Should I Make Any Lifestyle Changes Including In My Diet Or Physical Activity
Achieving and maintaining a healthy weight by eating a balanced diet with plenty of fruits, vegetables, and whole grains, and staying physically active, can help your overall health. These lifestyle changes can also have a positive effect for men with bone metastases, Tagawa says. Both diet and exercise, he says, are things that are under a mans direct control.
A healthy lifestyle can help you better manage side effects from treatment as well. Try setting small but realistic goals for yourself when it comes to eating a healthy diet and getting plenty of exercise.
While no single food is likely to have a benefit for prostate cancer, smart food choices may help you feel better day to day. Start by cutting out foods high in sugar, saturated fat, and added flavorings and preservatives.
If youre not sure which healthy foods to choose, ask your doctor for a referral to a dietitian. This specialist can help you develop a meal plan that includes foods that offer the best chance of slowing the cancers growth and keeping you as healthy as possible.
As an oncologist, Tagawa says he concentrates on treating the cancer itself, but hes aware that many of the men he sees with advanced prostate cancer are older and more likely than younger men to have health problems that can benefit from diet and exercise.
And if youre on hormone therapy, talk to your doctor about investing in some weights or elastic resistance bands to support your bone strength too.
Treatment For Metastatic Cancer
There are treatments for most types of metastatic cancer. Often, the goal of treating metastatic cancer is to control it by stopping or slowing its growth. Some people can live for years with metastatic cancer that is well controlled. Other treatments may improve the quality of life by relieving symptoms. This type of care is called palliative care. It can be given at any point during treatment for cancer.
The treatment that you may have depends on your type of primary cancer, where it has spread, treatments youve had in the past, and your general health. To learn about treatment options, including clinical trials, find your type of cancer among the PDQ® Cancer Information Summaries for Adult Treatment and Pediatric Treatment.
Epidemiology Of Advanced Prostate Cancer
Approximately 11.6% of men will develop prostate cancer in their lifetime, with the likelihood increasing with age prostate cancer is most often diagnosed in men age 55 to 74 years, and the median age at diagnosis is 66 years. Since the advent of prostate-specific antigen screening, prostate cancer is being detected and treated earlier.
Overall, incidence rates of prostate cancer began declining in 2000. Acceleration in the decline began in 2008, when organizations began recommending against routine PSA screening From 2011 to 2015, the rate decreased by about 7% per year.
A review of almost 800,000 cases of prostate cancer diagnosed from 20042013 found that although the incidence of low-risk prostate cancer decreased from 2007-2013 to 37% less than that of 2004, the annual incidence of metastatic prostate cancer during those years increased to 72% more than that of 2004. The increase in metastatic prostate cancer was greatest in men aged 5569 years.
At diagnosis, 77% of prostate cancer cases are localized in 13%, the cancer has spread to regional lymph nodes, and 6% have distant metastasis. The 5-year relative survival rate for localized and regional prostate cancer is 100%, compared with 30.5% for metastatic cases.
The mortality rate associated with prostate cancer continues to increase in Europe and in countries such as Australia, Japan, and Russia.
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What Types Of Testing Should I Expect For Monitoring My Condition
Since metastatic prostate cancer isnt curable, your doctor will most likely set up regular visits to check the cancers location, and to manage any long-term side effects from the cancer or any medication youre taking.
And since treatments for advanced prostate cancer are changing so fast and need to be given in a certain sequence to be the most effective, youll probably have not only a prostate cancer doctor but other specialists taking care of you. Your care team should coordinate closely, say the authors of a major study of such teams published in August 2015 in the journal Annals of Oncology.
Along with regularly testing your prostate-specific antigen levels, your care team may request blood tests that measure such prostate cancer indicators as alkaline phosphatase and lactate dehydrogenase. Magnetic resonance imaging or PET scans of the spine or other bones can also help identify how your cancer responds to treatment.
If youve had radiation, youre at an increased risk for bladder and colorectal cancer and should get screened regularly for these as well.
The tests youll have and how often youll need them should be customized to you. Your care team will consider your overall health, medications that are safe for you to take, other health conditions you might have, and what stage your cancer was when you were diagnosed.
