Radiation Therapy For Metastatic Prostate Cancer
Radiation therapy may be used to treat men with high-risk prostate cancer or stage 4A cancer .
In these instances, external beam radiation therapy is commonly used, also known as EBRT. Using an external machine, your doctor sends targeted beams of radiation to the cancer site. Its administered five days a week in an outpatient facility throughout several weeks.
Radiation may be targeted to cancer that has spread to the bones as well, helping reduce pain.
The Effect Of Prostate Cancer Bone Metastasis On Serum Opg Levels
The pooled data suggested that the serum OPG levels in the BM group were significantly higher than in the BM- group and healthy controls, with pooled SMDs of 2.34 and 2.21 , p< 0.05, respectively .3). However, no significant difference in serum OPG levels was found between the BM- group and healthy controls .
Forest plot for the comparison of serum OPG levels between BM- group and healthy controls in prostate cancer.
We conducted a sensitivity analysis regarding the comparison of serum OPG levels between the BM and BM- groups by sequentially eliminating one study from the relevant data Stata 12.0 software was used to pool the SMD for the remaining studies. The results consistently suggested that no single study significantly altered the combined results . Eggers regression test indicated little evidence of publication bias .
The plot of sensitivity analysis for the comparison of serum OPG levels between BM group and BM- group in prostate cancer.
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.
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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 .
Symptoms Of Prostate Cancer Spread To The Bones
The most common place for prostate cancer to spread to is the bones. This can include the:
The most common symptom if cancer has spread to the bone is bone pain. It is usually there most of the time and can wake you up at night. The pain can be a dull ache or stabbing pain.
Your bones might also become weaker and more likely to break .
When prostate cancer spreads to the spine, it can put pressure on the spinal cord and cause spinal cord compression. This stops the nerves from being able to work properly. Back pain is usually the first symptom of spinal cord compression.
Spinal cord compression is an emergency. You should contact your treatment team immediately if you are worried you might have spinal cord compression.
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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, its 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.
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
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Stage 4 Prostate Cancer: Symptoms And Treatment
Prostate cancer is a common ailment in older adults. It is currently the most commonly diagnosed cancer type in males. It is also the second cause of cancer-related death in males.
But not all types of prostate cancer are dangerous, and only aggressive cancer leads to advanced disease.
Every step in the clinical management of prostate cancer is complex and highly variable. From screening to watchful waiting and advanced prostate cancer management, almost everything related to this disease is currently not carved in stone. New advances and statistics contribute to advancing our understanding of the disease. Thus, management guidelines are always subject to change.
In this article, were reviewing the state-of-art in advanced prostate cancer management. Stage 4 prostate cancer causes a variety of health problems and complications. Thus, it is essential to identify and understand the disease to prevent late-stage cancer in high-risk patients.
In this article, were reviewing the state-of-art in advanced prostate cancer management. Stage 4 prostate cancer causes a variety of health problems and complications. Thus, it is essential to identify and understand the disease to prevent late-stage cancer in high-risk patients.
Metastatic Prostate Cancer Treatment
If youve been diagnosed with prostate cancer and youre concerned about prostate cancer metastasis, talk with your doctor about your risk of prostate cancer metastasis and your treatment options.
Treatments for metastatic prostate cancer may depend on where in the body the disease has spread. Options include:
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What Types Of Testing Should I Expect For Monitoring My Condition
Since metastatic prostate cancer isnt curable, your doctor will most likely set up regular visits to check the cancers location, and to manage any long-term side effects from the cancer or any medication youre taking.
And since treatments for advanced prostate cancer are changing so fast and need to be given in a certain sequence to be the most effective, youll probably have not only a prostate cancer doctor but other specialists taking care of you. Your care team should coordinate closely, say the authors of a major study of such teams published in August 2015 in the journal Annals of Oncology.
Along with regularly testing your prostate-specific antigen levels, your care team may request blood tests that measure such prostate cancer indicators as alkaline phosphatase and lactate dehydrogenase. Magnetic resonance imaging or PET scans of the spine or other bones can also help identify how your cancer responds to treatment.
If youve had radiation, youre at an increased risk for bladder and colorectal cancer and should get screened regularly for these as well.
