Testing For Prostate Cancer Metastasis
After your biopsy, additional tests or imaging may be performed to check for cancer spread, though these are not required in all men with newly diagnosed prostate cancer.
You may need additional tests if you have:
- High PSA levels
- Extensive prostate involvement on biopsy
- High Gleason scores
- Computed tomography scans of your abdomen and pelvis
- Magnetic resonance imaging of your pelvis
Many centers, including SCCA, are testing other means of finding cancer spread using new types of positron emission tomography scans. Sometimes lymph nodes around the prostate may be checked for metastasis in order to design treatment appropriately.
At SCCA and University of Washington Medical Center, a long-term effort has identified cells in the bone marrow that originated from prostate cancer, even in the absence of other evidence of spread. With these and other studies being offered to men with advanced prostate cancer, we hope to find ways to identify men at the highest risk of relapse so this knowledge can inform our treatment recommendations.
Can You Live Without A Prostate
Although the prostate is essential for reproduction, it is not essential to live.
In cases where the cancer is contained to the prostate it can be surgically removed through a prostatectomy.
A radical prostatectomy involves removing the entire prostate gland, the surrounding tissue, and some of the seminal vesicles.
Alternatively, laser prostatectomies can be effective as the least invasive type of prostate removal.
The most common prostatectomy is the transurethral resection of the prostate .
TURPs involve removing part of the prostate gland using a resectoscope which is passed through the urethra â this procedure is commonly used for people with an enlarged prostate.
In come cases prostate cancer can be treated with radiotherapy.
Radiation therapy for prostate cancer can irritate the bowel, the bladder, or both.
A person can develop:
Radiation proctitis: Symptoms include diarrhea and blood in the stool.
Radiation cystitis: Symptoms include a need to urinate more often, a burning sensation when urinating, and blood in the urine.
Bladder problems may improve after treatment, but they may not go away completely.
Will Treatment Cause Erectile Dysfunction
Radical prostatectomy is a surgery to remove the prostate gland. When your surgeon removes the gland, they may damage the nerves and blood vessels that run along it. If theyre damaged enough, you wont be able to get an erection following the procedure.
Today, doctors can do nerve-sparing surgery, which helps prevent permanent ED. Your surgeon can still touch those nerves and blood vessels, causing ED as a temporary side effect. Many men have trouble getting an erection for a few weeks, months, or even years after their procedure.
Radiation therapy also damages blood vessels and the nerves that control erection. Up to half of men who have radiation for prostate cancer experience ED afterward. In some men, this symptom will improve with time. Sometimes radiation side effects dont appear until a few months after the treatment. If ED starts late, it may not be as likely to go away.
A few treatments can help with ED until youre able to have erections on your own again.
Additional treatments include the following:
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What Are The Signs Of Prostate Cancer
Most early prostate cancers are detected with PSA tests or digital rectal exams before they cause any symptoms. However, more advanced prostate cancers can cause a variety of symptoms including:
- Trouble starting to urinate .
- Urinating much more often than usual.
- The feeling that you canât release all of your urine.
- Impotence/erectile dysfunction.
- Numbness in the lower extremities.
- Loss of bladder or bowel control.
All of these symptoms can be caused by things other than prostate cancer, so experiencing them doesnât necessarily mean you have prostate cancer. When older men have problems urinating, it is usually caused by a problem called benign prostatic hyperplasia , which is not prostate cancer. If you have any of these symptoms, you need to see your provider for testing.
What Are The Signs Of Bladder Cancer
The most common sign of bladder cancer is blood in the urine, called hematuria. Gross hematuria is blood that can be seen in the urine. Your urine can be pink, red, or dark red. In some cases, urine can only be seen with a microscope, called microscopic hematuria. Other signs of bladder cancer include increased frequency of urination, a feeling of urgency to urinate, nocturia , pain with urination, and feeling like your bladder is not empty. These can all be caused by irritation of the bladder wall by the tumor, but can also be signs of infection or other bladder problems.
In advanced cases of bladder cancer, the tumor can stop urine from entering the bladder, or from exiting the bladder. This may cause severe flank pain, infection, and damage to the kidneys. Other signs of advanced bladder cancer are loss of appetite, weight loss, feeling tired, bone pain, and swelling in the feet.
