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Prostate Cancer Spread To Bones Treatment

What Are Bone Metastases With Prostate Cancer

Treatment of Bone Metastases in 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.

Secondary Cancer In The Bones

After the lymph nodes, the most common place for prostate cancer to spread to is the bones. Prostate cancer may spread to bones, such as the:

It may affect different areas of the bones rather than only one area.

  • Pain

    The first sign of a secondary cancer in the bones is usually an ache in the bone. This is often in the hips or in the back. A secondary cancer in the bone may gradually make the bone weaker. Bones that are very weak may break more easily. There are treatments you can have to help strengthen the bones and reduce pain.

  • Spinal cord compression

    If the bones in the spine have cancer in them, the cancer may press on the spinal cord. This is called Malignant spinal cord compression . It usually affects your legs and may cause:

  • numbness or tingling in your legs.

Spinal cord compression is not common. But if you notice these symptoms, you should contact your doctors straight away even at the weekend or during a holiday period. If you cannot contact your GP or cancer doctor, you should go to the nearest emergency department .

  • Anaemia

    Prostate cancer can sometimes spread from the bone to the bone marrow. Bone marrow is the spongy material in the middle of our bones where our blood cells are made. This includes red blood cells, which carry oxygen around the body.

    If the bone marrow cannot produce enough red blood cells, you may become anaemic. This can make you feel very tired and breathless, and you may look very pale.

  • 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 person’s 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.

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    Prostate Cancer Survival Rates

    The good news about prostate cancer is that it usually grows slowly, and 9 out of 10 cases are found in the early stages. Overall, the 5-year relative survival rate is 100% for men with disease confined to the prostate or nearby tissues. Many men live much longer. When the disease has spread to distant areas, that figure drops to 31%. But these numbers are based on men diagnosed at least 5 years ago. The outlook may be better for men diagnosed and treated today.

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    Causes Of Advanced Prostate Cancer

    What Happens If You Have Prostate Cancer

    Prostate cancer is one of the most common cancers in the UK. It is more common over the age of 65. Prostate cancer can happen in younger people, but it is uncommon in people aged under 50.

    If you are a trans woman or are non-binary or assigned male at birth, you also need to be aware of prostate cancer. Advanced prostate cancer may affect trans women, but there is not enough evidence to know how common this is.

    Prostate cancer UK have detailed information about trans women and prostate cancer.

    The LGBT Foundation can also give you confidential advice and support. You can also talk to one of our cancer support specialists.

    Doctors do not know the exact causes of prostate cancer. But there are risk factors of prostate cancer that can increase the chance of developing it. Having one or more risk factors does not mean you will get prostate cancer.

    You may be diagnosed with advanced prostate cancer:

    • after previous treatment for early or locally advanced prostate cancer possibly many years ago
    • after being diagnosed with cancer in the prostate, if further tests show the cancer is advanced
    • after tests to check symptoms of bone pain, with no previous diagnosis of prostate cancer.

    The most common places for prostate cancer to spread to is to the bones and lymph nodes outside the pelvis.

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    Which Way To Choose For The Treatment Of Metastatic Prostate Cancer: A Case Report And Literature Review

    • 1Department of Urology, Kidney and Urology Center, Pelvic Floor Disorders Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
    • 2Department of Pathology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China

    Background: Prostate cancer is the second most common cancer among males in the world and the majority of patients will eventually progress to the metastatic phase. How to choose an effective way for the treatment of metastatic PCa, especially in the later stage of the disease is still confusing. Herein we reported the case of a patient diagnosed with metastatic PCa and conducted a literature review on this issue.

    The experiences of this case provide valuable evidence and reference for the treatment choices of metastatic PCa, in some circumstances modified and advanced regimens may produce unexpected effects.

    Treatment By Stage Of Prostate Cancer

    Different treatments may be recommended for each stage of prostate cancer. Your doctor will work with you to develop a specific treatment plan based on the cancers stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this same page. Clinical trials may also be a treatment option for each stage.

    Early-stage prostate cancer

    Early-stage prostate cancer usually grows very slowly and may take years to cause any symptoms or other health problems, if it ever does at all. As a result, active surveillance or watchful waiting may be recommended. Radiation therapy or surgery may also be suggested, as well as treatment in clinical trials. For those with a higher Gleason score, the cancer may be faster growing, so radical prostatectomy and radiation therapy are often recommended. Your doctor will consider your age and general health before recommending a treatment plan.

    ASCO, the American Urological Association, American Society of Radiation Oncology, and the Society of Urologic Oncology recommend that patients with high-risk early-stage prostate cancer that has not spread to other areas of the body should receive radical prostatectomy or radiation therapy with hormonal therapy as standard treatment options.

