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Chemotherapy For Prostate Cancer Stage 4

What Does It Mean For Prostate Cancer To Spread

How is stage 4 prostate cancer treated? – Dr. Anil Kamath

Cancer cells can spread to other parts of the body. If this occurs, doctors say the cancer has metastasized or spread.

Areas of the body to which prostate cancer can spread include:

  • the bones
  • the lungs
  • the lymph nodes, usually those around the pelvis

A doctor will typically recommend imaging scans and tissue samples to test for the presence of cancerous cells.

According to the Prostate Cancer Foundation, age is the biggest contributing factor to the risk for prostate cancer. An estimated 65 percent of all prostate cancers are diagnosed in men older than 65 years of age.

Additional risk factors for prostate cancer include:

  • Family history: Men who have a father or brother with prostate cancer are twice as likely to get prostate cancer as men who do not.
  • Race: African-American men face the greatest risk of prostate cancer.
  • Smoking: A history of smoking is associated with a higher risk of aggressive prostate cancer.

Researchers are also studying a link between diet and increased prostate cancer risk. Diets low in vegetables or high in calcium have been linked to an increased risk of aggressive prostate cancer.

The prostate is very close to the point at which urine drains from the body. As a result, many prostate cancer symptoms affect the urination process. Examples of these symptoms include:

Some of these symptoms are associated with aging and an enlarged prostate. As a result, some men may ignore these symptoms instead of seeking medical attention.

Chemotherapy And Other Treatments

Doctors sometimes recommend chemotherapy as a treatment for hormone-resistant prostate cancer, usually for men who fall into one of three groups:

  • Those with fast-rising PSA levels. When the PSA level begins doubling or tripling so quickly that hormone treatments cant control it, chemotherapy may be an option.
  • Those who are developing symptoms. Chemotherapy should be considered if a man with metastatic prostate cancer is losing weight, looking pale, or experiencing physical distress.
  • Those who have metastatic cancer that is growing quickly. These men are sometimes treated with radiation aimed at multiple tumor sites. However, radiation treatments to the bone can reduce the number of red blood cells in the bone marrow and lead to anemia. Using chemotherapy may reduce the need for radiation.

In the treatment of metastatic prostate cancer, one chemotherapy drug is usually given, rather than multiple drugs being given in combination. Some of the drugs used are docetaxel , cabazitaxel , mitoxantrone and estramustine .

In most cases, the first chemotherapy drug given is docetaxel, combined with the steroid drug prednisone. If this drug does not work , other chemotherapy options may be tried. Doctors give chemotherapy in cycles each cycle typically lasts a few weeks. A period of treatment is followed by a period of rest, which allows the body time to recover.

Chemotherapy is very unlikely to cure prostate cancer, but it may slow the cancers growth and reduce symptoms.

The Role Of Adjuvant Chemotherapy

The role of adjuvant chemotherapy after radiation therapy in PCa was recently evaluated in a large Phase III trial, the RTOG 0521 that randomized a total of 563 high-risk PCa patients to either ADT and radiotherapy or ADT and radiotherapy followed by sequential docetaxel and prednisone. Androgen suppression was given for 24 months external-beam radiation therapy was given for 8 weeks and docetaxel was given at 75 mg m2 on day 1 for 6 cycles, starting 4 weeks after the completion of radiotherapy along with prednisone 10 mg. The enrolled patients had Gleason scores between 8 and 10, PSA 20 ng ml1 , or T2 stage. At a median follow-up of 5.5 years, 4-year OS was 89% in ADT/radiation arm and 93% with the addition of docetaxel, for an absolute benefit of 4% resulting in a 30% reduction in risk of death favoring adjuvant docetaxel. In addition, there was an absolute 10% reduction in the rate of disease-free survival at 6 years and the risk of biochemical failure was reduced by 20% in the docetaxel-containing arm. As expected, there was more Grade 3 or 4 hematologic toxicity in the chemotherapy arm. This was one of the promising trials that evaluated adjuvant chemotherapy after radiation which was included in a provisionary statement in the National Comprehensive Cancer Network Guidelines for PCa treatment in men with high-risk disease as a consideration for selected patients who are fit to receive chemotherapy.

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Emerging Therapies For Prostate Cancer

Researchers are pursuing several new ways to treat advanced prostate cancer. Vaccines that alter the body’s immune system and use genetically modified viruses show the most promise. One vaccine technique works by manipulating blood cells from the patient’s immune system and causing them to attack the prostate cancer.