What Is My Outlook
If youre diagnosed with advanced prostate cancer, you may want to know how well your treatment is likely to control your cancer and for how long it will control it. This is sometimes called your outlook or prognosis. But not all men will want to know this.
While it isnt possible to cure advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain.
No one can tell you exactly what your outlook will be, as it will depend on many things such as where the cancer has spread to, how quickly it has spread, and how well you respond to treatment. Some men may not respond well to one treatment, but may respond better to another. And when your first treatment stops working, there are other treatments available to help keep the cancer under control for longer. Speak to your doctor about your own situation and any questions or concerns you have.
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What Are The Treatments For Prostate Cancer
There are many different ways to treat prostate cancer. For prostate cancer, it is important that you get a second opinion and you will most likely be consulting multiple types of healthcare providers before making a final decision. You should talk to both urologists and radiation oncologists to hear about the benefits and risks of surgery, hormonal therapy and radiation in your particular case. If your prostate cancer has already spread at the time of diagnosis, you will also need a medical oncologist to talk about chemotherapy. The most important thing is to review your options and make a decision that best suits your lifestyle, beliefs and values.
Surgery is a common form of treatment for men with prostate cancer. Surgery attempts to cure prostate cancer by removing the entire prostate and getting all of the cancer out of the body. An attempt at a surgical cure for prostate cancer is usually done with early stage prostate cancers. However, sometimes surgery will be used to relieve symptoms in advanced stage prostate cancers.
Talk to your surgeon about their complication rates before your operation. With surgery, urinary incontinence and impotence are often most severe right after the operation and generally get better with time. There are things that your providers can recommend to help you with either of these problems. Talk to your urologist about your options.
Hormonal Deprivation Therapy
Staging Of Prostate Cancer
The stage of a cancer describes its size and how far it has spread. The results of your tests help your doctors decide on the stage and plan your treatment.
We understand that waiting to know the stage and grade of your cancer can be a worrying time. We’re here if you need someone to talk to. You can:
Macmillan is also here to support you. If you would like to talk, you can:
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Where In The Body Cancer Can Spread
Cancer can spread to almost every part of the body. Some types of cancer tend to spread to certain parts of the body. For example:
Breast cancer tends to spread to the bones, liver, lungs, chest wall, and brain
Lung cancer tends to spread to the brain, bones, liver, and adrenal glands
Prostate cancer tends to spread to the bones
Colon and rectal cancers tend to spread to the liver and lungs
Less frequently, cancer can spread to the skin, muscle, or other organs in the body. Cancer cells can also spread to the lining around the lungs called the pleural cavity. It can also spread to the space around the belly called the peritoneal cavity. When these cancer cells cause fluid to build up in these areas, it is called malignant pleural effusion and malignant ascites.
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 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.
Where In The Body Does Prostate Cancer Spread
Metastatic prostate cancer can affect one or more parts of your body. The most common place for prostate cancer to spread to is your bones. Prostate cancer may also spread to other parts of the body such as your lymph nodes, your lungs, liver or brain.
The metastatic cancer is made up of prostate cancer cells, even if it is found in other parts of your body. It will be treated with prostate cancer treatments.
We use the term man / men in our prostate cancer information but we understand that not everyone who has a prostate gland identifies as a man.
It doesnt matter who you are or where you come from, we are here for you. For confidential advice, information and support, contact our Support Line on Freephone 1800 200 700.
Receiving Treatment For Prostate Cancer That Has Spread
At Moffitt Cancer Center, the experts within our Urologic Oncology Program treat patients with all stages of prostate cancer, including advanced-stage cancers that have metastasized to other areas of the body. Our multispecialty team collaborates as a tumor board, ensuring each patient receives a treatment plan tailored to his unique needs. For individuals with metastatic prostate cancer, treatment plans aim to alleviate symptoms, slow the rate of cancer growth and shrink tumors to help improve quality of life.
Early Versus Delayed Therapy
In our recently published article in the Journal of Urology, we reported results of early versus delayed hormonal treatment for PSA-only recurring prostate cancer after a radical prostatectomy among 1352 patients in the CPDR database. Differences in outcome and time to the development of clinical metastasis were measured, stratified by risk status and time of hormone therapy initiation . The median follow-up period was 5.5 years after PSA relapse.
