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.
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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.
What Is Brachytherapy For Prostate Cancer
Brachytherapy is a form of radiation treatment. During brachytherapy, doctors take small particles or seeds that contain a source of radiation and place them inside the body in or near a tumor.
The radioactive material only affects the tissue very close to it, so it tackles the tumor but doesnt harm the rest of the body.
According to the American College of Surgeons , healthcare professionals may recommend brachytherapy as a stand-alone treatment if you have very low- or low-risk prostate cancer or favorable intermediate-risk prostate cancer.
If you have a higher-risk case, healthcare professionals might use brachytherapy in addition to external beam radiation therapy .
The Underlying Molecular Mechanisms In Prostate Cancer Bone Metastases
Various types of prostate cancer cell lines, including LuCaP 23.1, LNCaP, C4-2, and IGR-CaP1, were utilized as prostate cancer models. The LuCaP 23.1 and LNCaP cells are highly sensitive to androgen . The C4-2 cell lines showed features of reduced androgen sensitivity and increased metastatic capability . In the androgen-sensitive prostate cancer cell lines, the downregulation in androgen receptor expression reduced AR-mediated transcription and cell growth. Meanwhile, the knockdown of AR expression had a marked effect on AR-mediated transcription and cell growth in the androgen-insensitive prostate cancer cell lines . The expression of AR is an important regulator of prostate cancer cell growth and development at the early stage. However, prostate cancer progresses to castration-resistant prostate cancer at the later stage. Thus, possible correlation between AR expression and the signaling molecules involved in prostate cancer bone metastasis could be considered. On the other hand, the IGR-CaP1 cell line represents a unique model recapitulating widespread bone metastasis with mixed osteoblastic and osteolytic bone lesions that resemble the conditions observed in patients .
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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.
If Treatment Does Not Work
Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for many people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
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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.
Questions To Ask Your Doctor Or Nurse
- What type of hormone therapy are you offering me and why?
- Are there other treatments I can have?
- What are the advantages and disadvantages of my treatment?
- What treatments and support are available to help manage side effects?
- Are there any lifestyle changes that might help me manage my cancer, symptoms, or side effects?
- How often will I have check-ups and what will this involve?
- How will we know if my cancer starts to grow again?
- What other treatments are available if that happens?
- Can I join any clinical trials?
- If I have any questions or get any new symptoms, who should I contact?
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Cancercares Free Support Services And Programs
Receiving a diagnosis of metastatic prostate cancer can be very difficult, and adjusting to the necessary changes in your life can be challenging.
CancerCare can help. We are a national nonprofit organization providing free, professional services to anyone affected by cancer. Our licensed oncology social workers can provide support and education, help in navigating the complicated health care system, and provide information on support groups and other resources.
To learn more about how CancerCare helps, call us at 800-813-HOPE or visit www.cancercare.org.
You will likely also build your own personal support network, comprised of family and friends. In doing so, its best to take some time to think about the people in your life and how they are best suited to help. Match the task to their strengthsask a family member who loves to shop to pick up something for you at the store; ask a friend whos a good listener to come over for a chat.
Advanced Prostate Cancer And Bone Metastases
Most all prostate cancer patients worry about metastases. ;Metastases used to signal that death was near. Most prostate cancer metastases take place in bones. ;New treatments such as Xofigo have helped thousands of men delay health while maintaining a pain free high quality of life. ;Bone metastases are tumors that have spread from the prostate;to your;bones. Usually;bone;metastases occur in the pelvis, spine, thighs and ribs. But, they can develop in any bone anywhere in your body.; Bone metastases can become extremely painful. Which is why it is reasonable and very human to fear bone;metastases. ;So, if you are feeling anything that you imagine to be bone pain, talk to your doctor right away.
Diagnosing Bone Metastases
Bone metastases symptoms are sometimes confused with arthritis. The symptoms such as pain seem to be the same. So, if you are already diagnosed with prostate cancer, you must talk to your doctor about anything at all that you imagine to be pain in your bones.;;X-rays can diagnose bone metastases best, but bone scans, CT scans, PET scans, MRIs and blood tests are also used for diagnosis.;
Untreated bone;metastases in;a man with castrate resistant prostate cancer could cause fractures and other skeletal problems none of which are pleasant.;
Early detection of bone metastases allows more effective treatment to delay bone pain and other complications.
Preventing and Treating Bone Metastases
The most common side effects of Radium 223 are:
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Active Surveillance And Watchful Waiting
If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend active surveillance or watchful waiting.
