size and number of tumors increase, and the cancerous cells spread into the nearby organs, such as the bladder and the rectum. In stage four prostate cancer, even bones and other parts of the body like lungs and liver are likely to be invaded by the cancerous cells.
Staging Spread And Survival Rates
As with all cancers, doctors use the term stage to describe the characteristics of the primary tumor itself, such as its size and how far prostate cancer has spread when it is found.
Staging systems are complicated. The staging system for most cancers, including prostate cancer, uses three different aspects of tumor growth and spread. It’s called the TNM system, for tumor, nodes, and metastasis:
- T, for tumor describes the size of the main area of prostate cancer.
- N, for nodes, describes whether prostate cancer has spread to any lymph nodes, and how many and in what locations.
- M, for metastasis, means distant spread of prostate cancer, for example, to the bones or liver.
Using the TNM system, each man’s prostate cancer can be described in detail and compared to other men’s prostate cancer. Doctors use this information for studies and to decide on treatments.
As far as survival rates for prostate cancer go, however, the staging system is pretty simple. As we’ve mentioned, in terms of survival rates, men with prostate cancer can be divided into two groups:
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What Are The Treatment Options For Prostate Cancer
Treatment for prostate cancer is determined based on the size of the tumor and extent of metastasis and may include the following:
Hormone therapy
Hormone treatment deprives the body of the male hormones needed for prostate cancer growth. Orchiectomy or luteinizing hormone-releasing hormone analogs are used alone or in conjunction with an anti-androgen.
Newer hormonal drugs that decrease androgen production and block androgen receptor signaling have been approved by the FDA for the treatment of metastatic prostate cancer following chemotherapy, and they are being studied for early usage in the disease.
Abiraterone
Abiraterone is an oral targeted medication that inhibits androgen synthesis not only in the testes but also in the adrenal glands and the tumor itself. When used with prednisone, abiraterone has been demonstrated to improve quality of life and decrease pain progression in patients with hormone-refractory prostate cancer .
Although this drug is normally well tolerated, adverse effects such as tiredness, elevated blood pressure, and electrolyte or liver problems are possible, and patients must be checked on a regular basis.
Enzalutamide
Enzalutamide interferes with molecular processes that enable prostate cancer growth by targeting various stages in the androgen-receptor-signaling cascade. Furthermore, the medicine does not cause the typical adverse effects of chemotherapy, such as nausea and hair loss.
Chemotherapy
Targeted therapy
Immunotherapy
Sipuleucel-T
Stage Iv Cancer Life Expectancy
The five-year relative survival rate for prostate cancer that has spread to distant organs is 28%. This means about 28% of the patients with stage 4 prostate cancer will live for five years.
According to certain studies, about 98% men with low or intermediate grade prostate cancer will live for more than five years. However, only 67% men with end stage prostate cancer will live for more than five years.
End stage prostate cancer life expectancy is normally less than five years. It may vary according to the age and overall health of the patient, the type of treatment, and the extent and location of metastases , etc.
Studies show that the five-year survival rate for prostate cancer without bone metastasis is 56%. For prostate cancer with bone metastasis, it is only 3%.
The five-year survival rate for prostate cancer with bone metastasis and skeletal involvement is unfortunately less than 1%.
Usually, at stage IV, doctors assure life only for three years. The life expectancy not only depends on the treatment, but also on the physical and mental health of the patient. Patients who are loved and cared by their family members can fight the disease courageously. Those with strong will power live longer. There are examples of patients who have lived for eight years, or even further. Some recent studies show that a prostatectomy, even in late stage prostate cancer, can double or triple the life expectancy of a patient . But more studies are required to prove this fact.
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What Happens If My Cancer Starts To Grow Again
Your first treatment may help keep your cancer under control. But over time, the cancer may change and it may start to grow again.
You will usually stay on your first type of hormone therapy, even if its not working so well. This is because it will still help to keep the amount of testosterone in your body low. But there are other treatments that you can have alongside your usual treatment, to help control the cancer and manage any symptoms. Other treatments include:
Which treatments are suitable for me?
Which treatments are suitable for you will depend on many things, including your general health, how your cancer responds to treatment, and which treatments youve already had. Talk to your doctor or nurse about your own situation, or speak to our Specialist Nurses.
Bone Metastases Life Expectancy
In the advanced stages of cancer, tumor cells may spread from the affected organ to different parts of the body, including the brain, liver, bones, etc. This process is called metastasis, and it occurs when cancer cells are released to the bloodstream, allowing them to freely invade other organs. The most common site of bone metastasis is the spine. Other sites include the hip, the upper leg, the upper arm, the ribs, and skull. Once cancer spreads to the bones, cure can be difficult. With bone metastases, life expectancy can be shortened, but there are ways of helping a patient feel more comfortable and improve the quality of life.
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Progression Of Bone Metastasis
Bone metastases results in injury to bone tissue.
There are two types of bone lesions:
- Lytic lesions, which destroy bone material, and
- Blastic lesions, which fill up bone with extra cells.
Normal bone is in a constant state of remodeling being broken down and rebuilt. Cancer cells that have spread to the bone disrupt this balance between the activity of cells that break down bone and cells that make bone .
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Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.
An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.
