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.
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Weakness Or Swelling In The Legs
Some men experience general weakness and swelling in the legs during advanced prostate cancer. A dull soreness, tingling, or numbness may also accompany these symptoms.
This happens when a prostate tumor starts pressing on the lower part of the spinal cord. The nerves get crowded and compressed, leading to leg issues.
Its easy to pass this symptom off as an age-related shortcoming. However, if the swelling, weakness, or soreness comes out of nowhere and persists, its time to see a doctor.
When managing the symptoms of prostate cancer, time is of the essence. The longer you leave these symptoms unaddressed, the more problems youll encounter them in the future. Disregarding any of these symptoms can also affect your finances as treating prostate cancer with severe symptoms can be expensive.
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.
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Cancer Highjacks The Immune System
The researchers also explored what happens once cancer gets to the lymph nodes. Similar to what other studies have found, it appears that when cancer cells arrive, they shift the amounts and types of immune cells in the lymph nodes.
In mice, for example, there were fewer cancer-killing immune cells in lymph nodes that were invaded by melanoma than in lymph nodes that were cancer-free, the researchers found.
There were also more immune cells called T-regulatory cells in lymph nodes that were invaded by melanoma cells.
And in tissue samples from people with head and neck cancer, there were more T-regs in lymph nodes where cancer had invaded than in lymph nodes that were cancer-free.
The main role of T-regs is to protect healthy cells from attack by other immune cells that have gone off the rails. By doing so, T-regs help prevent autoimmune diseases and chronic inflammation. But T-regs can sometimes get mixed up, protecting unhealthy cells that should be eliminated, like cancer cells.
Thats exactly what the researchers appeared to see in their mouse studies: In mice that were bred to lack T-regs, melanoma tumors were less able to spread to the lungs.
The scientists then removed T-regs from the lymph nodes of mice where melanoma had or hadnt invaded. They transferred the T-regs into other mice with melanoma that hadnt invaded the lymph nodes. Only the T-regs from lymph nodes with cancer helped melanoma cells spread to the lungs, the researchers found.
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:
- have bone pain
- 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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When To Contact A Doctor
If a person notices any signs of cancer having spread to their lymph nodes, they should speak with a doctor immediately.
Additionally, if a person with cancer notices any unusual new symptoms, they should contact a doctor. The sooner a person receives treatment for cancer that has spread, the better their chances of survival.
Can I Lower My Risk Of Getting A Second Cancer
There are steps you can take to lower your risk and stay as healthy as possible. For example, prostate cancer survivors should do their best to stay away from all tobacco products and tobacco smoke. Smoking can increase the risk of bladder cancer, as well as increase the risk of many other cancers.
To help maintain good health, prostate cancer survivors should also:
- Get to and stay at a healthy weight
- Keep physically active and limit the time you spend sitting or lying down
- Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and limits or avoids red and processed meats, sugary drinks, and highly processed foods
- Not drink alcohol. If you do drink, have no more than 1 drink per day for women or 2 per day for men
These steps may also lower the risk of some other health problems.
See Second Cancers in Adults to learn a lot more about the causes of second cancers.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Bostrom PJ, Soloway MS. Secondary cancer after radiotherapy for prostate cancer: Should we be more aware of the risk? Eur Urol. 2007 52:973-982.
Moon K, Stukenborg GJ, Keim J, Theodorescu D. Cancer incidence after localized therapy for prostate cancer. Cancer. 2006 107:991-998.
Last Revised: June 9, 2020
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What Happens After Treatment
If you’ve been treated, especially if a surgeon removed your prostate, your PSA levels should start to go down. Doctors usually wait several weeks after surgery before checking PSA levels.
A rise in PSA after treatment may suggest the 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.
Go to all of your follow-up doctor appointments. At these checkups, let your doctor know about any symptoms youâre having, especially ones like bone pain or blood in your pee. You could keep track of your symptoms by writing them down in a journal or diary.
At home, follow some healthy habits to feel your best:
Eat a balanced diet. It can boost your energy and your immune system. Fill your plate with fruits and vegetables and high-fiber foods. Cut back on fattening foods, sugar, and processed foods and meats.
Let your doctor know if youâre having trouble staying at a healthy weight or if youâre losing your appetite.
Get exercise if your doctor OKs it. It can be good for your body and mind. It can also help you stay at a healthy weight, keep up your strength, and help manage medication side effects.
Metastatic Prostate Cancer Treatment
Treatments for metastatic prostate cancer may depend on where in the body the disease has spread. Options include:
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Receiving Treatment For Prostate Cancer That Has Spread
At Moffitt Cancer Center, the experts within our Urologic Oncology Program treat patients with all stages of prostate cancer, including advanced-stage cancers that have metastasized to other areas of the body. Our multispecialty team collaborates as a tumor board, ensuring each patient receives a treatment plan tailored to his unique needs. For individuals with metastatic prostate cancer, treatment plans aim to alleviate symptoms, slow the rate of cancer growth and shrink tumors to help improve quality of life.
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Psa Levels In Metastatic Prostate Cancer
As part of your ongoing treatment, your care team will regularly test your PSA levels. PSA stands for prostate-specific antigen, which can be high in men who have prostate cancer. PSA tests are used not only for the initial cancer diagnosis but also to observe the advancement of the disease over time.
Generally, PSA levels are higher in men with metastatic prostate cancer. However, in rare cases, its possible to have a low PSA even if you have metastatic disease. For these patients, disease progression is better measured in other ways, such as through imaging tests and biomarker tools.
