How Prostate Cancer Spreads
Cancer cells sometimes break away from the original tumor and go to a blood or lymph vessel. Once there, they move through your body. The cells stop in capillaries — tiny blood vessels — at some distant location.
The cells then break through the wall of the blood vessel and attach to whatever tissue they find. They multiply and grow new blood vessels to bring nutrients to the new tumor. Prostate cancer prefers to grow in specific areas, such as lymph nodes or in the ribs, pelvic bones, and spine.
Most break-away cancer cells form new tumors. Many others don’t survive in the bloodstream. Some die at the site of the new tissue. Others may lie inactive for years or never become active.
Stem Cell Or Bone Marrow Transplant
A stem cell transplant, sometimes called bone marrow transplant, replaces damaged blood-forming cells with healthy ones. The procedure takes place following large-dose chemotherapy or radiation therapy to kill cancer cells and to stop your stem cells from producing cancerous cells.
Stem cell transplants can be used for several types of cancer, including multiple myeloma and some kinds of leukemia.
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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What Is Metastatic Cancer
Cancer that spreads from where it started to a distant part of the body is called metastatic cancer. For many types of cancer, it is also called stage IV cancer. The process by which cancer cells spread to other parts of the body is called metastasis.
When observed under a microscope and tested in other ways, metastatic cancer cells have features like that of the primary cancer and not like the cells in the place where the metastatic cancer is found. This is how doctors can tell that it is cancer that has spread from another part of the body.
Metastatic cancer has the same name as the primary cancer. For example, breast cancer that spreads to the lung is called metastatic breast cancer, not lung cancer. It is treated as stage IV breast cancer, not as lung cancer.
Sometimes when people are diagnosed with metastatic cancer, doctors cannot tell where it started. This type of cancer is called cancer of unknown primary origin, or CUP. See the Carcinoma of Unknown Primary page for more information.
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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Treating Prostate Cancer That Doesnt Go Away Or Comes Back After Treatment
If your prostate-specific antigen blood level shows that your prostate cancer has not been cured or has come back after the initial treatment, further treatment can often still be helpful. Follow-up treatment will depend on where the cancer is thought to be and what treatment you’ve already had. Imaging tests such as CT, MRI, or bone scans may be done to get a better idea about where the cancer is.
How Is Prostate Cancer Diagnosed
A blood test called a prostate-specific antigen test is the most common way to check for prostate cancer. A higher level of PSA may mean that you have prostate cancer or that your prostate cancer has come back.
Your doctor also may do a biopsy. In this test, your doctor takes samples of tissue from your prostate gland or from the area where the cancer may have spread and sends the samples to a lab for testing. A biopsy is the only way to know for sure that you have prostate cancer.
If you have had prostate cancer before, your doctor may also order a bone scan, CT scan, or MRI to see if it has come back or spread.
Learning that you have cancer that has spread or come back can be very hard. Some people find that it helps to talk about their feelings with their family and friends. You may also want to talk with your doctor or with other people who have had this kind of cancer. Your local Canadian Cancer Society chapter can help you find a support group.
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Mechanisms Of Lymph Node Metastasis
Tumor-associated lymphatic vessels serve as a route for lymph node metastasis
Lymph node. Metastases of tumor cells through lymphatic vessels to lymph nodes.
Local extension of tumor cells from the primary tumor into the surrounding lymphatics through a process called permeation is one means through which tumor cells can enter into the lymphatic vessels . In addition, tumor cells can be stimulated by cytokines produced by the lymphatic vessels, which promote chemotactic diffusion of tumor cells into the lymphatics . Finally, many tumors have the ability to secrete growth factors that induce the growth of new lymphatic vessels from a precursor, a process called lymphangiogenesis .
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.
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What Are The Symptoms Of Lymph Node Metastasis
Lymph node metastasis symptoms can vary widely. Typically, one or more of your lymph nodes will become hard or swollen.
However, due to the variance of size and location of your lymph nodes, you might not even feel anything. This is especially true of lymph nodes located deep inside your stomach or internal organs. However, if your affected lymph node presses on organs or structures, you may have symptoms.
When the lymph nodes press on the blood vessels, it can interfere with how the blood moves and lead to blood clotting. You may have:
- Trouble breathing
- Chest pain
Cancer cells can interfere with the passage of lymph fluid throughout your body. In the most severe cases, this happens in your arms or legs and is called lymphedema. As a result, you will notice swelling in those areas.