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Rp And Bt Improved Os In Patients With Bone
In our study, when all patients were pooled for multivariate Cox analysis, neither surgery nor RT had an effect in reducing the risk of mortality, with HRs of 1.006 and 0.955, respectively. Therefore, all patients were stratified according to the sites of metastases and treatment modalities for further evaluation of survival benefits. Although, in our study, in the group of PCa patients with bone-only metastases, only 206 and 94 patients underwent RP and BT, respectively. Interestingly, RP and BT both presented significant benefits in reducing the risk of mortality, with HRs of 0.339 and 0.567, respectively. However, similar to PCa patients with bone-only metastases, RP and BT were rarely used in PCa patients with bone metastases and other sites of metastases. Due to the small amount of data, multivariate Cox analysis was not possible. In 2014, Culp et al. reported that local therapy with RP and BT appeared to confer a survival benefit for metastatic PCa. Our study, therefore, provided meaningful support to the study by Culp et al., as we pointed out that the benefits of RP and BT were mainly observed in PCa patients with bone-only metastases. Due to the small sample size, further investigation is warranted to validate these findings.
Prognosis And Survival For Prostate Cancer
If you have prostate cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for prostate cancer.
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Hormone Therapy In Older Patients
The backbone of prostate cancer treatment is hormonal therapy, which aims to limit the activation of the androgen receptor with testosterone. This limitation of AR activation may occur through agents that decrease circulating testosterone, such as gonadotropin-releasing hormone agonists or antagonists. The use of these agents also decreases testosterone precursors and other off-target effects of testosterone. Agents such as nonsteroidal anti-androgens block AR activation and yet preserve circulating testosterone levels.
Providers must carefully consider the toxicities of androgen deprivation therapy in a physiologically older population. These patients have less reserve to absorb additional imbalances or conditions that will impact their current steady state. In general, agents that result in a hypogonadal state can lead to toxicities within the following domains: metabolic and body composition sexual health and mood and central nervous system symptoms .
What Are Risk Factors For Prostate Cancer
The main cause of prostate cancer is unknown. However, several factors may increase the risk of developing the disease:
- Age: As you become older, your chances of acquiring prostate cancer increase. Most of the prostate cancer cases are observed in men over the age of 50 years.
- Ethnicity: Prostate cancer is more common in Black men and less common in Asian men for unknown reasons.
- Genetics: Men who have a parent or sibling who has had prostate cancer are at a slightly higher risk of developing prostate cancer.
- Obesity: Studies have revealed that obesity may potentially raise the risk of prostate cancer.
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Breast Cancer Metastasis To Bone
Breast cancer metastasis to bone survival rate
Metastatic or stage IV breast cancers, have a 5-year relative survival rate of about 22% 1).
Remember, these survival rates are only estimates they cant predict what will happen to any individual. We understand that these statistics can be confusing and may lead you to have more questions. Talk to your doctor to better understand your specific situation.
Enzalutamide Improves Survival In Patients With Metastatic Prostate Cancer
Summary
In an international randomizedphase III clinical trial, the hormone therapy enzalutamide extended survival in men with metastatic prostate cancer that had progressed during treatment with androgen deprivation therapy. Participants in the trial had not received chemotherapy.
New England Journal of Medicine, June 1, 2014.
Background
Early in their development, prostate cancers need relatively high levels of male sex hormones to grow. The testes are the main source of androgens, and treatments that stop the testes from producing male sex hormonesknown as hormone therapy or androgen deprivation therapy are therefore a common treatment for androgen-sensitive prostate cancer. However, most prostate cancers eventually become castrate resistantthat is, they can grow even when androgen levels in the blood are very low. ADT does not block production of the small amount of androgen that is made by the adrenal glands and by prostate cancer cells themselves, and this low level is sufficient to fuel the growth of castrate-resistant prostate cancers.
Enzalutamide is among several hormone therapies that have been developed to prevent the androgen-fueled growth of castrate-resistant prostate cancers. This drug works by keeping androgens from binding to the androgen receptors on prostate cancer cells.
The Study
Men in the trial were randomly assigned to receive 160 mg of enzalutamide or a placebo taken orally once daily.
Results
- Posted:June 27, 2014
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What Are Prostate Cancer Survival Rates By Stage
Staging evaluation is essential for the planning of treatment for prostate cancer.
- A basic staging evaluation includes the patient examination, blood tests, and the prostate biopsy including ultrasound images of the prostate.
- Further testing and calculations may be performed to best estimate a patientâs prognosis and help the doctor and patient decide upon treatment options.
Prognosis refers to the likelihood that the cancer can be cured by treatment, and what the patientâs life expectancy is likely to be as a consequence of having had a prostate cancer diagnosis.
If a cancer is cured, your life expectancy is what it would have been had you never been diagnosed with prostate cancer. If the cancer cannot be cured due to it recurring in distant locations as metastases, or recurs either locally or in an area no longer able to be treated in a curative manner, then estimates can be made of what is likely to be your survival based again on group statistics for people who have been in the same situation.
Nomograms are charts or computer-based tools that use complex math from analysis of many patientsâ treatment results.
The prognosis for prostate cancer varies widely, and depends on many factors, including the age and health of the patient, the stage of the tumor when it was diagnosed, the aggressiveness of the tumor, and the cancerâs responsiveness to treatment, among other factors.
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