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Where Does Prostate Cancer Metastasis To

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What Are The Symptoms Of Advanced Prostate Cancer And Bone Metastases

Prostate Cancer and Bone Metastasis

When cancer cells spread to the bones, the condition weakens the very frame on which the body rests. The cells interfere with the strength and hardness of the bones structure, interrupting its normal cycle of building up and dissolving.

Theres no cure for advanced prostate cancer, but theres a lot that doctors can do to help with the symptoms that might develop. This includes managing pain. A common misconception is that if theres cancer in the bone, there must be pain, Tagawa says. Thats not true. Cancer can be in the bone without pain. However, if there is pain, he says, it can be controlled with anticancer therapies and pain medication, and good quality of life can be maintained.

In addition to pain, some men with bone metastases develop a condition called hypercalcemia, in which, because of the damage to bones from the cancer cells, too much calcium builds up in the blood. Hypercalcemia can make you feel constipated, thirsty, sleepy, or sluggish, and it can increase the urge to urinate, according to the ACS. Over time, hypercalcemia can cause muscle and joint achiness, as well as weakness in the muscles. In advanced stages, it can cause the kidneys to shut down.

There are treatments for hypercalcemia as well as for other complications from advanced prostate cancer, such as bones that become weak and break or fracture, and for growths in the spine that can press on the spinal cord and damage nerves.

General Prostate Cancer Survival Rate

According to the American Cancer Society:

  • The relative 5-year survival rate is nearly 100%
  • The relative 10-year survival rate is 98%
  • The 15-year relative survival rate is 91%

Note: Relative survival rate means the percentage of patients who live amount of years after their initial diagnosis.

Keep in mind, however, that because the compiled list figures are of cancers diagnosed up to 15 years ago, you may have an even greater chance of survival than these indicate due to advances in prostate cancer treatment technology

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 persons 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:

  • A PSA test every 3 to 6 months

  • A DRE at least once every year

  • 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.

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Where Does Metastatic Prostate Cancer Spread To

    Prostate cancer that has metastasized, or spread, beyond the prostate is known as stage 4 or metastatic prostate cancer. Stage 4 prostate cancer may spread locally, staying within the pelvic region, or it can spread to more distant areas of the body. While this form of cancer can travel to any organ in the body, there are specific areas where it most commonly occurs.

    Finding Out If The Cancer Has Spread

    Metastatic prostate cancer

    To find out if cancer has spread outside of the prostate, doctors may perform the imaging tests listed below. Doctors are able to estimate the risk of spread, called metastasis, based on PSA levels, tumor grade, and other factors, but an imaging test can confirm and provide information about the cancers location.

    Imaging tests may not always be needed. A CT scan or bone scan may not be necessary for those with no symptoms and low-risk, early-stage prostate cancer, as determined with information from the PSA test and biopsy. Learn more about when these tests are recommended to find out if the cancer has spread.

    For people with advanced prostate cancer, ASCO recommends that 1 or more of the imaging tests below be done to provide more information about the disease and help plan the best treatment. This includes when there is a newly diagnosed, high-risk cancer if metastasis is suspected or confirmed if the cancer has returned following treatment or when the cancer grows during the treatment period. Learn more about this guideline on the ASCO website.

    Magnetic resonance imaging . An MRI scan uses magnetic fields, not x-rays, to produce detailed images of the body. An MRI can be used to measure the tumors size, and a scan can focus specifically on the area of the prostate or on the whole body. A special dye called contrast medium is given before the scan to create a clearer picture, which is injected into a patients vein.

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    The Top 7 Signs Of Advanced Prostate Cancer

    In the early stages, you may not notice any symptoms related to prostate cancer. This is why screenings are important. Symptoms can sometimes be noticed for the first time when the cancer advances.

    Advanced prostate cancer, also called metastatic cancer, means the cancer has spread to other areas of your body beyond your prostate gland. The most common areas for prostate cancer to spread are your bladder, rectum, and bones. It can also spread to your lymph nodes, liver, lungs, and other body tissues.

    Whether youve just been diagnosed or youre in treatment, its also important to know the signs of advanced cancer. Cancer can behave differently depending on your genetics, so not every person will experience the same symptoms in the same way.

    Read on to learn more about the seven top symptoms of advanced prostate cancer and how to spot them.

    Prostate Cancer Survival Rates

    Answering the question of how curable is prostate cancer? first requires understanding what doctors mean when they refer to curability. Regardless of the type of cancer, doctors consider cancer cured when a patient remains cancer-free for a specified period after treatment. The higher the number of patients who stay cancer-free for five years or longer, the higher the curability of that particular disease.

    Prostate cancer, therefore, has one of the highest curability rates of all types of cancer, thanks in large part to early detection standards and advances in treatment, such as the stereotactic body radiation therapy offered by Pasadena CyberKnife. When the cancer is detected in the early local or regional stages that is, before the cancer has spread or when it has only spread to limited areas in the pelvic regions the five-year survival rate is nearly 100 percent.

    Survival rates decline significantly when cancer is detected at later stages however, the good news is that only about five percent of men are diagnosed after the cancer has become widespread throughout the body. In short, more than 90 percent of men who are diagnosed with prostate cancer live for five years or longer after treatment, making it one of the most curable forms of cancer.

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    Is Going To The Bathroom Frequently A Sign Of Prostate Cancer

    Thats one of the challenging things having urinary symptoms is very rarelyalmost nevera sign of prostate cancer. Having urinary symptoms means you should probably be evaluated for an enlarged prostate, also known as benign prostatic hyperplasia . We can treat your urinary symptoms and help you pee better.

