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Bone Scan Prostate Cancer Metastasis

How Long Does It Take For Prostate Cancer To Metastasize To Bone

Bone Metastasis: Treatments, Scans & Side Effects | Ask a Prostate Expert, Mark Scholz, MD

prostate cancerspreadspread to bonesbones

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.

Also, what is the treatment for prostate cancer that has spread to the bones? Men with prostate cancer that has spread to the bones may consider treatment that infuses a radioactive substance into a vein. Strontium-89 , samarium-153 and radium-223 are medications that target fast-growing cancer cells in the bones, and may help relieve bone pain.

One may also ask, how do you know if prostate cancer has spread?

Prostate cancer that has spread to the liver, intestines, or bones of the abdomen and pelvis can usually be found with a CT scan. Cancer which has spread to the lymph nodes can sometimes be detected if the lymph nodes have become enlarged.

What is the prognosis for prostate cancer that has spread to the bones?

There is currently no cure for advanced prostate cancer, but advances in treatments are extending life expectancy and improving quality of life. The ACS state that the 5-year relative survival rate for individuals with prostate cancer that has spread to distant lymph nodes, organs, or the bones is 29 percent.

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Is It Time To Let A Dog With Cancer Go

Our canine companions are a member of our family, making a cancer diagnosis extremely devastating. Not only is it difficult to hear the words, but many owners struggle with understanding the process of their disease and when its actually time to let them go. In this article we will help you understand the diagnosis of cancer in dogs.

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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 324.9×432.2 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 .

Fig. 6

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 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.

Patient Population And Treatment

Booklet: Prostate Cancer Nuclear Medicine Treatment

Thirty patients with biopsy-proven prostate carcinoma, that had been referred to our department for therapy of bone metastasis with radium-223-dichlorid , were retrospectively analyzed in this study. All patients underwent bone scans and Ga-PSMA PET/CT examination within an average interval of 21 days before planned therapy. In 22 patients, therapy with 223RaCl2 was initiated in seven patients a therapy with Lu-PSMA-617 was initiated, as organ metastases were found in the PET/CT examination and one patient was found not suitable for a therapy in our department. In all patients, serum blood levels for PSA were obtained at the time as the bone scan or PET/CT examination. In all patients except one serum levels of ALP and bALP were taken, and in 15 of the 30 patients serum level of pGRP was additionally obtained. At the same time point, ECOG performance status was evaluated for 15 of the 30 patients . All procedures performed in retrospective analysis involving patient data were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. As a retrospective analysis, the ethics statement is waived in our institution by the institutional ethics committee. All patients gave written and informed consent for all imaging procedures and treatment.

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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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The Role Of Biochemical Markers

Urokinase, a member of serine proteases that also function as a growth factor to osteoblastic cells, is believed to play a catalytic role in the metastasis of prostate cancer to the skeleton and extraskeletal sites. In a model of urokinase overexpression, Copenhagen rats inoculated with MatLyLu rat prostate carcinoma cells transfected with plasmids encoding overexpression of urokinase were investigated for the pattern of metastasis . The study outcomes revealed significantly earlier and more widespread development of bone metastasis in the ribs, scapula, and femora of rats inoculated with pYN-ruPA as compared to the control that manifested metastasis only in the lumbar vertebrae at 2021 days post inoculation. Biochemical assay and histological evaluation revealed an accompanying progressive increase in serum ALP level and osteoblastic activity compared to the control animals .

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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.

What Tests Will I Have

Bone Scan for Metastatic Prostate Cancer

You may have tests to find out how far the cancer has spread. If you are generally not very well it may not be necessary to do extra tests. Your doctor will still be able to recommend treatment. Some of these tests can also be used to check how you are responding to treatment.

You may have some or all of the following tests:

PSA blood test

Prostate specific antigen is a protein that can rise due to disease in your prostate gland. A sample is taken from your blood and measured. A PSA test can also show how well your cancer is responding to treatment.

Biopsy

A biopsy is where a sample of your prostate tissue is taken and examined under a microscope. It isnt common to have a biopsy with metastatic prostate cancer, but if this is your first prostate cancer diagnosis it may be necessary. Treatment can still start without a biopsy.