Blood is drawn from the patient. From the blood sample, cells that are part of the immune system are exposed to cells that make up prostate cancer. Then the blood cells are placed back in the body, with the hope that they will cause other immune system cells to attack the prostate cancer. In a more traditional type of vaccine, the patient is injected with a virus that contains PSA. When the body is exposed to the virus, it becomes sensitized to cells in the body that contain PSA and their immune system attacks them.

Immune or genetic therapy have the potential to deliver more targeted, less invasive treatments for advanced prostate cancer. This would result in fewer side effects and better control of the prostate cancer.

Who Is At Risk For Advanced Prostate Cancer

Stage 4 Prostate Cancer Survival Rates

The exact cause of prostate cancer isnt clear. Your risk of developing this particular cancer increases after you reach age 50.

Certain groups are more likely to develop aggressive forms of prostate cancer, including African-American men and men who carry certain inherited genetic mutations such as BRCA1, BRCA2, and HOXB13.

Most men with prostate cancer dont always have a family history of the disease. But having a father or brother with prostate cancer more than doubles your risk.

Also Check: 10 Early Warning Signs Of Prostate Cancer

There Are Different Types Of Treatment For Patients With Prostate Cancer

Different types of treatment are available for patients withprostate cancer. Some treatments are standard , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Understanding The Conventional Cancer System

Standard oncology insists on following typical chemotherapy protocols, despite documentation that indicates ineffectiveness with advanced stage cancers. Why, do you ask?

Well, you should know that virtually all cancer Center use fundamentally identical variations of protocol regimens because they follow each other. In fact, the more prestigious the organization, the more this occurs. It is not uncommon to attend their respective board meetings and hear the discussion repeatedly return to using the same old non-proven method.

Unbelievably, most new and innovative cancer information and treatments are coming from outside the United States. “It doesn’t work,” or “It isn’t proven” seem to be the popular answers given to patients with alternative curiosities. This is ironic, knowing that research indicates that traditional treatments ARE regularly being proven to NOT work

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But Don’t Abandon Chemotherapy Quite Yet

While we have discovered that chemotherapy does not always deliver desired outcomes, it should be pointed out that most chemotherapeutic drugs are not customized or matched to patient-specific cancer/tumor or biopsy. Instead, pharmaceutical drugs are developed to fit a model that promotes certain drug regimens for certain cancer types. Sadly, these Chemo-regimens are constructed through pharmaceutical sponsorship in partnership with prestigious cancer doctors and hospitals working together to politically position protocols as standards of care. The end result means such protocols are moved through the FDA with quantities of sales pre-approved and guaranteed by Medicare.

As a result, chemotherapy drugs are often miss-matched to the patient’s actual tumor. Amazingly, we have found this to be true for more than 75 percent of our patients, determined through molecular and genetic testing. For example, if someone has colon cancer, it is entirely possible that their specific biopsy or tumor would respond best to a chemotherapy drug typically used for breast cancer. These observations become increasingly important for those with advanced and stage 4 cancers.

Is Stage 4 Cancer Always Terminal

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More severe cancers are more likely to be terminal. However, that is never a certainty. For example, the American Cancer Society say the 5-year survival rate for breast cancer that spreads to distant body parts is 27%, or 86% when it only spreads locally.

Determining the severity of cancer and its stage is a complex process. Doctors are still learning about all the factors that affect how cancer develops and affects the body.

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Chemotherapy For Prostate Cancer

Chemotherapy refers to any type of therapy that uses chemicals to kill or halt the growth of cancer cells. While chemotherapy is unlikely to cure prostate cancer, it may provide some benefits to patients. For example, it may be used:

  • To relieve symptoms associated with very advanced or metastatic disease, improving the patients quality of life

  • To improve the outcome of prostate cancer surgery if administered for a short time after the procedure

  • To work in conjunction with hormone therapy and improve the patient outcome

  • To prolong the life of a prostate cancer patient who no longer responds to hormone therapy

  • To treat men with advanced prostate cancer who carry the AR-V7 gene variant

Prostate Cancer Treatments Chemotherapy For Prostate Cancer Stage 4

The medications for cancer will be determined after a diagnosis and staging is complete. There will be a lot of information to think about before discussing management options with your doctor. If an individual has been lately diagnosed, then many prostate cancer treatments are available.

ManagementBasic prostate cancer treatments involve the active surveillance of the cancer and attentive waiting. Active surveillance is a care option that involves monitoring the cancer exerting specific blood tests and various ultrasounds.This is normally done at standard intervals to determine if the cancer is flourishing. Attentive waiting will be less intensive with research and locating the decisions on the symptoms of individual patients. The option to use different forms of management skill is often done in early stages.