    If urinary symptoms bring men to the doctor, we can discuss screening for prostate cancer. Thats important because not all men will go to a doctor until theres something wrong with them. And prostate cancer screening really is the only way to detect prostate cancer, because its almost always asymptomatic.

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    The Seed And The Soil Hypothesis

    Metastases with a Low PSA, What is PSA Doubling Time | Mark Scholz, MD | PCRI

    Stephen Paget, more than 100 years ago, observed in women autopsies that, in cancer of breast the bones suffer in a special way . This landmark observation has led to the seed and soil hypothesis that postulates the reciprocal need of the seed and the soil so that metastasis can occur in distant individual organs. The uniqueness of the microenvironment in the individual organs supports or opposes the colonization events that lead to the secondary tumor growth.

    The tumor cells that leave the primary site and enter circulation are defined as circulating tumor cells only a fraction of these cells has the capability to extravasate at a distant site and persist/survive as DTCs. Of these DTCs, an even smaller fraction is capable of forming metastasis .

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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.

    Prostate Cancer Invasion: Roles Of Proteases

    Prostate cancer invasion requires partial degradation of the ECM. The ECM is comprised of basement membrane and connective tissue. Partial degradation of the ECM is an obligatory step in metastasis. The families of proteinases most associated with ECM degradation in prostate cancer are matrix metalloproteinases and serine proteinases such as urokinase-type plasminogen activator .

    Matrix metalloproteinases

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    Distant Metastatic Prostate Cancer

    Distant metastatic prostate cancer is more advanced, having spread to areas outside the pelvic region. The most common distant places where prostate cancer spreads include the:

    • Bones
    • Lungs
    • Liver

    Less commonly, prostate cancer may spread to the adrenal glands, kidneys, brain, pancreas or another organ. It is important to note that it is still considered prostate cancer when it spreads to other regions, as the cancer cells in distant areas are the same as the original cancer cells in the prostate gland, even if the prostate gland was previously removed. A biopsy may be recommended to confirm this.

    Understanding Statistics About Survival

    Potential Metastatic Prostate Cancer Biomarker Identified

    Doctors estimate prognosis by using statistics that researchers have collected over many years about people with the same type of cancer. Several types of statistics may be used to estimate prognosis. The most commonly used statistics include:

    • Cancer-specific survivalThis is the percentage of patients with a specific type and stage of cancer who have not died from their cancer during a certain period of time after diagnosis. The period of time may be 1 year, 2 years, 5 years, etc., with 5 years being the time period most often used. Cancer-specific survival is also called disease-specific survival. In most cases, cancer-specific survival is based on causes of death listed in medical records.
    • Relative survivalThis statistic is another method used to estimate cancer-specific survival that does not use information about the cause of death. It is the percentage of cancer patients who have survived for a certain period of time after diagnosis compared to people who do not have cancer.
    • Disease-free survivalThis statistic is the percentage of patients who have no signs of cancer during a certain period of time after treatment. Other names for this statistic are recurrence-free or progression-free survival.

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    Treatment Of Metastatic Stage Iv Or D2 Prostate Cancer

    Prostate cancer that has spread to distant organs and bones is treatable, but not curable with current standard therapies. Hormone therapy has been the standard treatment of metastatic prostate cancer for many years. Metastatic prostate cancer can be controlled with hormone therapy for many years and new treatment options continue to become available.

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    Transitional Cell Prostate Cancer

    This is also known as urothelial carcinoma. This cancer starts in the cells that line the urethra . Transitional cell cancer can start in the bladder and spread to the prostate or, more rarely, it can start in the prostate itself.

    Studies of men with transitional cell prostate cancer show that PSA levels can be low or high. More research is needed before we can know whether PSA tests can help to diagnose transitional cell prostate cancer.

    Men with this cancer often have difficulty urinating and find blood in their urine. This is because the cancer grows around the urethra, causing it to narrow. This means transitional cell carcinoma is often diagnosed when men have surgery called transurethral resection of the prostate to treat their urinary problems, as the tissue removed during surgery is looked at under the microscope.

    If the cancer started in the prostate and has not spread outside the prostate, then you may be offered surgery and radiotherapy. If the cancer has spread to areas just outside the prostate or to more distant areas of the body such as the bones then chemotherapy and/or radiotherapy may be an option.

    Your doctor or nurse will tell you what treatment options are available to you. Read more about how these cancers are treated below.

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    Remission And The Chance Of Recurrence

    A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.

    A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someones risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

    In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.

    When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA-only or biochemical recurrence.

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    Why You May Need Treatment While In Remission

    Where Does Prostate Cancer Spread To?

    Because there are still cancer cells in your body even when youre in remission, you might have treatment during remission. This reduces the risk that the remaining cancer cells will start growing again.

    Whether or not you have treatment during remission, youll be watched closely to make sure that your cancer doesnt become active again.

    The most common type of treatment during remission is maintenance chemotherapy. This is chemo thats given regularly to stop the cancer from spreading.

    Maintenance therapy shouldnt make you feel worse. If you find that the side effects start to become too much for you, talk to your doctor. They may take you off maintenance therapy.

    Maintenance therapy may also become less effective over time, in which case your doctor may stop the therapy to help ensure your cancer doesnt become resistant to chemo.

    For some people, cancer remission can last a lifetime. Others may have their cancer come back, which is called a recurrence.

    types of cancer recurrence

    • Local. The cancer comes back in the place it was originally found.
    • Regional. The cancer comes back in lymph nodes and tissues near the original cancer site.
    • Distant. The cancer comes back in other places throughout the body .

    The chance of recurrence depends on many things, including the type of cancer you had, what stage the cancer was found in, and your overall health.

    The outlook for the five most common types of cancers is:

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