Bone scan

Metastatic prostate cancer often spreads to the bones. Bone scans can find cancer spots before they show up on an ordinary X-ray. For this test, a tiny amount of radioactive liquid is put into a vein, usually in your arm. After the injection you will have to wait up to 3 hours. A scan is then taken of all the bones in your body. Abnormal bone takes up more radioactive liquid than normal bone. These areas will show up on the scan and are known as âhot spotsâ. The scan can also show bone changes like arthritis.

Read more about cancer tests.

These tests will help your doctor to decide on the best treatment for you.

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Bone Scans In Diagnosis Of Prostate Cancer

A bone scan uses tiny amounts of radioactive materials called tracers that are injected into the patient. These tracers accumulate in certain organs and tissues, such as bones, and give off a type of radiation called gamma radiation. The gamma rays can be seen by using a special camera, which produces images that can be interpreted by radiologists or by specialists in nuclear medicine.

A clever way to think about a bone scan is that it is the complete opposite of a X-ray examination. In an X-ray examination the radiation passes into or through your body from an external machine to create an image on film placed on the other side of your body. In a bone scan, the source of the radiation is inside your body and travels to the surface, where a camera detects it.

For patients who are newly diagnosed with prostate cancer, the value of a bone scan is limited. It would be unusal for the doctor to request a bone scan for any patient with a Gleason score of less than 7 and a PSA level of less than 20 ng/mL.

Patients with a Gleason score of 7 or higher may, however, be candidates for a bone scan, whatever their PSA level. A bone scan may be considered important in any patient with a Gleason score of 7 or higher who appears to be at high risk of bony metastatic disease. A bone scan is also indicated for any patient with prostate cancer who has symptoms suggesting bony metastases.

Content on this page last reviewed and updated April 26, 2008.

Pet Scans & Bone Scans For Diagnosing Prostate Cancer

Cancer is a very frightening prognosis, and can take quite a toll on the body. Thats why it is important to diagnose cancer as soon as possible, with the hopes that a malignant tumor can be found and dealt with before it metastasizes. When cancer becomes metastatic, the cells start spreading throughout the body, making the task of finding and fighting cancer much more difficult. The process of determining how developed a persons cancer is, and what type, is called staging. The staging process assists the doctor in understanding a patients cancer prognosis and in making the most accurate pathology report and if diagnosed with cancer, it aids them in deciding what kind of treatment is best.

Prostate cancer is the most common type of cancer diagnosed among men, other than skin cancer. Globally, 1.1 million men are diagnosed with prostate cancer each year. This type of cancer is usually slow progressing, but has the potential to spread quickly if left untreated.

Prostate cancer is divided into four stages . These stages tell how far the cancer has spread. Stages I and II are considered early-stage prostate cancer. The cancer has not yet spread outside the prostate. Stages III and IV, indicate that the cancer has already spread to other parts of the body.

What tests are used to stage prostate cancer?

There are 2 types of staging for prostate cancer:

Doctors use the results from diagnostic tests and scans to answer the following questions:

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Are Achy Bones A Sign Prostate Cancer Has Metastasized

Pain can often be a symptom of advanced prostate cancer, particularly pain felt deep in the bones.

Since more than 60 percent of men with advanced prostate cancer will go on to develop bone metastases, or cancer cells that have spread to the bones, achy bones may be a sign that prostate cancer has metastasized.

While achiness due to weakened bones can be quite painful, there are various ways to manage the pain.

Heres what to be on the lookout for if youre concerned about metastatic prostate cancer, what bone pain really feels like, and how pain and discomfort can be treated.

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How Will My Cancer Be Monitored

Slide Show: Prostate Cancer

Your doctor will talk to you about how often you should have check-ups. At some hospitals, you may not have many appointments at the hospital itself. Instead, you may talk to your doctor or nurse over the telephone. You might hear this called self-management.

You will have regular PSA tests. This is often a useful way to check how well your treatment is working. Youll also have regular blood tests to see whether your cancer is affecting other parts of your body, such as your liver, kidneys or bones.