SurgeryA common therapy that is meant to heal cancer is surgery. This is often a medication option when the cancer is at the T1 or T2 stage and has not spread outside the gland. The most frequent type of surgery for cancer is announced progressive prostatectomy.In this enterprise, the surgeon is lifting the prostate gland along with some of the bordering material. There are a lot access this action can be done discussing options with your doctor will be a good thing.

Any prostate cancer treatments that are considered will take into account the current senility of the patient, lifespan expectancies, and the grade or stage of the cancer.

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Pca Working Group Criteria For Response

Given the challenges and lack of standardization in defining PSA responses as well as progression, the PSA working group initially convened a consensus conference and published the guidelines in 1999 in order to guide selection of candidate agents for further testing and choosing which agents that can proceed to Phase III trials especially if they are based on different gauge of PSA changes. They also proposed that response duration and time to PSA progression may be important clinical endpoints. The working group criteria were further revised in 2009 with an emphasis on using different parameters, not just PSA progression alone, and patients with early changes in PSA and/or pain are not encouraged to be acted upon without other evidence of objective disease progression such as radiographic technetium scan or computed tomography scans using the Response Evaluation Criteria in Solid Tumors criterion and pain scales. In addition, given drugs that were felt to be more cytostatic than cytotoxic, treatment was encouraged to be continued for at least 3 months so that drug exposure was ensured to be adequate. The Prostate Cancer Clinical Trials Working Group 3 reconvened and published updated guidelines in 2016. The emphasis was to be able to distinguish between first progression and the clinical need to switch treatment, with the provision for using blood-based diagnostics, novel imaging and biologic profiling wherever applicable.

After Prostate Cancer Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Prostate Or To Other Parts Of The Body

What happens in the very end stages of Metastasized Stage ...

The process used to find out if cancer has spread within theprostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnoseprostate cancer are often also used to stage the disease. In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score.

The following tests and procedures also may be used in the staging process:

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There Are Three Ways That Cancer Spreads In The Body

Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Guide To Managing Side Effects Of Chemotherapy

Follow these simple rules to manage your side effects:

  • Pay attention. Be aware of all expected and unexpected reactions to the drugs.

  • Be proactive. Make a list of your medications. Talk with your health care providers about what signs to look for and when to call them.

  • Relax and get well. Chemotherapy drugs are powerful and can take a toll on the body. Focus on getting well by finding ways to alleviate stress. These may include listening to music, doing yoga or stretching exercises, taking walks or watching TV.

  • Keep a journal. Write down any physical and emotional changes you experience while taking the medications. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your health care team to manage your side effects.

  • Consult your doctor. Talk with your health care providers about any side effects you experience. There are several drugs designed to help ward off or treat different side effects.

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Here are 10 more facts about prostate cancer. Breast cancer is the second most common cancer found in women after skin cancer but that doesn’t mean men aren’t at risk as well. The pancreas is located behind the stomach, so having pancreatic cancer doesn’t involve a palpable mass that you can feel. The pancreas is an organ that releases enzymes involved with digestion, and hormones to regular blood sugar levels. Although the percentage of cases in men is much lower than in women, male breast cancer accounts for a por.

Side Effects Of Chemotherapy

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All chemotherapy drugs work in slightly different ways, making it challenging to predict side effects for individual patients. Dosages, drug combinations and drug responses will vary from patient to patient.

The American Cancer Society lists the following as the most common side effects of chemotherapy:

  • Hair loss

  • Increased risk of infections

  • Easy bruising or bleeding

  • Fatigue

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Stage 4 Prostate Cancer: Survival Rates Treatment And Support

Prostate cancer is in stage 4 when the cancer spreads beyond the lymph nodes and into other areas of the body. While the vast majority of prostate cancer cases are caught before this happens, when the cancer is treatable, stage 4 is far more difficult to treat. Therefore, the survival rate among men with stage 4 prostate cancer is much lower.

There are two types of stage 4 prostate cancer: 4A and 4B, according to the American Cancer Society. The type assigned to a persons diagnosis is based on whether the cancer has spread and to what degree, and the value assigned to two additional factors called the Grade Group and the prostate-specific antigen . The Grade Group is a measure of how likely the cancer is to spread quickly, and the PSA is a measure of a protein in the blood produced by cells in the prostate.

With stage 4A, the tumor has already spread into the lymph nodes and may be spreading into tissues adjacent to the prostate, but has not spread to other areas of the body. The Grade Group can be of any value, as can the PSA.

With stage 4B, the tumor may have spread into the lymph nodes, may be spreading into nearby tissues and has spread to other areas of the body like the bones, certain organs and distant lymph nodes. The Grade Group and PSA can be of any value.


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