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How Fast Does Prostate Cancer Spread To The Bones
Early detection can catch prostate cancer even before there are any symptoms. Some types of prostate cancer grow very slowly.
There are four main stages of prostate cancer. Within each stage, the cancer is graded based on factors like the size of tumor, prostate-specific antigen level, and other clinical signs.
If the cancer has spread to the bones, its considered to be the most advanced, or stage 4.
Newer lab tests look at the genes inside cancer cells. This can provide more information on how quickly the prostate cancer may progress.
Theres also a grading system known as the Gleason system, which assigns the cancer into a grade group based on how closely it resembles normal tissue.
During the biopsy to diagnose prostate cancer, the cells are closely examined. The more abnormal cells that are in the biopsy sample, the higher the Gleason score and grade group.
When more abnormal cells are present, the cancer is more likely to spread quickly.
Risk Factors For Formation Of Urethral Stenosis And Stricture
Post-radical prostatectomy
Radiotherapy
Risk factors include age, obesity, hypertension, diabetes, previous TURP , longer follow-up, higher radiation dose, HDR-BT, adjuvant RT and combination with BT . Delaying adjuvant RT for more than 9 months after RP may decrease stricture formation, however this is at the expense of an increase in cancer-specific mortality . Zelefsky found that intensity modulated RT increases the risk of late urinary toxicities including urethral stricture compared to 3-D conformal RT, but with lower rectal toxicity . However, a recent review found no difference in urethral stricture between 3-dimensional conformal radiotherapy and IMRT . Similar to ERBT, BT strictures affect the bulbomembranous urethra in the majority of cases, which could be due to a âhot spotâ in the distal bulbar urethra or due to caudal needle shifting in patients receiving HDR-BT , although Hindson found no relation between needle shifting and stricture incidence . A prospective, matched-pair analysis by Diez found no association between urethral stricture incidence and urethral dosimetry in patients receiving HDR-RT, however the number of events was too small to draw a definitive conclusion .
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How Does Bladder Cancer Spread
Bladder cancer spreads when cancerous cells reproduce and invade surrounding healthy tissues. This is known as metastasis. Usually, metastatic bladder cancer refers to cancer that has spread to distant organs, but metastasis can occur locally in the muscles and connective tissues that are directly adjacent to the bladder as well.
Can You Notice Prostate Cancer
Medically reviewed by Elaine K. Luo, M.D. Written by Rena Goldman Updated on April 1, 2019. 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,
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What Symptoms Do I Need To Watch Out For
MSCC can cause any of the following symptoms.
- Pain or soreness in your lower, middle or upper back or neck. The pain might be severe or get worse over time. It might get worse when you cough, sneeze, lift or strain, go to the toilet, or lie down. It may wake you at night or stop you from sleeping.
- A narrow band of pain around your chest or abdomen that can move towards your back, buttocks or legs.
- Pain that moves down your arms or legs.
- Weakness or loss of control of your arms or legs, or difficulty standing or walking. You might feel unsteady on your feet or feel as if your legs are giving way. Some people say they feel clumsy.
- Numbness or tingling in your legs, arms, fingers, toes, buttocks, stomach area or chest that doesnt go away.
- Problems controlling your bladder or bowel. You might not be able to empty your bladder or bowel, or you might have no control over emptying them.
These symptoms can also be caused by other conditions, but its still important to get medical advice straight away in case you do have MSCC.
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How Is Bladder Cancer Treated
Treatment for bladder cancer will depend on the stage and type of cancer you have. Your provider will talk to you about treatment options and which plan of care is best for you.
Superficial Bladder Cancer
Superficial bladder cancer is bladder cancer that has not invaded into the muscle. It is often treated with surgery and intravesicular therapy.
Surgery
A TURBT is a surgical treatment in which a surgeon removes the bladder tumor using a tool placed into the body through the urethra. The extent of the disease is based mainly on findings during this test. TURBT is the main treatment for superficial disease since all of the tumor is often able to be removed. After a TURBT, you may have intravesicular therapy to prevent the cancer from coming back.
