Why Does Prostate Cancer Spread
Medical treatment of metastatic prostate cancer is challenging and not appropriate for all patients. Luckily, prostate cancer is usually very slow to progress.
Many patients will remain stagnant in a stage of localized prostate cancer. Others will continue rapidly, spreading locally and to other organs.
Why is cancer progression so different among patients? Why does prostate cancer spread?
In this article, were covering the topic of prostate cancer metastasis. After considering the incidence and why it happens, we talk about prevention and how you know prostate cancer is spreading locally or to distant organs.
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.
How You Might Feel
When prostate cancer is advanced, it can no longer be cured. But treatment can control it for some time and help to relieve symptoms.
Finding out that your cancer cant be cured is distressing and can be a shock. Its common to feel uncertain and anxious. It’s normal not to be able to think about anything else.
Lots of information and support are available to you, your family and your friends. It can help to find out more about your cancer and the treatments you might have. Many people find that knowing more about their situation can make it easier to cope.
Talk to your doctor or nurse to understand:
- what your diagnosis means
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How Is Advanced Prostate Cancer Treated
Androgen deprivation therapy is usually the choice of treatment of metastatic prostate cancer. Also known as hormone therapy, it is also used for treating patients who are unfit or unwilling to undergo surgery or/and radiation therapy.
Examples of hormone therapies for advanced prostate cancer include
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What If You Have Metastatic Castration
This means you have a type of metastatic prostate cancer thatâs able to grow and spread after you had hormone therapy to lower your testosterone levels.
Still, most people with mCRPC stay on androgen deprivation therapy because it might still be effective against some prostate cancer cells.
Your doctor may recommend adding other treatments like:
- Treatments to ease symptoms like pain
You could also find out if a clinical trial might be right for you.
Some people with mCRPC simply choose to try active surveillance or watchful waiting.
Clinical Staging Options For Lymph Node Involvement
Several user-friendly but sometimes sophisticated tools based on initial clinical and pathological characteristics have been developed to predict the risk of nodal involvement in patients.1014 These tools are useful for predicting the probability of finding positive nodes in populations of patients, but they cannot determine if and where nodes are involved in an individual. As a result, the use of these tools has generated a lot of controversy not only because of significant differences in the observed vs. expected rates of pathological stage in the modern era of lymph-node dissection, but also because of concerns about their clinical relevance.
The Seed And The Soil Hypothesis
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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What Is The Outlook
No cure is available for stage 4 prostate cancer. Your healthcare team will work with you to help control the cancer for as long as possible while maintaining a good quality of life.
Your outlook will depend on how fast the cancer is spreading and how well you respond to therapies.
With treatment, you can live for many years with metastatic prostate cancer.
Fast Facts On Prostate Cancer Bone Metastasis
In a previous blog published on the GDO website, we discussed breast cancer bone metastasis, which occurs when breast cancer metastasizes in an area of bone. To accompany that blog, well now discuss prostate cancer bone metastasis, which is similar in many ways to its breast cancer counterpart but also differs in some significant aspects.
As always, this information is meant to be purely educational and is no substitute for tangible medical advice. If you or a loved one is suffering from prostate cancer and is concerned about the possibility of bone metastasis, consult your specialists immediately.
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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.
If You Have Been Diagnosed With Adenocarcinoma Cancer You Have A Cancer That Developed In One Of The Glands That Lines The Inside Of Your Organs
Despite this, pancreatic cancer is among the deadliest types of cancer, which is why its extremely important to know and recogni. The american cancer society estimates that over 21,000 people in the united states will be diagnosed with ova. Prostate cancer is one of the most common types of cancer diagnosed in men. Being armed with information is vital to begin the fight. If you have been diagnosed with adenocarcinoma cancer, you have a cancer that developed in one of the glands that lines the inside of your organs. Nearly 2 million american adults each year are diagnosed with cancer. But hearing the words can still be scary. This type of cancer forms in the cells that give color to your skin, called melanocytes. One in seven men in the united states will receive a prostate cancer diagnosis during his lifetime. Webmd explains what metastatic prostate cancer is and how it is found. The pancreas is a bodily organ that few people think about. In fact, most people dont even know what it does. If you receive a diagnosis, your schedule can quickly start to fill up with doctors appointments, medical procedures and pharmacy visits.