You might have more scans to see how your cancer is responding to treatment and whether your cancer is spreading.

Your doctor or nurse will also ask you how youre feeling and if you have any symptoms, such as pain or tiredness. This will help them understand how youre responding to treatment and how to manage any symptoms. Let them know if you have any side effects from your treatment. There are usually ways to manage these.

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General Statement On Bone Metastases

Bone metastasis is a devastating condition that has wide-ranging negative impacts on the lives of patients with advanced cancer . To date, no large-scale etiological studies on the prevalence or incidence of bone metastasis have been conducted worldwide . However, the current 5-year survival rate for prostate cancer is> 95% across numerous countries , and an increase in survival time may increase the incidence of bone metastasis.

Irrespective of the primary malignant location, bone metastases are commonly found in the spine, pelvis, shoulder, and distal femur . These bone lesions can cause serious complications, such as spinal cord and nerve root compression, pathological fracture, and hypercalcemia . Bone metastases most commonly affect the axial skeleton. In adults, the axial skeleton contains red marrow, which suggests that the properties of the circulation, cells and extracellular matrix within this region assist in the formation of bone metastasis . Batson showed that venous blood from the breast and pelvis flowed not only into the vena cava but also into the vertebral venous plexus, which extends from the pelvis to throughout the epidural and peri-vertebral veins . Blood drainage to the skeleton via the vertebral venous plexus may, at least in part, explain the tendency of breast and prostate cancers to produce metastases in the axial skeleton and limb girdles .

Fig. 1

Batsons venous plexus. Cited from Diseases of the Spine and Spinal Cord

Fig. 2

Presentations Of Some Typical Cases Of Bone Metastases In Prostate Cancer

WB-MRI is useful not only for diagnosing the distribution and spread of bone metastases, but also for monitoring the therapeutic effect.

In this section, we presented several cases that compare CT findings.

1. Primary osteoblastic metastases .

In general, osteoblastic-type metastases are frequently observed in prostate cancer in the initial stage. In this case, osteosclerotic change is evident on CT images and appears as low intensity on T1WI images and high intensity on DWI images.

2. Primary mixed-type metastases/inter-trabecular metastases .

Other types, such as osteolytic and inter-trabecular types, are also detectable.

In this case, CT images do not show the abnormal findings, such as bone formation or destruction, and DWI of MRI show high signal intensity.

3. Primary unknown osteoblastic metastases histologically confirmed as prostate cancer .

During routine clinical experiences, we often encounter cases of osteoblastic metastases in men with an unknown primary site of origin, and prostate cancer is confirmed following initial radiological examinations. In such cases, multiple high-intensity areas are noted in WB-DWI images, and these are diagnosed as multiple bone metastases. In addition, the prostate gland is carefully observed on axial and coronal reconstructed DWI images. Predicting the primary site before assessing for high serum PSA levels is sometimes possible.

4. Therapeutic effect of bone metastases .

Fig. 8

DWI enables precise evaluation of such lesions.

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Managing Bone Pain And Weakness

Symptoms like nausea, hot flashes, and pain can usually be relieved with medication. Some people find that complimentary treatments like acupuncture or massage help manage side effects.

Your doctor may also recommend orthopedic surgery to stabilize your bones, relieve pain, and help prevent bone fractures.

Metastatic Prostate Cancer Treatment

Body Scans for Prostate Cancer | Prostate Cancer Staging Guide

If youve been diagnosed with prostate cancer and youre concerned about prostate cancer metastasis, talk with your doctor about your risk of prostate cancer metastasis and your treatment options.

Treatments for metastatic prostate cancer may depend on where in the body the disease has spread. Options include:

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Ethics Approval And Consent To Participate

As the data used was extracted from SEER dataset , Ethics approval and Consent to participate could be checked in SEER. We were permitted to have Internet access after our signed data-use agreement was approved by the SEER administration . The date collected from the Second Affiliated Hospital of Zhejiang University School of Medicine was approved by the Ethics Committee of Zhejiang University .

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