Intravesicular Therapy
Intravesicular therapy is when chemotherapy or immune therapy is injected directly into the bladder. This treatment destroys any remaining cancer cells. Both immunotherapy and chemotherapy medications can be used in intravesicular therapy.
Bacillus Calmette-Guerin is an immunotherapy medication that is used. BCG is a type of virus that works to stimulate the immune system to destroy any cancer cells in the area. You will likely be given this medication multiple times. After treatment, you will have regular cystoscopies to monitor for any reoccurrence or new tumor development.
Muscle Invading Bladder Cancer
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What You Need To Know About The Prostate What Happens If Prostate Cancer Spreads
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.
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Symptoms Of Metastatic Prostate Cancer
Metastatic prostate cancer means that a cancer that began in the prostate gland has spread to another part of the body. It is also called advanced prostate cancer.
If your prostate cancer has spread you might:
- feel generally unwell
- have weight loss for no known reason
You might have specific symptoms depending on where the cancer has spread to. These symptoms can also be caused by other medical conditions so might not be a sign that the cancer has spread.
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What Is The Difference Between Prostate Cancer And Advanced Prostate Cancer
Prostate cancer occurs when cells in the prostate gland begin to grow out of control. In the early stages of prostate cancer, the cancer cells are only present in the prostate and have not spread to nearby tissues.
Advanced prostate cancer, also known as stage 4 prostate cancer, occurs when cancer cells have spread to other areas of the body.
The Following Stages Are Used For Bladder Cancer:
Stage 0
In stage 0, abnormalcells are found in tissue lining the inside of the bladder. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stages 0a and 0is, depending on the type of the tumor:
- Stage 0a is also called noninvasive papillary carcinoma, which may look like long, thin growths growing from the lining of the bladder.
- Stage 0is is also called carcinoma in situ, which is a flat tumor on the tissue lining the inside of the bladder.
Stage I
In stage I, cancer has formed and spread to the layer of connective tissue next to the inner lining of the bladder.
Stage II
In stage II, cancer has spread to the layers of muscle tissue of the bladder.
Stage III
Stage III is divided into stages IIIA and IIIB.
- cancer has spread from the bladder to the layer of fat surrounding the bladder and may have spread to the reproductive organs and cancer has not spread to lymph nodes or
- cancer has spread from the bladder to one lymph node in the pelvis that is not near the common iliac arteries .
Stage IV
- cancer has spread from the bladder to the wall of the abdomen or pelvis or
- cancer has spread to lymph nodes that are above the common iliac arteries .
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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.
What Causes Bladder Cancer And Am I At Risk
Each year, about 83,730 new cases of bladder cancer will be diagnosed in the United States. It affects more men than women and the average age at diagnosis is 73.
Cigarette smoking is the biggest risk factor for bladder cancer. About half of all bladder cancers are caused by cigarette smoking. Other risk factors for developing bladder cancer include: family history, occupational exposure to chemicals , previous cancer treatment with cyclophosphamide, ifosfamide, or pelvic radiation, the medication pioglitazone, exposure to arsenic , aristolochic , bladder infections caused by schistosoma haematobium, not drinking enough fluids, a genetic condition called Lynch Syndrome, a mutation of the retinoblastoma gene or the PTEN gene. and neurogenic bladder and the overuse of indwelling catheters.
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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?
What Is Ivu In Prostate
IVU or IVP Intravenous urogram. It is less common to be used in diagnosing prostate cancer. But it may bes suggested if you have difficulties associated with urination or symptoms of a blockage /problem associated with the kidneys. See also how cancer of prostate affects the male urinary system in this section!
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How Soon Can We Detect This
One of the main advantages of surgery over radiotherapy for prostate cancer is that following prostate removal, the PSA should be very low , which we can of course detect with blood tests. If metastasis occurs, because the metastatic cells originated in the prostate and therefore make PSA, the PSA level in the blood starts to rise. Once it has reached a given threshold additional or salvage treatment will be discussed.
A PSA level of more than 0.2 ng/ml defines biochemical recurrence. At this stage the cancer is still much too small to be seen on scanning. If it can be seen on a scan it is termed clinical recurrence, which generally does not occur until the PSA level is more than 0.5 ng/ml. Symptoms, such as bone pain, dont usually occur until the PSA is more than 20 ng/ml.
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