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What Happens If My Cancer Starts To Grow Again
Your first treatment may help keep your cancer under control. But over time, the cancer may change and it may start to grow again.
You will usually stay on your first type of hormone therapy, even if its not working so well. This is because it will still help to keep the amount of testosterone in your body low. But there are other treatments that you can have alongside your usual treatment, to help control the cancer and manage any symptoms. Other treatments include:
Which treatments are suitable for me?
Which treatments are suitable for you will depend on many things, including your general health, how your cancer responds to treatment, and which treatments youve already had. Talk to your doctor or nurse about your own situation, or speak to our Specialist Nurses.
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Metastatic Prostate Cancer Prognosis
Prostate cancer prognosis varies from person to person, as every situation is different. Five-year relative survival rates are categorized by the type of cancer: localized, regional and distant.
According to the American Cancer Society, localized cancer has a five-year relative survival rate of more than 99 percent. For regional cancer , the five-year relative survival rate is also more than 99 percent.
For distant cancer , the five-year relative survival rate drops to 31 percent.
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Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.
An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.
A bacterial infection can also lead to prostate issues. Acute bacterial infections can be hard to treat. Some men with a bacterial infection may need to take antibiotics to prevent or treat symptoms. Symptoms of the disease include fever and chills, pain in the lower back and the tip of the penis. Some men may have blood in the urine, frequent urination, and blood in the urine. If you suffer from acute bacterial prostatitis, a medical professional should be able to prescribe you the appropriate treatments to prevent the disease.
Effects Of Removing Lymph Nodes
When lymph nodes are removed, it can leave the affected area without a way to drain off the lymph fluid. Many of the lymph vessels now run into a dead end where the node used to be, and fluid can back up. This is called lymphedema, which can become a life-long problem. The more lymph nodes that are removed, the more likely it is to occur. To learn more about what to look for, ways reduce your risk, and how to manage this side effect, see Lymphedema.
Removing lymph nodes during cancer surgery is highly unlikely to weaken a persons immune system, since the immune system is large and complex and is located throughout the body.
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Treatments To Control And Prevent Further Cancer Spread In Patients With Castrate Refractory Advanced Prostate Cancer:
At BPC we offer:
- Hormones , Enzalutamide , Diethylstilboestrol)
- Chemotherapy .
Other treatment options ongoing clinical studies:
- Autologous cellular immunotherapy, which is in late trial stage and although not currently available outside a trial setting in the UK, is likely to be licensed soon.
Pathological Stage: A Look At The Actual Cancer Cells And Their Distribution Within The Pelvic Area
This system assesses how pervasive the cancer cells are within and around the prostate. These stages begin at T2.
T2: The tumor is located in the prostate only.T3: The tumor has breached the prostate border on 1 or more sides.T3b: The tumor has begun to grow in the seminal vesicles.T4: The tumor has grown into other neighboring structures, like the bladder, the rectum, or the pelvic wall.
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Stage Iv Bladder Cancer
Stage IV cancer is the most advanced form of bladder cancer. It is called metastatic. This means the cancer has spread to distant lymph nodes or organs. Cancers that have spread beyond the bladder into the wall of the abdomen or pelvis are also considered Stage IV. Stage IV cancer is usually treated with chemotherapy and, more recently, with immunotherapy as well.
People with bladder cancer of all stages may be able to participate in a clinical trial. Clinical trials are research studies that test new treatments to see how well they work.
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What Is Metastatic Prostate Cancer
If your prostate cancer spreads to other parts of your body, your doctor may tell you that it’s “metastatic” or that your cancer has “metastasized.”
Most often, prostate cancer spreads to the bones or lymph nodes. It’s also common for it to spread to the liver or lungs. It’s rare for it to move to other organs, such as the brain, but that can happen.
It’s still prostate cancer, even when it spreads. For example, metastatic prostate cancer in a bone in your hip is not bone cancer. It has the same prostate cancer cells the original tumor had.
Metastatic prostate cancer is an advanced form of cancer. There’s no cure, but you take steps to treat and control it. Most men with advanced prostate cancer live a normal life for many years.
The goals of treatment are to:
- Manage symptoms
- Slow the rate your cancer grows
- Shrink the tumor
Some cancers are called “locally advanced.” That means the cancer has spread from the prostate to nearby tissue. It’s not the same as metastatic cancer since it hasn’t spread to other parts of your body. Many locally advanced prostate cancers can be cured.
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What About Other Treatments I Hear About
When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.
Diagnosing Cancer Of The Lymph Nodes
In addition to a biopsy, the TNM system is commonly used to issue a diagnosis and determine which type of treatment is best. The T refers to the size of the tumor or cancerous growth. The N refers to the number of lymph nodes that contain cancerous cells. And, the M is for metastasis, which refers to cancer thats spread to areas far from the originating tumor.5
This categorization is used in addition to other diagnostic tests and tools to determine the cancer stage such as:
- Imaging tests X-rays, CT scans, MRIs, and other types of imaging tests can provide a clearer picture and more information about where the cancer is located and how much is present.
- Endoscopy exams An endoscope is a thin, lighted tube with a video camera attached that looks around on the inside of the body for cancerous areas.
In general, cancers assigned as Stage I are less advanced and have a better prognosis and response to treatment. Whereas, a higher stage indicates that the cancer has spread further and requires a more intense or multiple types of treatment. Other factors that affect treatment are:
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