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Prostate Cancer Metastasis To Bone

Should I Make Any Lifestyle Changes Including In My Diet Or Physical Activity

Prostate Cancer and Bone Metastasis

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.

The Underlying Molecular Mechanisms In Prostate Cancer Bone Metastases

Various types of prostate cancer cell lines, including LuCaP 23.1, LNCaP, C4-2, and IGR-CaP1, were utilized as prostate cancer models. The LuCaP 23.1 and LNCaP cells are highly sensitive to androgen . The C4-2 cell lines showed features of reduced androgen sensitivity and increased metastatic capability . In the androgen-sensitive prostate cancer cell lines, the downregulation in androgen receptor expression reduced AR-mediated transcription and cell growth. Meanwhile, the knockdown of AR expression had a marked effect on AR-mediated transcription and cell growth in the androgen-insensitive prostate cancer cell lines . The expression of AR is an important regulator of prostate cancer cell growth and development at the early stage. However, prostate cancer progresses to castration-resistant prostate cancer at the later stage. Thus, possible correlation between AR expression and the signaling molecules involved in prostate cancer bone metastasis could be considered. On the other hand, the IGR-CaP1 cell line represents a unique model recapitulating widespread bone metastasis with mixed osteoblastic and osteolytic bone lesions that resemble the conditions observed in patients .

The Role Of The Rank/rankl/opg System

The receptor activator of nuclear factor-kappa B /RANKL/OPG system is a key molecular system discovered to regulate the bone modeling and remodeling process. Osteoprotegerin is a decoy receptor produced by osteoblasts that blocks the association between RANKL and RANK, thus inhibiting osteoclastogenesis and increasing bone mass. Apart from controlling the normal bone metabolism, this system also plays an essential role in pathological bone metabolism, such as metastatic disease in bone.

Taken together, these previous findings reiterate that: OPG may be beneficial in preventing osteolytic lesions but overexpression of OPG leads to osteoblastic lesions, and a high level of RANKL expression causes osteolytic lesions, thus RANKL blockade will potentially limit the formation and progression of osteolytic lesions. Hence, maintenance of a balanced profile between OPG and RANKL may represent a potential therapeutic strategy for interfering with prostate tumor metastases and progression to bone.

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Managing Bone Metastases And Pain

When prostate cancer cells spread to the bone, this is known as prostate cancer bone metastases . Bones are the most common site of prostate cancer metastasis, occurring in 85%90% of patients with metastatic prostate cancer. Once the cells settle in the bone, they start to interfere with the bones normal health and strength, often leading to bone pain, fracture, or other complications that can significantly impair a mans health.

Early detection of bone metastases can help determine the best treatment strategy. It can also help ward off complications. Because men with prostate cancer bone metastases often experience painful episodes, pain management and improving quality of life are important goals of treatment.

Ethics Approval And Consent To Participate

Metastatic Prostate Cancer to Bone

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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Prostate Cancer Survival Rates Are Favorable Overall

Thinking about survival rates for prostate cancer takes a little mental stretching. Keep in mind that most men are around 70 when diagnosed with prostate cancer. Over, say, five years, many of these men will die from other medical problems unrelated to prostate cancer.

To determine the prostate cancer survival rate, these men are subtracted out of the calculations. Counting only the men who are left provides whatâs called the relative survival rate for prostate cancer.

Taking that into consideration, the relative survival rates for most kinds of prostate cancer are actually pretty good. Remember, weâre not counting men with prostate cancer who die of other causes:

  • 92% of all prostate cancers are found when they are in the early stage, called local or regional. Almost 100% of men who have local or regional prostate cancer will survive more than five years after diagnosis.
  • Fewer men have more advanced prostate cancer at the time of diagnosis. Once prostate cancer has spread beyond the prostate, survival rates fall. For men with distant spread of prostate cancer, about one-third will survive for five years after diagnosis.

Many men with prostate cancer actually will live much longer than five years after diagnosis. What about longer-term survival rates? According to the American Society of Clinical Oncology, for men with local or regional prostate cancer:

  • the relative 10-year survival rate is 98%
  • the relative 15-year survival rate is 96%

B The Role Of The Rank/rankl/osteoprotegerin Signaling Pathway In Pca Bone Metastases

Many of the factors that control bone homeostasis are at play in pathologic PCa bone metastases. In normal bone remodeling, osteoblasts mediate osteoclast differentiation and function by secreting RANKL, which induces osteoclast differentiation when bound to the RANK receptor on osteoclasts and OPG, a decoy receptor that binds to RANKL and inhibits its activity. Previous reports demonstrate that PCa cells in bone express RANK, RANKL, and OPG and communicate directly with bone cells via this same signaling pathway . High RANKL in the bone microenvironment favors osteolysis and promotes PCa growth in bone. Osteolysis releases PCa growth-promoting factors from the bone matrix including TGF-, IGF-1, matrix metalloproteinases , fibroblast growth factors , bone morphogenic proteins , and platelet-derived growth factors . The RANK/RANKL/OPG pathway is also involved in OB bone metastases. High levels of OPG are associated with end-stage OB bone metastases, and serum OPG levels are the most reliable indicator of such lesions . Recently, it has been shown that maturing osteoclasts secrete vesicular RANK that binds to OB RANKL and promotes bone formation by triggering RANKL reverse signaling and activating Runt-related transcription factor 2 . It is plausible that vesicular RANK derived from PCa cells in bone has a similar effect on pathologic bone formation in OB PCa metastases.

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What Is Advanced Prostate Cancer

Advanced prostate cancer is cancer that has spread from the prostate to other parts of the body. It develops when prostate cancer cells move through the blood stream or lymphatic system.

Watch our video about advanced prostate cancer.

