The second most common cancer among men is prostate cancer, affecting 1 in 8 men. Prostate cancer is treatable, in most cases, when the cancer remains localised to the prostate gland. But if the cancer advances to stage 4, cancer cells can break away from the original tumour and metastasise to other parts of the body.
When the cancer has metastasised beyond the prostate gland, it’s considered advanced.
Cancer cells commonly spread to the bones first – 9 out of 10 men with advanced prostate cancer also have it in their bones.
“At this advanced stage, the cancer can’t be cured,” says Scott T. Tagawa, MD, a Medical Oncologist at NewYork-Presbyterian Hospital and Professor of Urology at Weill Cornell Medicine in New York City.
“But with treatment, many men can live a long time. There are men I’ve been treating for advanced prostate cancer for 10 or 20 years.”
Today, even better treatments are available. “For a long time,” Dr. Tawaga says, “men with advanced prostate cancer lived an average of three to five years. But that changed around 2012, as newer, more effective drugs were introduced.” He often starts men on these drugs right away, when they walk in the door with prostate cancer that has spread. This has led to a longer survival time and better quality of life for many of the men he treats.
Arm yourself with the facts about what happens when prostate cancer spreads to the bones and what you can do to help manage it.
What Are Bone Metastases With Prostate Cancer?
Bone metastases are areas of bone that contain cancer cells that have spread from another place in your body.
In the case of prostate cancer, the cells have spread beyond your prostate gland. Because the cancer cells originated in your prostate gland, the cancer is referred to as metastatic prostate cancer.
The cancer cells spread to the bones by breaking away from your prostate gland and escaping attack from your immune system as they travel to your bones.
These cancer cells then grow new tumours in your bones. Cancer can spread to any bone in your body, but the spine is most often affected. Other areas cancer cells commonly travel to include the pelvis, ribs, and upper legs and arms.
What Are the Symptoms of Advanced Prostate Cancer and Bone Metastases?
When cancer cells spread to your bones, the condition weakens the very frame on which your body rests.
The cells interfere with the strength and hardness of the bone’s structure, interrupting its normal cycle of building up and dissolving.
There’s no cure for advanced prostate cancer, but there’s a lot that doctors can do to help with the symptoms that might develop. This includes managing pain. “A common misconception is that if there’s cancer in the bone, there must be pain,” Tagawa says. “That’s not true. Cancer can be in the bone without pain.” But if you do have pain, he says, it can be controlled with anticancer therapies and pain medication, and a good quality of life can be maintained.
In addition to pain, you may develop hypercalcaemia, a condition in which too much calcium builds up in your blood, because of the damage to bones from the cancer cells.
Hypercalcemia can make you constipated, sleepy, sluggish, or thirsty and increase the urge to urinate.
Over time, hypercalcaemia can cause muscle and joint achiness, as well as weakness in the muscles. In advanced stages, it can cause your kidneys to shut down. This includes bones that become weak and break or fracture and growths in the spine that can press on your spinal cord and damage nerves.
Additional symptoms of prostate cancer may include painful ejaculation, and a weak urine flow.
There are treatments for hypercalcaemia, as well as other complications of advanced prostate cancer. No matter what symptoms you develop, palliative care can help. This type of supportive care aims to ease any discomfort you’re experiencing and improve your overall quality of life with prostate cancer.
Can You Survive Advanced Prostate Cancer?
Prostate cancer is the second leading cause of death from cancer in men.
While there’s no cure for advanced disease, men can live with it for years with the right treatment.
Each person with advanced prostate cancer is different, of course. You and the cancer have unique qualities that your doctor takes into consideration when planning the best treatment strategy for you.
The prognosis for men with advanced prostate cancer is improving because of newer medications that help get past a resistance to androgen deprivation therapy (ADT), which typically develops after a few years on this therapy that deprives the body of the hormones the cancer needs to keep growing.
With these medications, many men are living longer, and a number who are 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 your 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 cancer specialists, who use sophisticated imaging technologies such as PET scans, have become very good at finding even tiny bone metastases, which is valuable in diagnosing and treating it early.
SOURCE: Everyday Health
