Stage 4 Prostate Cancer Treatments And Prognosis
Stage 4 prostate cancer is the most advanced stage of the disease. It means that cancer has spread beyond the prostate to distant areas of the body. Learn more about this stae, what treatments are available, and the prognosis.
Brianna Gilmartin / Verywell
What Are Bone Metastases
Bone metastases are not the same as cancer that starts in the bone. Cancer that starts in the bone is called primary bone cancer. There are different types of primary bone cancers, like osteosarcoma and Ewing sarcoma.
A tumor that has metastasized to bone is not made of bone cells. Bone metastases are made up of abnormal cancer cells that started from the original tumor site. For instance, lung cancer that spreads to the bone is made of lung cancer cells. In this case, the bone metastasis would be called metastatic lung cancer. In adults, metastatic bone cancer is much more common than primary bone cancer.
Cancer cells that spread to the bone often affect these places:
Cancer cells that spread from tumors in other parts of the body can form two main types of bone tumors:
The tumor may eat away areas of bone. This creates holes called osteolytic lesions. They can make bones fragile and weak. So the bones can break or fracture easily. These areas may be painful.
The tumor may cause the bone to form and build up abnormally. These areas of new bone are called osteosclerotic or osteoblastic lesions. They’re hard, but they’re weak and unstable. They may break or collapse. They can also be painful.
Bone Metastases And Mortality In Prostate Cancer Can We Be Doing More
Variable Migratory Pathways of Bone Metastases.Bone metastases are associated with higher mortality.Impact of Bone Metastases on Quality of Life
- Fatigue: 85%
- Difficulty sleeping as a result of pain: 42%
- Difficulty performing normal activities: 40%
- Anxiety or distress as a result of pain: 40%
- Vomiting: 25%18
- Loss of appetite18
Economic Burden of Bone MetastasesIs Earlier Detection of Bone Metastatic Disease of Value?Use of ALP and PSA to Predict Risk of Bone Metastatic Disease
Don’t Miss: Digital Examination Of The Prostate
Although The Percentage Of Cases In Men Is Much Lower Than In Women Male Breast Cancer Accounts For A Por
Hearing the doctor tell you that you’ve got cancer is undoubtedly one of the worst things you may experience. One in seven men in the united states will receive a prostate cancer diagnosis during his lifetime. Although the percentage of cases in men is much lower than in women, male breast cancer accounts for a por. There are a number of different treatments doctors recommend. Although it is the most commonly diagnosed cancer in american women, breast cancer can impact people of all genders. Here are 10 more facts about prostate cancer. Understanding liver cancer is important if you want to develop an effective treatment plan and live a long and healthy life. Of course, your specialist is the main person whose advice you should follow but it doesn’t do anyone harm. 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 hormones that your thyroid gland produces help regulate several of your bodily functions. Although screenings for prostate cancer are one tool for early detecti. To detect the spread of cancer to the bones It may grow slowly and it’s typically treatable.
But hearing the words can still be scary. When malignant cancer cells form and grow within a person’s breast tissue, breast cancer occurs. The hormones that your thyroid gland produces help regulate several of your bodily functions.
What Treatments Are Available
If you have advanced prostate cancer, treatment wont cure your cancer. But it can help keep it under control and manage any symptoms.
If youve just been diagnosed with advanced prostate cancer, you may be offered the following treatments:
- chemotherapy with hormone therapy
- clinical trials.
Research has found that having radiotherapy together with one of the main treatments listed above can help some men with advanced prostate cancer to live longer. But radiotherapy isnt suitable for all men with advanced prostate cancer.
If you live in Scotland, you may also be offered a type of hormone therapy called abiraterone acetate together with standard hormone therapy. In the rest of the UK, abiraterone is currently only given to men with advanced prostate cancer that has stopped responding to other types of hormone therapy. The National Institute for Health and Care Excellence is currently deciding whether to make it available for men who have just been diagnosed with advanced prostate cancer.
Before you start treatment
Before you start any treatment, make sure you have all the information you need. Its important to think about how you would cope with the possible side effects. Speak to your doctor or nurse about this.
It can help to write down any questions you want to ask at your next appointment. It may also help to take someone with you, such as your partner, a family member or friend.
If you have any questions, speak to our Specialist Nurses.
Recommended Reading: How To Avoid Getting Prostate Cancer
The Role Of Bone Morphogenetic Protein
Bone morphogenetic protein belongs to the TGF- superfamily, which functionally stimulates the replication and differentiation of normal cells in the osteoblast lineage. It also plays a crucial role during the process of mesoderm induction, neural tissue differentiation, and morphogenesis of various tissues . Interestingly, BMPs are not only synthesized by osteoblasts but also secreted by prostate cancers. The unusual expression of BMPs in prostate cancer has been implicated in the progression of the disease.
Taken together, BMP expressions are detectable in either normal prostate tissue or prostate cancer cells. The pattern of BMP expression has a close relationship with the progression of prostate cancer and contributes to the onset of bone lesions. It is clear that BMPs play a role in the vicious cycle of metastatic bone formation from prostate cancer. BMPs produced by prostate cancer will induce osteoblastic activities and promote osteoblastic lesions. On the other hand, BMPs synthesized by osteoblasts subsequently enhance the growth of prostate cancer cells allowing further production of BMPs from prostate cancer.
Characteristics Of Lymph Node Metastasis
Taken together, the concept of the pre-metastatic niche also holds true in prostate cancer lymph node metastasis. Identifying key pathways of niche communication may have significant implications for prognostic and therapeutic purposes in prostate cancer, such as targeting the VEGR3-VEGF-C axis to halt the progression of lymph node metastasis and improve the patient´s prognosis.
Don’t Miss: How Do You Treat An Enlarged Prostate
How Will My Cancer Be Monitored
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.
