How Does Prostate Cancer Spread
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 breakaway 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.
Surgery And Advanced Prostate Cancer
An indication for immediate bilateral orchiectomy is spinal cord compression. Surgical intervention is mandatory for pathologic fractures involving weight-bearing bones.
In patients with clinical stage T3 prostate cancer at initial presentation, radical prostatectomy has not historically been considered beneficial, because of the increased probability of incomplete resection of the cancer, likelihood of micrometastatic disease, and increased morbidity.
However, a retrospective review of approximately 840 men with stage cT3 prostate cancer who underwent RP at the Mayo Clinic reported outcomes similar to those with organ-confined disease during the same period at this institution. Pathologic stage, Gleason grade, positive surgical margin, and nondiploid chromatin were found to be independently associated with increased progression of disease.
In another Mayo Clinic study, in which the long-term survival of patients with high-risk prostate cancer was compared after RP and after external beam radiation therapy , RP alone and EBRT plus ADT provided similar long-term cancer control. However, the risk of all-cause mortality was greater after EBRT plus ADT than after RP.
In the study, RP was used in 1238 men, EBRT plus ADT was used in 344 men, and 265 received EBRT alone. The 10-year cancer-specific survival rates in the study were 92% in patients treated with RP or EBRT plus ADT, and 88% in those receiving EBRT alone, with a median follow-up of 6-10 years.
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
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
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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 dont survive in the bloodstream. Some die at the site of the new tissue. Others may lie inactive for years or never become active.
For Patients With Metastatic Cancer What Kinds Of Clinical Trials Does Msk Offer
At MSK, were fortunate to have many clinical trials available to patients. These trials may be testing a new surgical procedure, a different kind of radiation treatment, or a new drug or combination of drugs. Many of the treatments that are now considered standard for treating metastatic cancer began with clinical trials led by doctors at MSK. This includes many types of targeted therapies as well as immunotherapies.
Many of the clinical trials open at our main campus in Manhattan are also open at MSK Commack, where I see patients, as well as MSKs other Regional Care Network sites on Long Island and in Westchester and New Jersey. This means that patients can participate in these trials without traveling into the city. There are some trials that are available exclusively at our main campus in Manhattan, but were continually opening more trials at our regional sites.
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How Does Cancer Spread From One Part Of The Body To Another
Metastasis or metastatic cancer occurs when cancer cells break off from the tumor where they originated, travel through the bloodstream or lymph vessels, and establish new tumors in another part of the body. Scientists at MSK are studying how and why this happens, with the goal of finding ways to prevent it.
What If You Have Metastatic Castration
This means you have a type of metastatic prostate cancer thatâs able to grow and spread after you had hormone therapy to lower your testosterone levels.
Still, most people with mCRPC stay on androgen deprivation therapy because it might still be effective against some prostate cancer cells.
Your doctor may recommend adding other treatments like:
- Treatments to ease symptoms like pain
You could also find out if a clinical trial might be right for you.
Some people with mCRPC simply choose to try active surveillance or watchful waiting.
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Prostate Cancer Metastasis: Roles Of Recruitment And Reprogramming Cell Signal Network And Three
Shabnam Ziaee1*, Gina Chia-Yi Chu1*, Jen-Ming Huang1*, Shirly Sieh1,2, Leland W. K. Chung1,3
1 Department of Medicine, Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA Australian Prostate Cancer Research Centre, Brisbane, Queensland 4102, Australia Department of Surgery, Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
Contributions: Conception and design: S Ziaee, GC Chu, JM Huang, LW Chung Data analysis and interpretation: S Ziaee, S Sieh Manuscript writing: S Ziaee, GC Chu, JM Huang, LW Chung Final approval: All authors.
*These authors contributed equally to this work.
Correspondence to:
Keywords: Metastasis-initiating cells dormant cells recruitment and reprogramming cell signaling network in tumor microenvironment three-dimensional cell culture
Submitted Oct 22, 2014. Accepted for publication Mar 23, 2015.
doi: 10.3978/j.issn.2223-4683.2015.04.10
Anatomy And Metastasis Of Prostate Cancer
The pudendal nerve innervates the few striated muscles within the prostatic capsule. The parasympathetic nerves emanate from S2 to S4 and form the pelvic nerve. The sympathetic preganglionic nerves, which reside in the thoracolumbar region between T6 and L2, provide the major neural input to the prostate and reach the pelvis through the hypogastric nerve .
