When prostate cancer metastasizes – what does it mean?

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No man wants to hear his doctor say “You’re prostate cancer has spread.”  Metastatic prostate cancer simply means that the cancer has spread outside of the prostate into other areas of the body.  A doctor often will refer to this as “the cancer has metastasized or that it’s metastatic.” Even though metastatic prostate cancer is an advanced form of cancer with no cure, it can be treated and controlled.  The majority of men who have advanced prostate cancer do go on to live a normal life for many years.

When cancer of the prostate has metastasized, it usually will have spread to the bones or lymph nodes but it can also have spread to the liver or lungs.  When it spreads to other regions of the body, it is still referred to as prostate cancer since it is the same prostate cancer cells from the original tumor.

How does prostate cancer metastasize?

All types of cancers can metastasize or spread to other parts of the body. Whether it is prostate cancer or another type of cancer, cancer cells can sometimes break away from the original tumor.  Once the cancer cells have freed themselves from the original tumor, they can travel through the lymphatic system or the bloodstream to other areas of the body.  The cells can break through the wall of a blood vessel attaching themselves to whatever tissue they find. At this point, they can begin to multiply and grow new blood vessels in order to bring nutrients to the new tumor. 

Not all cancer cells that break away from the original tumor will form new tumors.  Often, they will not survive in the bloodstream or some will die once they get to a new site.  Other breakaway cancer cells can remain inactive for many years or never become active at all.

Cancer cells originating from prostate cancer have a tendency to spread to specific areas such as lymph nodes, in the ribs, pelvic bones or spine.

The number of men who are diagnosed with prostate cancer and who will have a subsequent diagnosis of metastatic cancer is around 50%.  In some men, they may not even discover they have prostate cancer until it has metastasized.

Discovering metastatic prostate cancer

When first diagnosed with prostate cancer, an oncologist will most likely order tests to see if the cancer has spread beyond the prostate itself.  These tests could include x-rays, CT scans, or an MRI.  Because of the location of the prostate, the tests will primarily focus on the pelvic region and spine for any signs that the cancer has metastasized.

If a man has bone pain or has experienced recent broken bones for no reason, then a bone scan may be ordered also.

Another test the doctor will order are blood tests including a PSA or prostate specific antigen test to check the levels of the PSA which is a protein made by the prostate gland.  If the PSA level has risen, it is one of the first signs the cancer could be growing however, a high PSA can also be due to an enlarged prostate or prostatitis.

When a man has completed initial treatment for his prostate cancer such as radiation or hormone treatment, a rise in PSA could also indicate the possibility that the cancer has spread.

Managing metastasized prostate cancer

The goal of any treatment regimen for prostate cancer is to manage any symptoms, slow down the rate of cancer growth and to shrink the tumor.   Even though there are currently no treatments that can cure prostate cancer that has spread, but there are way to help control it and any related symptoms. 

A thorough discussion with your doctor looking into all options is necessary.  There are treatments that can slow the spread of advanced prostate cancer and relieve symptoms but they often cause side effects.  Older patients may decide that the risk of side effects outweigh the benefits of treatment and there for may choose not to treat their advanced prostate cancer. 

Whatever a man decides to do, he should remember that researchers are always looking for new and better treatments that will cause fewer side effects, better disease control, and longer survival rates.