Imaging Of Metastasis Status In Prostate Cancer Patients
The screening for PSA level in the serum of patients was introduced in the late 1980s and enabled a dramatic increase in early PCa detection . On the other hand, PSA is not solely a PCa-specific biomarker and, as such, leads to overdiagnosis and overtreatment of clinically insignificant cases, representing a significant burden for patients . Moreover, absolute PSA level does not always correlate with prognosis . Therefore, more specific and sensitive PSA-based values like PSA density , PSA velocity , free-to-total PSA , and PSA doubling time are seen as options with stronger predictive value. For example, PSADT is defined as the length of time for two-fold PSA level increase. A PSADT < 6 months is strongly associated with metastatic disease, increased PCa mortality , and relapse . Nonetheless, the reported benefit of PSADT in PCa management did not enter clinical routine and some studies even reported discrepant results indicating that further studies are required to determine the reliability of PSADT and other available biomarkers .
Also Check: Cyberknife Prostate Cancer Side Effects
Causes Of Advanced Prostate Cancer
Prostate cancer is the most common cancer in men in the UK. It is more common over the age 65. Although it can happen at a younger age it is uncommon under 50. People who have a prostate include men, transwomen and people assigned male at birth. If you are a trans woman and have had genital gender affirming surgery as part of your transition, you still have a prostate. Trans men do not have a prostate. It is important to talk to your GP or nurse if you are worried about prostate cancer or have symptoms.
We have more information about the risk factors of prostate cancer.
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 .
Recommended Reading: How Does A Urologist Check For Prostate Cancer
Bone Metastases: When Cancer Spreads To The Bones
Cancer that has started in one place can spread to and invade other parts of the body. This spread is called metastasis. If a tumor spreads to the bone, it’s called bone metastasis.
Cancer cells that have spread to the bone can damage the bone and cause symptoms. Different treatments can be used to control the symptoms and the spread of bone metastases. To better understand what happens in metastasis, it helps to understand more about the bones.
Staging Spread And Survival Rates
As with all cancers, doctors use the term stage to describe the characteristics of the primary tumor itself, such as its size and how far prostate cancer has spread when it is found.
Staging systems are complicated. The staging system for most cancers, including prostate cancer, uses three different aspects of tumor growth and spread. It’s called the TNM system, for tumor, nodes, and metastasis:
- T, for tumor describes the size of the main area of prostate cancer.
- N, for nodes, describes whether prostate cancer has spread to any lymph nodes, and how many and in what locations.
- M, for metastasis, means distant spread of prostate cancer, for example, to the bones or liver.
Using the TNM system, each man’s prostate cancer can be described in detail and compared to other men’s prostate cancer. Doctors use this information for studies and to decide on treatments.
As far as survival rates for prostate cancer go, however, the staging system is pretty simple. As we’ve mentioned, in terms of survival rates, men with prostate cancer can be divided into two groups:
Don’t Miss: Brca Gene And Prostate Cancer
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.
You May Like: Prostate Cancer Ruined My Marriage
What Is Bone Metastasis
The bone is a common site for metastasis. Bone metastasis or âbone metsâ occurs when cancer cells from the primary tumor relocate to the bone. Prostate, breast, and lung cancers are most likely to spread to the bone. However, other cancers are not excluded. Bone metastases do not begin from the bones but move there from the primary tumor site. On the other hand, primary bone cancers are rare cancers where the primary tumor actually starts in the bone. Therefore, bone cancer and bone metastases are not the same.
As an example, consider a patient with prostate cancer. Prostate cancer cells from the primary tumor can break away and get into the bloodstream. Once in the blood, the cancer cell can travel to the bone and form a new tumor. It is important to remember that this secondary tumor is made up of abnormal prostate cancer cells, not abnormal bone cells. The result of this process is referred to as prostate cancer that has metastasized to the bone or metastatic prostate cancer. This is otherwise known as bone metastasis.
When cancer cells metastasize to the bone, they can cause changes to the bone. The process by which portions of the bone are damaged is called osteolysis. Oftentimes, small holes result from osteolysis. These holes in the bone are referred to as osteolytic lesions or lytic lesions. Lytic lesions can weaken the bones and increase the risk of breakage or other problems. It is also common for bone metastasis patients to experience pain with lesions.
Read Also: Drinking Alcohol After Prostate Surgery
Where Can I Find Support
It can be very difficult to deal with a diagnosis of advanced prostate cancer. Its natural to wonder if youre doing all you can to fight the cancer and how to handle guilt, intimacy with a partner, and concerns about masculinity. And finding and paying for the best care can, of course, be a challenge.
But emotional and practical support can help you move forward. An important thing to remember is that youre not alone. There are many kinds of help available, and the right cancer resources can make a world of difference.
Ask your doctor for resources you can contact, including social workers and support systems in your community. The Patient Navigator Program of the ACS can be reached at 1-800-227-2345 youll be connected to a patient navigator at a cancer treatment center who can help you with practical and emotional issues.
The Prostate Cancer Foundation has links to in-person and online support groups around the country, and the ACS lists nationwide support programs as well. The PCF also offers resources ranging from help with housing during cancer treatment to finding ways you can look good and feel better while living with cancer.
Metastatic Spread In Prostate Cancer Patients Influencing Radiotherapy Response
- 1National Center for Tumor Diseases , Dresden, Germany
- 2German Cancer Research Center , Heidelberg, Germany
- 3Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- 4Helmholtz-Zentrum DresdenRossendorf , Dresden,Germany
- 5Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
Read Also: How To Reduce Prostate Swelling Naturally
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
What Are The Symptoms Of Advanced Prostate Cancer And Bone Metastases
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.
Also Check: How Do Doctors Check Prostate Cancer