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 Treatments Are Available
If you have advanced prostate cancer, treatment wont cure your cancer. But it can help keep it under control and manage any symptoms.
If youve just been diagnosed with advanced prostate cancer, you may be offered the following treatments:
- chemotherapy;with hormone therapy
- clinical trials.
Research has found that having;radiotherapy;together with one of the main treatments listed above can help some men with advanced prostate cancer to live longer. But radiotherapy isnt suitable for all men with advanced prostate cancer.
If you live in;Scotland, you may also be offered a type of hormone therapy called;abiraterone acetate ;together with standard hormone therapy. In the rest of the UK, abiraterone is currently only given to men with advanced prostate cancer that has stopped responding to other types of hormone therapy. The;National Institute for Health and Care Excellence ;is currently deciding whether to make it available for men who have just been diagnosed with advanced prostate cancer.
Before you start treatment
Before you start any treatment, make sure you have all the information you need. Its important to think about how you would cope with the possible side effects. Speak to your doctor or nurse about this.
It can help to write down any questions you want to ask at your next appointment. It may also help to take someone with you, such as your partner, a family member or friend.
If you have any questions, speak to our;Specialist Nurses.
What Is Bone Metastasis
The bone is a common site for metastasis. Bone metastasis or “bone mets” occurs when cancer cells from the primary tumor relocate to the bone. Prostate, breast, and lung cancers are most likely to spread to the bone. However, other cancers are not excluded. Bone metastases do not begin from the bones but move there from the primary tumor site. On the other hand, primary bone cancers are rare cancers where the primary tumor actually starts in the bone. Therefore, bone cancer and bone metastases are not the same.
As an example, consider a patient with prostate cancer. Prostate cancer cells from the primary tumor can break away and get into the bloodstream. Once in the blood, the cancer cell can travel to the bone and form a new tumor. It is important to remember that this secondary tumor is made up of abnormal prostate cancer cells, not abnormal bone cells. The result of this process is referred to as prostate cancer that has metastasized to the bone or metastatic prostate cancer. This is otherwise known as bone metastasis.
When cancer cells metastasize to the bone, they can cause changes to the bone. The process by which portions of the bone are damaged is called osteolysis. Oftentimes, small holes result from osteolysis. These holes in the bone are referred to as osteolytic lesions or lytic lesions. Lytic lesions can weaken the bones and increase the risk of breakage or other problems. It is also common for bone metastasis patients to experience pain with lesions.
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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:
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.
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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.
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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Treatments To Control And Prevent Further Cancer Spread In Patients With Castrate Refractory Advanced Prostate Cancer:
At BPC we offer:
- Hormones , Enzalutamide , Diethylstilboestrol)
- Chemotherapy .
- Radium-223
Other treatment options ongoing clinical studies:
- Autologous cellular immunotherapy, which is in late trial stage and although not currently available outside a trial setting in the UK, is likely to be licensed soon.
- Cabozantinib
How Is Prostate Cancer Diagnosed
Doctors describe the growth and spread of prostate cancer in stages. Doctors use these stages as guides when choosing treatment options or offering prognoses to their patients.
Prostate cancer staging is based on a number of different factors, including prostate cancer screening tests such as a digital rectal exam or; prostate-specific antigen test and imaging studies like bones scans, MRIs, CT scans, and trans-rectal ultrasounds.
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How Is Prostate Cancer Staged
Prostate cancer is one of the most common types of cancer that develops in men and is the second leading cause of cancer deaths in American men, behind lung cancer and just ahead of colorectal cancer. The prognosis for prostate cancer, as with any cancer, depends on how advanced the cancer has become, according to established stage designations.
The prostate gland is a walnut-sized gland present only in men, found in the pelvis below the bladder. The prostate gland wraps around the urethra and lies in front of the rectum. The prostate gland secretes part of the liquid portion of the semen, or seminal fluid, which carries sperm made by the testes. The fluid is essential to reproduction.
The term to stage a cancer means to describe the evident extent of the cancer in the body at the time that the cancer is first diagnosed.
- Clinical staging of prostate cancer is based on the pathology results, physical examination, PSA, and if appropriate, radiologic studies.
- The stage of a cancer helps doctors understand the extent of the cancer and plan cancer treatment.
- Knowing the overall results of the different treatments of similarly staged prostate cancers can help the doctor and patient make important decisions about choices of treatment to recommend or to accept.
Symptoms Of Advanced Prostate Cancer
If you are worried about prostate cancer, we have more information about the signs and symptoms.
Symptoms of prostate cancer may not develop for many years. The symptoms of advanced prostate cancer may be caused by an enlarged prostate. Or symptoms may be a sign of secondary cancer, where the cancer has spread to another part of the body.
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How Cancer Spreads To The Bone
When cells break away from a cancer tumor, they can move through the bloodstream or lymph vessels to other parts of the body. Cancer cells can settle in an organ far from where it started and start a new tumor. The original tumor that cells break away from is called the primary tumor. The new tumor that forms is called the secondary tumor. Secondary tumors in the bone are called bone metastases.
Different types of cancer tend to spread to certain parts of the body. These cancers commonly spread to the bones:
-
Breast
-
Bladder
How Is Advanced
Prostate cancer diagnosed in the advanced stages is difficult to cure, although many people live for many years with effective treatment. Prostate cancer that has spread to distant organs and bones is treatable but cannot be cured with current standard therapies.
Treatment choices for advanced-stage prostate cancer involve
- Hormone therapy;– Hormone therapy intends to lower a mans testosterone or hormone levels. Testosterone is the main energy source for prostate cancer cells. Hormone therapy targets to slow down the prostate cancer growth in men with stage IV prostate cancer. Hormone therapy options include:
- Medications that stop the body from producing testosterone: Some of the commonly used medications include leuprolide, goserelin, triptorelin, histrelin, and degarelix.
- Orchiectomy: It involves the removal of testicles to lower testosterone levels in the body.
- Anti-androgens: Medications that block testosterone from reaching cancer cells include bicalutamide, flutamide, and nilutamide.
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What Is A 5
A relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of prostate cancer is 90%, it means that men who have that cancer are, on average, about 90% as likely as men who dont have that cancer to live for at least 5 years after being diagnosed.
What Is Clinically Localized Prostate Cancer
If you have been diagnosed with prostate cancer and your doctor has indicated that your cancer appears to not have spread beyond the prostate gland, you have what is known as clinically localized prostate cancer. Sometimes, doctors will also call cancer that has spread into the lining of the prostate gland clinically localized.
According to the U.S Department of Health and Human Services, about 90 percent of men with prostate cancer have localized prostate cancer, and it is typically considered low-risk, meaning patients can expect to live long after their diagnosis, in many cases even without treatment.
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Where Can I Find Support
It can be very difficult to deal with a diagnosis of advanced prostate cancer. Its natural to wonder if youre doing all you can to fight the cancer and how to handle guilt, intimacy with a partner, and concerns about masculinity. And finding and paying for the best care can, of course, be a challenge.
But emotional and practical support can help you move forward. An important thing to remember is that youre not alone. There are many kinds of help available, and the right cancer resources can make a world of difference.
Ask your doctor for resources you can contact, including social workers and support systems in your community. The Patient Navigator Program of the ACS can be reached at 1-800-227-2345 youll be connected to a patient navigator at a cancer treatment center who can help you with practical and emotional issues.
The Prostate Cancer Foundation has links to in-person and online support groups around the country, and the ACS lists nationwide support programs as well. The PCF also offers resources ranging from help with housing during cancer treatment to finding ways you can look good and feel better while living with cancer.
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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