You might hear cancer that has spread described as metastatic prostate cancer, secondary prostate cancer, secondaries, metastases or mets. It is still prostate cancer, wherever it is in the body.

Prostate cancer can spread to any part of the body, but most commonly to the bones and lymph nodes. Lymph nodes are part of your lymphatic system, which is part of the bodys immune system. Lymph nodes are found throughout the body including in the pelvic area, near the prostate.

Advanced prostate cancer can cause symptoms, such as fatigue , bone pain, and problems urinating.

The symptoms you have will depend on where the cancer has spread to. Speak to your doctor or nurse if you have any symptoms. There are treatments available to help manage them.

Its not possible to cure advanced prostate cancer. But treatments can help keep it under control and manage any symptoms.

How Doctors Find Metastatic Prostate Cancer

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

When you are diagnosed with prostate cancer, your doctor will order tests such as:

  • X-rays
  • MRI scans
  • PET scans

These tests may focus on your skeleton and in your belly and pelvic areas. That way doctors can check for signs that the cancer has spread.

If you have symptoms such as bone pain and broken bones for no reason, your doctor may order a bone scan. It can show if you have signs of cancer spread in your bones.

Your doctor will also ask for blood tests, including a check of PSA levels, to look for other signs that the cancer is spreading.

PSA is a protein made by the prostate gland. A rise in PSA is one of the first signs your cancer may be growing. But PSA levels can also be high without there being cancer, such as if you have an enlarged prostate a prostate infection, trauma to the perineum, or sexual activity can also cause PSA level to be high.

If you’ve been treated, especially if a surgeon removed your prostate, your PSA levels should start to go down. Doctors usually wait seve,ral weeks after surgery before checking PSA levels. A rise in PSA after treatment may suggest the possibility cancer is back or spreading. In that case, your doctor may order the same tests used to diagnose the original cancer, including a CT scan, MRI, or bone scan. The radiotracer Axumin could be used along with a PET scan to help detect and localize any recurrent cancer.

Though very rare, it’s possible to have metastatic prostate cancer without a higher-than-normal PSA level.

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Active Surveillance And Watchful Waiting

If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend active surveillance or watchful waiting.

Active surveillance. Prostate cancer treatments may seriously affect a personâs quality of life. These treatments can cause side effects, such as erectile dysfunction, which is when someone is unable to get and maintain an erection, and incontinence, which is when a person cannot control their urine flow or bowel function. In addition, many prostate cancers grow slowly and cause no symptoms or problems. For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.

ASCO encourages the following testing schedule for active surveillance:

  • A PSA test every 3 to 6 months

  • A DRE at least once every year

  • Another prostate biopsy within 6 to 12 months, then a biopsy at least every 2 to 5 years

Treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.

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.

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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

The Role Of Biochemical Markers

Xgeva (Denosumab) for the Prevention of Metastatic Bone Cancer

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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What Is Brachytherapy For Prostate Cancer

Brachytherapy is a form of radiation treatment. During brachytherapy, doctors take small particles or seeds that contain a source of radiation and place them inside the body in or near a tumor.

The radioactive material only affects the tissue very close to it, so it tackles the tumor but doesnt harm the rest of the body.

According to the American College of Surgeons , healthcare professionals may recommend brachytherapy as a stand-alone treatment if you have very low- or low-risk prostate cancer or favorable intermediate-risk prostate cancer.

If you have a higher-risk case, healthcare professionals might use brachytherapy in addition to external beam radiation therapy .

Where Prostate Cancer Spreads In The Body Affects Survival Time

Sarah Avery

EMBARGOED FOR RELEASE until 4 p.m. on Monday, March 7, 2016

DURHAM, N.C. â Patients with lymph-only metastasis have the longest overall survival, while those with liver involvement fare worst. Lung and bone metastasis fall in the middle.

Smaller studies had given doctors and patients indications that the site of metastasis in prostate cancer affects survival, but prevalence rates in organ sites were small, so it was difficult to provide good guidance, said Susan Halabi, Ph.D., professor of biostatistics at Duke and lead author of the study published online March 7 in the Journal of Clinical Oncology.

With the large numbers we analyzed in our study, we were able to compare all of these different sites and provide information that could be helpful in conveying prognosis to patients, Halabi said. This information could also be used to help guide treatment approaches using either hormonal therapy or chemotherapy.

Halabi and colleagues from leading U.S. and international cancer research centers pulled data from nine large, phase III clinical trials to analyze outcomes of 8,736 men with metastatic prostate cancer. The patients had all undergone standard treatment with the chemotherapy drug docetaxel.

Site of metastases was categorized into four groups: lung, liver , lymph nodes only, bone with or without lymph nodes and no other organ metastases.

Halabi said more research is needed to understand how and why prostate cancer spreads to different organs.

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Ccl20 Blocking Antibody Treatment

C57BL6/J male mice received an intraperitoneal injection of 45g anti-CCL20 blocking antibody or rat IgG isotype control antibody 1 day prior to intracardiac injection of RM1-BoM3 prostate cancer bone metastasis cells. The administration of blocking antibody and isotype control then continued on a twice-weekly basis until the end of the experiment.

A Potential Method To Prevent Prostate Cancer From Spreading In The Future

Management of Bone Metastases and Bone Health in Patients With Prostate Cancer

Recent studies have detected a transcription factor known as STAT3 as a promoter of prostate cancer metastasis. It has been proposed as a potential target to inhibit metastasis.

A study published in 2021 showed for the first time how a STAT3 inhibitor could obstruct the progression of prostate cancer. In other words, it wont allow prostate cancer to spread to the bone .

However, we should note that the latter is the first study performed in animal models. It should be replicated and tested several times in clinical trials before finding an application in humans.

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