    Locally advanced prostate cancer

    Watchful waiting may be considered for older adults who are not expected to live for a long time and whose cancer is not causing symptoms or for those who have another, more serious illness.

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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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    Myths About Prostate Cancer

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

    Here are some things that will not cause prostate cancer: Too much sex, a vasectomy, and masturbation. If you have an enlarged prostate , that does not mean you are at greater risk of developing prostate cancer. Researchers are still studying whether alcohol use, STDs, or prostatitis play a role in the development of prostate cancer.

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    Certain Factors Affect Prognosis And Treatment Options

    The prognosis and treatment options depend on the following:

    • The stage of the cancer .
    • The patients age.
    • Whether the cancer has just been diagnosed or has recurred .

    Treatment options also may depend on the following:

    • Whether the patient has other health problems.
    • The expected side effects of treatment.
    • Past treatment for prostate cancer.
    • The wishes of the patient.

    Most men diagnosed with prostate cancer do not die of it.

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    Clinical Settings For Osteoclast

    How does inhibition of osteoclast activity and bone remodeling influence disease progression? Four common clinical questions have been studied. Does inhibition of bone remodeling reduce skeletal-related events in prostate cancer patients with bone metastases and castration-resistant disease? Can SREs be reduced in patients with bone metastases and castration-sensitive disease? Does osteoclast-targeted therapy prolong bone metastasis-free survival in men with castration-resistant disease and no bone metastases at baseline? Can such therapies reduce fracture rates due to ADT-induced osteoporosis? The clinical trials addressing these questions are presented below and are summarized in tables 1â-33.

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    Advanced Prostate Cancer: Symptoms Treatment And Outlook

    Men are at greater risk for prostate cancer as they age. According to the National Cancer Institute, an estimated 20 percent of men will experience prostate cancer in their lifetimes.

    While doctors detect most forms of prostate cancer in their earliest stages, prostate cancer can progress. When it spreads to other parts of the body, its said to be in the more advanced stages.

    This diagnosis is not common as doctors diagnose most men in the cancers earliest, most treatable stages, according to the Mayo Clinic.

    Contents of this article:

    • How does prostate cancer develop?
    • Symptoms of prostate cancer
    • Treatments for advanced prostate cancer
    • Outlook for prostate cancer survival

    If Treatment Does Not Work

    Advanced and metastatic prostate cancer â what is it?

    Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

    This diagnosis is stressful, and for some people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

    People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

    After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

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    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.

    Destroying Bone Mets With Mrgfus

    If pain medication becomes ineffective, the patients medical team may recommend an intervention aimed at the bone lesion itself. Traditionally, surgery or radiation therapy were the only available methods to remove or try to destroy the lesion. However, surgery is invasive, and radiation therapy takes several weeks to take effect if at all while exposing patients to the effects of ionizing radiation.

    Now there is a remarkable new approach to destroying prostate cancer bone mets and relieving the pain they cause. It is called MR-guided Focused Ultrasound .

    Within 3-7 days, most patients have significant pain reduction in many cases, almost none.

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    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.

    Treatment Of Bone Complications

    Prostate Cancer and Bone Metastasis

    Patients with advanced prostate cancer can have cancer cells that have spread to their bones, called bone metastases. Bone metastases commonly cause pain, increase the risk of fractures, and can lead to a life-threatening condition characterized by an increased amount of calcium in the blood called hypercalcemia. Treatments for bone complications may include drug therapy or radiation therapy.

    Zometa® is a bisphosphonate drug that can effectively prevent loss of bone that occurs from cancer that has spread to the bones thereby reducing the risk of fractures, and decreasing pain. Bisphosphonate drugs work by inhibiting bone resorption, or breakdown. Zoledronic acid may be used to reduce the risk of complications from bone metastases or to treat cancer-related hypercalcemia,

    Xgeva targets a protein known as the RANK ligand. This protein regulates the activity of osteoclasts . Studies have suggested that Denosumab may be more effective than Zoledronic acid at delaying bone complications in prostate cancer patients with bone metastases. Denosumab is associated with side effects including hypocalcemia and osteonecrosis of the jaw .

    Radiation therapy: Pain from bone metastases may also be relieved with radiation therapy directed to the affected bones.

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    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.

    Good Prostate Cancer Care

    Your MDT will be able to recommend what they feel are the best treatment options, but ultimately the decision is yours.

    You should be able to talk with a named specialist nurse about treatment options and possible side effects to help you make a decision.

    You should also be told about any clinical trials you may be eligible for.

    If you have side effects from treatment, you should be referred to specialist services to help stop or ease these side effects.

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