Prostate cancer is a common type of cancer in men, according to the mayo clinic. Nearly 2 million american adults each year are diagnosed with cancer. Creating a checklist of things.
One in seven men in the united states will receive a prostate cancer diagnosis during his lifetime.
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Survival By Disease Recurrence
If a man develops an elevated PSA level after cancer surgery, then the disease is viewed as recurrent.
The number of lymph nodes at the time of prostatectomy can influence the risk of recurrence. One study suggests the removal of a large number of nodes is associated with an improvement in odds of recurrence, but this doesnt appear to impact overall survival.
But disease recurrence doesnt always influence survival times. If a recurrence does occur, the 15-year survival rate at the time of diagnosis may be as high as 94% in those with low-risk recurrence.
The main factors influencing survival rates are:
- The Gleason score
- The PSA doubling time
- Whether the recurrence occurred within three years or after three years
A recurrence that occurs within three years reduces survival rates by anywhere from 15 to 20%and even more, if the doubling time is short.
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.
Medically reviewed by Monica Chatwal, MD.
If you have been diagnosed with prostate cancer, whether early stage or late stage, you can find the treatment you require at Moffitt. We welcome patients with or without a referral to fill out a new patient registration form or call to schedule an appointment.
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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?
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
- 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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Environment For Image Interpretation
The size of the imaging data is enormous therefore, the environment for image interpretation is important. In our department, two 324.9Ã432.2 mm monitors are used for viewing all station-combined sagittal and coronal direction images simultaneously. Three image planes should always be shown, equipped with a reference line .
Imaging layout. This image was captured using WB-MRI by the radiologists and comprised two monitors. On the left side of the monitor, the sagittal T1W images and STIR images are displayed by longitudinal two partings, and on the right side of the monitor, the coronal in-phase T1W images, coronal reconstructed DW images, axial b=0, and axial b=1000 images were displayed by four partings. For all image planes, reference lines were used to detect the precise level of the regions
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What Happens Without Treatment
Physicians will sometimes talk about a particular diseases natural history or typical progression if it is left untreated indefinitely.
With regard to prostate cancer, most cases of the disease are discovered while the cancer is still confined to the prostate itself. This is called local disease or localized disease.
The disease is easiest to treat while it is confined to the prostate. At this stage, surgery and radiation are most likely to be curative and completely kill or remove whatever cancer cells are present.
If left untreated, however, prostate cancer can proceed on a number of different paths.
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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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Stage Iv Prostate Cancer Prognosis
Prostate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate. This average survival rate represents stage IV prostate cancers that have metastasized beyond nearby areas to lymph nodes, organs or bones in other parts of the body.
How We Treat Prostate Cancer
The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.
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Lymph Nodes And What They Do
Lymph vessels send lymph fluid through nodes throughout the body. Lymph nodes are small structures that work as filters for foreign substances, such as cancer cells and infections. They contain immune cells that can help fight infection by attacking and destroying germs that are carried in through the lymph fluid. Lymph nodes are located in many parts of the body, including the neck, armpit, chest, abdomen , and groin. They contain immune cells that can help fight infection by attacking and destroying germs that are carried in through the lymph fluid.
There are hundreds of lymph nodes throughout the body. Each lymph node filters the fluid and substances picked up by the vessels that lead to it. Lymph fluid from the fingers, for instance, works its way toward the chest, joining fluid from the arm. This fluid may filter through lymph nodes at the elbow, or those under the arm. Fluid from the head, scalp, and face flows down through lymph nodes in the neck. Some lymph nodes are deep inside the body, such as between the lungs or around the bowel, to filter fluid in those areas.
What Are The Symptoms Of Lymph Node Metastasis
Lymph node metastasis symptoms can vary widely. Typically, one or more of your lymph nodes will become hard or swollen.
However, due to the variance of size and location of your lymph nodes, you might not even feel anything. This is especially true of lymph nodes located deep inside your stomach or internal organs. However, if your affected lymph node presses on organs or structures, you may have symptoms.
When the lymph nodes press on the blood vessels, it can interfere with how the blood moves and lead to blood clotting. You may have:
- Trouble breathing
Cancer cells can interfere with the passage of lymph fluid throughout your body. In the most severe cases, this happens in your arms or legs and is called lymphedema. As a result, you will notice swelling in those areas.
Otherwise, you might also have generalized cancer symptoms like:
- Loss of appetite
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