Otherwise, you might also have generalized cancer symptoms like:
- Loss of appetite
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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Lymph Nodes And What They Do
Lymph vessels send lymph fluid through nodes throughout the body. Lymph nodes are small structures that work as filters for foreign substances, such as cancer cells and infections. They contain immune cells that can help fight infection by attacking and destroying germs that are carried in through the lymph fluid. Lymph nodes are located in many parts of the body, including the neck, armpit, chest, abdomen , and groin. They contain immune cells that can help fight infection by attacking and destroying germs that are carried in through the lymph fluid.
There are hundreds of lymph nodes throughout the body. Each lymph node filters the fluid and substances picked up by the vessels that lead to it. Lymph fluid from the fingers, for instance, works its way toward the chest, joining fluid from the arm. This fluid may filter through lymph nodes at the elbow, or those under the arm. Fluid from the head, scalp, and face flows down through lymph nodes in the neck. Some lymph nodes are deep inside the body, such as between the lungs or around the bowel, to filter fluid in those areas.
Clinical Staging Options For Lymph Node Involvement
Several user-friendly but sometimes sophisticated tools based on initial clinical and pathological characteristics have been developed to predict the risk of nodal involvement in patients.1014 These tools are useful for predicting the probability of finding positive nodes in populations of patients, but they cannot determine if and where nodes are involved in an individual. As a result, the use of these tools has generated a lot of controversy not only because of significant differences in the observed vs. expected rates of pathological stage in the modern era of lymph-node dissection, but also because of concerns about their clinical relevance.
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What Is The Best Treatment For Prostate Cancer
Depending on each case, treatment options for men with prostate cancer might include:
- Observation or Active Surveillance for Prostate Cancer.
- Surgery for Prostate Cancer.
- Radiation Therapy for Prostate Cancer.
- Cryotherapy for Prostate Cancer.
- Hormone Therapy for Prostate Cancer.
- Chemotherapy for Prostate Cancer.
What Causes Prostate Cancer And Am I At Risk
Every man is at risk for prostate cancer as he ages. Although prostate cancer can affect younger men, about 6 out of 10 cases are diagnosed in men over the age of 65. The average age of diagnosis is 66. After non-melanoma skin cancer, prostate is the most common cancer diagnosed in men in the United States. The American Cancer Society estimates there will be 248,530 new cases of prostate cancer each year.
Although there are several known risk factors for getting prostate cancer, no one knows exactly why one man gets it and another doesn’t. Some important risk factors for prostate cancer are:
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Chances Of Developing Metastatic Prostate Cancer
About 50% of men diagnosed with local prostate cancer will get metastatic cancer during their lifetime. Finding cancer early and treating it can lower that rate.
A small percentage of men aren’t diagnosed with prostate cancer until it has become metastatic. Doctors can find out if it’s metastatic cancer when they take a small sample of the tissue and study the cells.
Lymphangiogenesis & Lymph Node Metastasis
During embryogenesis lymphatic vessels develop from blood vessels . Therefore, lymphangiogenesis and angiogenesis are stimulated by the same family of growth factor proteins. VEGF-A/VPF is the most potent growth factor for angiogenesis . Other VEGF family members, such as VEGF-C and VEGF-D, are potent lymphangiogenic factors . Flt-4, also known as VEGF receptor-3 , is the tyrosine kinase receptor for VEGF-C or -D in lymphatic endothelial cells. Upon activation, this receptor triggers signaling events to initiate the proliferation and migration of lymphatic endothelial cells . Neuropilin-2, a nontyrosine kinase receptor, is also expressed in lymphatic endothelial cells and acts as a coreceptor for VEGF-C during lymphangiogenesis . Both VEGF-C and -D are expressed by tumor cells and, therefore, promote lymphangiogenesis from the tumor-associated surrounding lymphatics . Importantly, cancer cells have also been shown to express neuropilin-2 and/or VEGFR-3, thus suggesting autocrine regulation of lymphangogenic growth factors . Our laboratory has reported one such autocrine regulation of VEGF-C and its receptor neuropilin-2 in prostate cancer this autocrine function promotes the survival of prostate cancer cells during oxidative stress and, thereby, is important for metastatic progression .
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Treatment For Metastatic Prostate Cancer
Treatment for prostate cancer that has spread to the bones and/or other organs in the body is aimed at relieving symptoms and slowing the cancer’s growth. Treatment may include:
- Hormone therapy to slow cancer growth.
- Radiation therapy to shrink tumours and ease pain.
- Chemotherapy to stop the growth of cancer cells.
- Surgery to remove blockages that are causing problems .
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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Experiments With Tissue Culture & Animal Models Of Prostate Cancer
Experiments with tissue culture and animal models of prostate cancer have revealed the mechanisms of the synthesis of lymphangiogenic growth factors in prostate cancer and their important contribution to lymphangiogenesis in prostate cancer lymph node metastasis.
Signaling pathways for VEGF-C synthesis in prostate cancer
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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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.