Early hormonal therapy administered at PSA 5 ng/mL or less affects clinical metastasis survival in patients with pathological Gleason sum greater than 7 or PSA-DT 12 months or less. Time zero is from PSAR time. PSA, prostate-specific antigen PSA-DT, PSA doubling time PSAR, PSA relapse only. Reproduced with permission from Moul JW et al.
Early hormonal therapy administered at PSA 10 ng/mL affects clinical metastasis-free survival in patients with pathological Gleason sum greater than 7 or PSA-DT 12 months or less. Time zero is from PSAR time. PSA, prostate-specific antigen PSA-DT, PSA doubling time PSAR, PSA relapse only. Reproduced with permission from Moul JW et al.
Early hormonal therapy administered at PSA 5 ng/mL or less did not affect clinical metastasis-free survival in the overall cohort of 1,352 patients with PSAR at current followup. Time zero is from PSAR time. PSA, prostate-specific antigen PSAR, PSA relapse only. Reproduced with permission from Moul JW et al.
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What Are Some Of The Limitations And Potential Harms Of The Psa Test For Prostate Cancer Screening
Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors that do not cause symptoms. Finding a small tumor, however, may not necessarily reduce a mans chance of dying from prostate cancer. Many tumors found through PSA testing grow so slowly that they are unlikely to threaten a mans life. Detecting tumors that are not life-threatening
that requires treatment.
Can I Survive Advanced Prostate Cancer Whats The Prognosis
Prostate cancer is the second leading cause of death from cancer in men, according to the National Cancer Institute. While theres no cure, men can live with it for years if they get the right treatment. Each man with advanced prostate cancer is different, of course. You and your cancer have unique qualities that your doctor takes into consideration when planning the best treatment strategy for you.
According to Harvard Medical School, the prognosis for men with advanced prostate cancer is improving because of newer medications that help them get past a resistance to androgen-deprivation therapy that typically develops after a few years of treatment. With these medications, many men are living longer, and a number of men diagnosed with advanced prostate cancer are dying with the cancer, not from it.
Promptly treating prostate cancer bone metastases with the newest medication can help change a mans prognosis dramatically, Tagawa says. There are men who do well for decades, he says. Some men can even stop treatment, go on to live many years, and actually die of something unrelated.
Tagawa says that cancer specialists who use sophisticated imaging technologies, like positron-emission tomography scans, have gotten very good at finding even tiny bone metastases, which is valuable in diagnosing and removing early stage metastases.
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How Metastases Develop
Metastases is the plural form of metastasis. Metastases most commonly develop when cancer cells break away from the main tumor and enter the bloodstream or lymphatic system. These systems carry fluids around the body. This means that the cancer cells can travel far from the original tumor and form new tumors when they settle and grow in a different part of the body.
Metastases can also sometimes develop when cancer cells from the main tumor, typically in the belly, or abdominal cavity, break off and grow in nearby areas, such as in the liver, lungs, or bones.
Any type of cancer can spread. Whether this happens depends on several factors, including:
The type of cancer. Some cancers are more likely to spread than others.
How fast the cancer is growing
Other factors about the behavior of the cancer that your doctor may find
Where Cancer Spreads
Cancer can spread to almost any part of the body, although different types of cancer are more likely to spread to certain areas than others. The most common sites where cancer spreads are bone, liver, and lung. The following list shows the most common sites of metastasis, not including the lymph nodes, for some common cancers:
|Bone, liver, lung, peritoneum, vagina|
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What Are Next Steps
Bone metastasis have a profound effect on the long-term outlook for prostate cancer. But its important to remember that the numbers are only statistics.
The good news is that life expectancy for advanced prostate cancer continues to increase. New treatments and therapies offer both longer life and better quality of life. Speak to your doctor about your treatment options and long-term outlook.
Everyones cancer experience is different. You may find support through sharing your treatment plan with friends and family. Or you can turn to local community groups or online forums like Male Care for advice and reassurance.
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
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