The tests youll have and how often youll need them should be customized to you. Your care team will consider your overall health, medications that are safe for you to take, other health conditions you might have, and what stage your cancer was when you were diagnosed.
Stage 4 Prostate Cancer: Firmagon + Abiraterone
I have a question my brother has stage 4 prostate cancer metastasis to bones. He has had 10 sessions of radiation followed now with Firmagon Shot. He has had 3 of these shots his Psa was at 1000 and now is at 2.7. His onocologist would like him to start next month on Abiraterone tablets with Prednisone or his other option is Enzalutamide tablets. He will continue with the Firmagon shot monthly in his stomach. The question we are asking is the Firmagon shot sufficient at this time if his PSA keeps dropping? Why does he have to start the other hormone therapy tablets at this time. If anyone has had experience and advice on the side effects, how long will these drugs work, please let us know. Thank you
Hi @vickyjayne, weclome. I adjusted the title of this discussion a little to reflect that question you’re asking fellow members. Allow me to bring @9876@pauljay@mikesuess@403211th@donnelson@norske46@rso@rxharleydude into this discussion as they have experiences with degarelix abiraterone and/or enzalutamide .
Here are a couple of related discussions: Enzalutamide : Anyone have experience with this drug? Zytiga for Prostate Cancer
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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
- 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
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Stage Iv Prostate Cancer Prognosis
Prostate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate. This average survival rate represents stage IV prostate cancers that have metastasized beyond nearby areas to lymph nodes, organs or bones in other parts of the body.
How We Treat Prostate Cancer
The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.
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Should I Make Any Lifestyle Changes Including In My Diet Or Physical Activity
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.
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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Grading System For Prostate Cancer
As you progress through the prostate cancer stages, your medical team needs to be aware of the grading of the cells, meaning how they differentiate from normal, healthy cells. This helps to decide on the best course of treatment for you. For Acinar Adenocarcinoma, the Gleason Classification System is used to grade the cells based on a scale of 5 different levels.
A grade of 1, 2, or 3 indicates that the prostate cancer stages should progress at a very slow rate. If the cells are given a grade of 4 or 5, this indicates cancer that is likely to grow and spread fast, and grade 5 will move more quickly than 4.
To calculate the final Gleason score, the pathologist will do an evaluation and decide how many new patterns of cells they see. Then they will determine the rating for each and add them together for the final number.
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. Theyre hard, but theyre weak and unstable. They may break or collapse. They can also be painful.
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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.
The Role Of Inflammation
Acute inflammation is a biological response triggered by harmful stimuli such as infection, trauma, and tissue injury to eliminate the source of damage . The tumor microenvironment is unequivocally linked with inflammation, whether the infiltration of immune cells engages with tumor cells causing inflammation or chronic inflammation promotes the malignant transformation of cells and carcinogenesis .
In an experiment performed by Morrissey et al., it was found that IL-6 was highly expressed in prostate cancer bone metastases. PC-3 cells inhibited osteoblast activity and induced osteoblast to produce IL-6 that promoted osteoclastogenesis . In addition, a recent study by Roca et al. observed that macrophage-driven efferocytosis induced the expression of pro-inflammatory cytokines, such as C-X-C motif chemokine ligand 5 by activating the signal transducer and activator of transcription 3 and the nuclear factor kappa-light-chain-enhancer of activated B cells signaling. CXCL5-deficient mice had reduced tumor progression. These findings suggested that the myeloid phagocytic clearance of apoptotic cancer cells accelerated CXCL5-mediated inflammation and tumor growth in bone . In summary, findings from available evidence suggest the alleviation of chronic inflammation as a potential therapeutic approach for prostate cancer bone metastases.
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What Happens If You Stop Hormone Therapy For Prostate Cancer
If you stop your hormone therapy, your testosterone levels will gradually rise again and some side effects will reduce. Your side effects won’t stop as soon as you finish hormone therapy it may take several months. Surgery to remove the testicles can’t be reversed, so the side effects are permanent.
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
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Where Does Prostate Cancer Spread
The most common place for prostate cancer to spread to is the bones. It can also spread to the:
A large tumour in the prostate gland can spread into or press on areas around the prostate, such as the back passage or urethra. The urethra is the tube which carries urine from the bladder to the outside of the body.