Active surveillance. Prostate cancer treatments may seriously affect a person’s quality of life. These treatments can cause side effects, such as erectile dysfunction, which is when someone is unable to get and maintain an erection, and incontinence, which is when a person cannot control their urine flow or bowel function. In addition, many prostate cancers grow slowly and cause no symptoms or problems. For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.
ASCO encourages the following testing schedule for active surveillance:
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A PSA test every 3 to 6 months
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A DRE at least once every year
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Another prostate biopsy within 6 to 12 months, then a biopsy at least every 2 to 5 years
Treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.
Poor Integration Of Services
The variety of pca treatments has unfortunately translated into a lack of coordination between the specialists responsible for treating the patient. Treating bone pain caused by metastatic disease is a multifaceted task. At the moment, many patients wait for separate appointments to see each specialist , often in sequence, which compounds wait times. Timing is key to the effective treatment of patients with impending pathologic fracture, spinal cord compression, and bone pain. Early diagnosis and treatment are vital for the patients qol and for the prevention of permanent or further neurologic damage ,.
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Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.
Side Effects Of Chemotherapy
The side effects of chemotherapy depend on the type and dose of drugs given and the length of time they are used, and can include:
Mouth sores are also a side effect of chemotherapy. Your doctor may recommend treatments such as:
- Coating agents. These medications coat the entire lining of your mouth, forming a film to protect the sores and minimize pain.
- Topical painkillers. These are medications that can be applied directly to your mouth sores.
- Over-the-counter treatments. These include rinsing with baking soda or salt water, or magic mouthwash, a term given to a solution used to treat mouth sores. Magic mouthwash usually contains at least three of these ingredients: an antibiotic, an antihistamine or local anesthetic, an antifungal, a corticosteroid, and/or an antacid.
Chemotherapy can cause changes in the way food and liquids taste, including causing an unpleasant metallic taste in the mouth. Many people find that switching to plastic utensils helps. It may also help to avoid eating or drinking anything that comes in a can, and to use enamel-coated pots and pans for food preparation.
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Managing Bone Metastases And Pain
When prostate cancer cells spread to the bone, this is known as prostate cancer bone metastases . Bones are the most common site of prostate cancer metastasis, occurring in 85%90% of patients with metastatic prostate cancer. Once the cells settle in the bone, they start to interfere with the bones normal health and strength, often leading to bone pain, fracture, or other complications that can significantly impair a mans health.
Early detection of bone metastases can help determine the best treatment strategy. It can also help ward off complications. Because men with prostate cancer bone metastases often experience painful episodes, pain management and improving quality of life are important goals of treatment.
Coordination Between Myeloid And Lymphoid Compartments
The observed deficiencies of cytotoxicity in the proximity of the tumor may arise through repressive actions by other immune populations . For instance, we find that the Treg cells, which typically act to suppress immune response , showed increased activity signatures at the site of the metastasis . The complex patterns of immune signaling are also likely to involve the myeloid compartment. Indeed, considering variation of TAM and TIM abundance among patients we find that increased proportion of TAMs at the site of metastasis is correlated with CTL-2 exhaustion . Similarly, increased abundance of TIMs coincides with a reduction in the CTL-2 cytotoxicity signature . While these associations suggest that TIM or TAM populations may be directly affecting T lymphocyte state, identifying a specific signaling channel through which communication takes place is challenging.
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A Potential Method To Prevent Prostate Cancer From Spreading In The Future
Recent studies have detected a transcription factor known as STAT3 as a promoter of prostate cancer metastasis. It has been proposed as a potential target to inhibit metastasis.;
A study published in 2021 showed for the first time how a STAT3 inhibitor could obstruct the progression of prostate cancer. In other words, it wont allow prostate cancer to spread to the bone .
However, we should note that the latter is the first study performed in animal models. It should be replicated and tested several times in clinical trials before finding an application in humans.
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Outlook For Advanced Prostate Cancer
Even though a cure for advanced prostate cancer doesnt exist today, significant research regarding treatment is constantly occurring as scientists study how combined therapies may improve prognosis, how to identify cancers that are resistant to certain treatments, and how new technologies such as artificial intelligence can provide better information about prostate cancer cells.
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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.
Treatments For Prostate Cancer Spread To Bones
If prostate cancer spreads to other parts of the body, it nearly always goes to the bones first. Bone metastasis can be painful and can cause other problems, such as fractures , spinal cord compression ,;or high blood calcium levels, which can be dangerous or even life threatening.
If the cancer has grown outside the prostate, preventing or slowing the spread of the cancer to the bones is a major goal of treatment. If the cancer has already reached the bones, controlling or relieving pain and other complications is also a very important part of treatment.
Treatments such as hormone therapy, chemotherapy, and vaccines may help with this, but other treatments specifically target bone metastasis and the problems it may cause.
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