Prostate cancer has been shown to metastasize by following the venous drainage system through the lower paravertebral plexus, or Batson’s plexus.4,9 Although hematogenous spread of other malignancies is most commonly to the lungs and liver, 90 percent of prostatic metastases involve the spine, with the lumbar spine affected three times more often than the cervical spine. Prostate cancer also spreads to the lungs in about 50 percent of patients with metastatic disease, and to the liver in about 25 percent of those with metastases.4
Epidural metastases are the result of contiguous spread from lesions of the calvaria to the meninges. Because of the protective layer of the dura mater, subdural and intra-parenchymal metastases from prostate cancer are rare .
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What Is The Likelihood Of Prostate Cancer Spreading
Cancer behaves like a species competing for survival, similar to Darwinian evolution. More and more subclones of cancer emerge in the primary tumor. The more aggressive cells survive for a longer time and continue creating subclones.
Among these, the most aggressive continue surviving. This is how the disease progresses into a more dangerous stage in every step.
Thus, the question is not if cancer will spread but when. All cancers may ultimately spread, but since prostate cancer tends to progress very slowly, older men usually dont live through this process.
They may die for unrelated causes, especially if prostate cancer is diagnosed after age 70 years. Considering patients who die for unrelated reasons, extra-prostatic disease risk is very high .
Younger prostate cancer patients are more likely to live through the initial and intermediate stages. The younger you are at the moment of diagnosis, the more likely it is to experience metastasis. Youre giving cancer more time to reach that stage. It also depends on the genes involved in the process and your risk factors .
According to recent statistics, the incidence of metastatic prostate cancer is rising. The spread of this type of cancer is becoming more common with passing years to an alarming degree.
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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Fast Facts On Prostate Cancer Bone Metastasis
In a previous blog published on the GDO website, we discussed breast cancer bone metastasis, which occurs when breast cancer metastasizes in an area of bone. To accompany that blog, well now discuss prostate cancer bone metastasis, which is similar in many ways to its breast cancer counterpart but also differs in some significant aspects.
As always, this information is meant to be purely educational and is no substitute for tangible medical advice. If you or a loved one is suffering from prostate cancer and is concerned about the possibility of bone metastasis, consult your specialists immediately.
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someones risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA-only or biochemical recurrence.
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Can I Survive Advanced Prostate Cancer Whats The Prognosis
Prostate cancer is the second leading cause of death from cancer in men, according to the National Cancer Institute. While theres no cure, men can live with it for years if they get the right treatment. Each man with advanced prostate cancer is different, of course. You and your cancer have unique qualities that your doctor takes into consideration when planning the best treatment strategy for you.
According to Harvard Medical School, the prognosis for men with advanced prostate cancer is improving because of newer medications that help them get past a resistance to androgen-deprivation therapy that typically develops after a few years of treatment. With these medications, many men are living longer, and a number of men diagnosed with advanced prostate cancer are dying with the cancer, not from it.
Promptly treating prostate cancer bone metastases with the newest medication can help change a mans prognosis dramatically, Tagawa says. There are men who do well for decades, he says. Some men can even stop treatment, go on to live many years, and actually die of something unrelated.
Tagawa says that cancer specialists who use sophisticated imaging technologies, like positron-emission tomography scans, have gotten very good at finding even tiny bone metastases, which is valuable in diagnosing and removing early stage metastases.
Treatments For Prostate Cancer Spread To Bones
If prostate cancer spreads to other parts of the body, it nearly always goes to the bones first. Bone metastasis can be painful and can cause other problems, such as fractures , spinal cord compression , or high blood calcium levels, which can be dangerous or even life threatening.
If the cancer has grown outside the prostate, preventing or slowing the spread of the cancer to the bones is a major goal of treatment. If the cancer has already reached the bones, controlling or relieving pain and other complications is also a very important part of treatment.
Treatments such as hormone therapy, chemotherapy, and vaccines may help with this, but other treatments specifically target bone metastasis and the problems it may cause.
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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 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 Is Stage 4 Prostate Cancer
The fourth stage of prostate cancerdefines a tumor that has progressed to other regions of the body, such as the lymph nodes, lungs, liver, bones, or bladder. The 5-year survival rate for these tumors is 29 percent.
Keep in mind that each case is unique, and figures like these are merely suggestions. As advances in prostate cancer treatment become more common, your odds of surviving this disease improve.
In general, prostate cancer has a very good survival rate one of the greatest of any cancer type. Because prostate cancer is frequently a slow-moving disease, the majority of men diagnosed with it will die from an unrelated reason.
Stage 4 prostate cancer means the cancer has spread to lymph nodes or to other parts of the body. It is further divided into two substages:
- Prostate Cancer Stage 4A Stage 4A: The cancer has spread to nearby lymph nodes but may or may not have spread to nearby tissues.
- Prostate Cancer Stage 4B Stage 4B: The cancer has spread to another area of the body, such as the bones or distant lymph nodes.