Metastatic Prostate Cancer

Prostate cancer is the most common form of cancer diagnosed in men. In the United States alone, approximately 240,000 men are diagnosed with prostate cancer each year. While it can affect men of any age, it is most commonly diagnosed in men 65 or older. This form of cancer can spread throughout the body, which is referred as metastasis.

What Is Metastatic Prostate Cancer?

A diagnosis of prostate cancer is made when a tumor has been discovered in the prostate gland. Medical experts are unsure what causes prostate cancer, but they believe it usually affects older men with a family history of it. If the cancer spreads from the original prostate tumor, it is said to have metastasized.

When prostate cancer spreads, it may first progress into the lymph nodes and the bones, but it isn’t uncommon for it to spread to the lungs or liver. When it does metastasize, it is still considered prostate cancer because that is where the cancer originated and the treatment options for it remain the same.

What Are the Symptoms?

Although symptoms may not be noticed with prostate cancer in the early stages, you may experience symptoms as it advances. Some of the symptoms may involve urinary problems like:

  • An inability to urinate
  • Unable to start or stop urination
  • The urge to urinate frequently
  • The need to urinate during the night
  • Experiencing pain or a burning sensation while urinating
  • An inability to achieve an erection
  • Bloody semen or urine
  • Recurring pain in the hips, pelvis, lower back or stomach

There are other symptoms that may indicate the presence of metastatic prostate cancer, such as:

  • Unexplained weight loss
  • Feeling bone pain
  • Edema in the feet and legs

Some Treatments You May Go Through

1. Tests

Once you’ve been diagnosed with prostate cancer, your doctor may order tests to check to see if the cancer has spread. The tests will focus on areas commonly affected by the spread of prostate cancer, such as the skeleton, abdomen and pelvis. The doctor may order tests like:

  • X-rays
  • CT
  • MRI

2. Hormone Therapy

In order for prostate cancer to thrive, it needs to have testosterone. To help stop the cancer, hormone therapy, also known as androgen deprivation therapy, is used to decrease the amount of testosterone, along with other hormones, in the body. This will often help shrink the tumor, which can relieve bone pain caused by metastatic prostate cancer.

There are several methods that can help reduce the amount of testosterone in the body, including the use of drugs to help stop the production of testosterone or surgery. The drugs used to block testosterone production are categorized as LH-RH or GnRH agonists or they may be a combination of both. Drugs classified as both LH-RH and GnRH agonists include:

  • Goserelin
  • Leuprolide
  • Triptorelin

Some GnRH agonist drugs help block testosterone production, but they can make symptoms feel worse for several weeks. However, another drug classification can do the same thing without the adverse effects. These drugs, GnRH antagonists, include: Degarelix. Antiandrogen drugs, like bicalutamide, will block the testosterone already present and they are often used in conjunction with LH-RH agonists.

If necessary, a surgery to remove the testicles, called an orchiectomy, may be done. This surgery will prevent the production of 90 percent of the male hormones, including testosterone. Many doctors recommend starting hormone therapy if cancer has spread to the lymph nodes, but others consider the side effects and recommend waiting to use this form of treatment.

3. Radiation Therapy

There are three different types of radiation used to try to shrink prostate tumors and reduce the chances of the cancer metastasizing.

  • 3D-CRT or conformal radiotherapy, is used to help target the cancer with a strong dose of radiation and keep the surrounding healthy tissues safe.
  • IMRT or intensity modulated radiation therapy,uses a newer version of 3D-CRT to better target prostate cancer and maintain healthy tissues.
  • Proton beam therapy uses protons instead of x-rays to target the cancer and help keep the surrounding tissues, like the rectum, healthy. This type of radiation may be used with x-ray as well.

4. Chemotherapy

Chemotherapy may be recommended if other treatments do not work or have stopped working to stop your cancer. The drugs used in chemotherapy move through your body to kill cancer cells and they may be administered through an IV or in pill form. When this treatment begins will depend on the previous treatments you’ve had, if radiation is needed before chemotherapy, how well you tolerate the drugs and any other options you have available. If you have metastatic prostate cancer, then you doctor may combine the chemotherapy drugs with prednisone.

5. Vaccines/Immunotherapy

Vaccines made from your body’s own cells are being created to try to get the immune system to attack cancer cells as they would fight infectious diseases. One such vaccine being used against prostate cancer is sipuleucel-T.

What Is the Life Expectancy With Metastatic Prostate Cancer?

The life expectancy can be hard to determine, especially because a cure has not yet been developed. New treatment methods have helped men live longer than they once did with this disease and some statistics include men diagnosed more than five years ago, which is before some of the newer treatment methods were available.

Recent studies show that the lifespan of men who undergo some of the newer treatment methods has increased by two years when compared to what they might have lived a decade ago.

This is an average survival rate of patients with this cancer for reference:

Cancer Stages

Survival Rates

Without bone metastasis

1-year 87%

5-year 56%

With bone metastasis

1-year 47%

5-year 3%

With bone metastasis involving the skeleton

1-year 40%

5-year less than 1%

Factors That Would Influence Life Expectancy

These factors can influence the life expectancy of someone with metastatic prostate cancer:

  • Age
  • General health, including other medical issues
  • The location and involvement of the metastases
  • Tumor grade
  • Levels of PSA
  • The types of treatments given to the patient
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