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Metastases to the prostate

 
, medical expert
Last reviewed: 19.11.2021
 
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Prostate cancer is one of the most common oncological diseases among men. To date, this disease is "younger" and is more and more common in men under 50 years old. There are many reasons for the development of prostate cancer, but the main ones are genetic predisposition, age-related hormonal changes, intoxication of the body with cadmium (happens during welding, rubber production), prostate adenoma. The most important and perhaps the most dangerous feature of this disease is that prostate cancer is characterized by a very long latent (latent) course of the disease.

trusted-source[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12]

Prostate cancer and bone metastases

When it comes to stage I and II cancer, the patient has a significant chance of recovery, since the cancer stages in most cases do not have metastases and the affected cells are not spread throughout the body. But when the cancer reaches the late stages - III and IV, then in this case there is very little chance of saving the human life. In this case, the tumor has already begun the process of metastasis and no surgeon will undertake to remove metastases of the prostate, which have already spread throughout the body and began to develop in other organs. Actually, for the III and IV stages of prostate cancer, the appearance of metastases in bone tissue is peculiar to the greatest extent, according to statistics, they appear in 54-85% of all cases.

Metastases to the bones with blood flow occur and most often they appear in the femur, spine, pelvic bones and are characterized by pain in a particular area. The incidence of bone metastases is as follows:

  • lumbar - 59%
  • thoracic department - 57%
  • basin - 49%
  • thigh bone - 24%
  • other bones - 3%

Distinguish between osteolytic and osteoblastic metastases of prostate cancer in the bone. Osteolytic leach minerals from the bones, which leads to its weakening and risk of fractures, and osteoblastic on the contrary - strengthen the mineral component.

To diagnose metastases, radioisotope scanning is used. It will cure metastases of prostate cancer in the bone in 80-90 percent of cases can not, but slow the progress of the disease, ease the pain and maintain a stable and appropriate level of calcium and vitamin D is still necessary.

Prostate cancer and metastasis to the lungs

With the progression of the tumor, metastases begin to affect the body more and more. They appear in the retroperitoneal lymph nodes, liver, lungs and pleura. Lung metastases of prostate cancer get through the bloodstream or lymph, and in most of their appearance is characterized by persistent coughing, shortness of breath, coughing with bloody discharge, pain and pressing sensations in the chest. In some cases, lung metastases can be diagnosed earlier than the cancer itself because prostate cancer often is asymptomatic.

For the diagnosis of metastases, computer tomography, chest X-ray, MRI, biopsy are used. Therapy and treatment of lung metastases in this situation will be aimed at alleviating the negative symptoms and inhibiting the progress of the disease. Chemotherapy and hormone therapy can control and stop the growth of prostate cancer metastases, radiation therapy and radiosurgery make it possible to mitigate the symptoms of the disease, in rare cases, when lung metastasis is one and has a clear localization and envelope, surgical intervention is used.

Symptoms of metastases in the prostate

Symptoms of metastases in the prostate are different and depend on the location of their localization.

The main and main symptom of metastases in bone tissue is pain in any bone, it can have different intensity, depending on the complexity of the degree of the disease. Another indicator of metastases in the bone is hypercalcemia (an increase in the level of calcium in the blood). The reason for this is the leaching of calcium ions from the bones. Hypercalcemia respectively pulls a chain of other symptoms, this: general and muscle weakness, depressive states, nausea, vomiting, lack of appetite, low blood pressure, and sometimes swelling of the lower extremities. To consider these symptoms characteristic of hypercalcemia is not relevant in all cases, but they may suggest an increase in the level of calcium in the blood. When metastases of the prostate appear in the lymph nodes, the main symptom is their increase and soreness. Most often metastases of the prostate are affected by inguinal lymph nodes. Lymph nodes located close to the skin, we can palpate (in norm they are not palpable and not enlarged). The situation is more complicated with intrathoracic and intra-abdominal lymph nodes, which can not be palpated.

Less often metastases of the prostate affect the liver and lungs. Symptoms of metastases in the liver are pain in the right hypochondrium and upper abdomen, nausea and vomiting; symptoms of metastases in the lungs are pressure in the chest, shortness of breath, cough.

It must be remembered that all of the above symptoms do not always indicate the presence of metastases, it can be any other disease that is characterized by their inflammation.

Prostate cancer and metastases

In a large part of cases , prostate cancer is not characterized by any symptoms, it is very slow, the patient can begin to feel changes in the body only after a few years, and often these complaints are associated with an increase in the tumor, the appearance of prostate metastases and their spread throughout the body. Symptoms of metastasis of prostate cancer are similar to those of prostate adenoma: the urge to frequent urination, difficulty urinating, urinary incontinence, pain in the perineum. Most often, metastases to the prostate extend to the lymph nodes, adrenal glands, lungs, liver, bone tissue of the pelvis, spine and thighs.

Regarding the development of prostate cancer itself, it has 4 stages:

  • I stage - the tumor does not manifest itself in any way, it can only be examined with the help of a biopsy
  • II stage - the neoplasm is manifested to a greater degree, it can be examined with the help of ultrasound
  • III stage - the tumor extends beyond the prostate and extends to the adjacent tissue
  • IV stage - the tumor begins to metastasize, prostate metastases spread to other organs and systems

Until the appearance of metastases, the tumor can still be removed, but if prostate metastases are present, there is virtually no chance of cure. Prognosis for prostate cancer is negative today, because 80% of tumors are diagnosed in stages III and IV, when metastasis has already begun. For the prevention of prostate cancer, men after 40 need to undergo an annual medical check-up. The problem is that men do not always seek the advice of a specialist on time, which leads to a negative outcome of the disease.

Diagnosis of metastases in the prostate

Regarding the diagnosis of metastases in bone tissue, a radioisotope scan is used here - the patient is injected intravenously with a radioactive substance, it accumulates in the cells of metastatic tissue and after the patient is placed in a special chamber where a picture is taken, on which the focus of the accumulation of cancer cells is clearly visible. If we talk about the diagnosis of other types of metastases, then very often metastasis is detected earlier than prostate cancer itself, since cancer often proceeds asymptomatically. In these cases, the use of MRI, computed tomography, biopsy, ultrasound, and also make an analysis for determining the level of PSA (prostate-specific antigen).

trusted-source[13], [14], [15], [16], [17]

Treatment of metastases in the prostate

Treatment of metastases in the prostate rarely has a positive outcome, as metastases themselves are very poorly treatable, especially if they are numerous and they spread chaotically through the body along with the blood flow. Only those metastases that are solitary, have clear localization and clear boundaries can be treated. In other cases, the treatment will be aimed at sending pain symptoms and stopping the development of the disease.

The most popular methods of treatment of metastases in the prostate are hormonal therapy, chemotherapy, the use of radioactive drugs and radiation therapy.

  • Hormone therapy is to lower the level of male sex hormone testosterone in the blood, as it stimulates the growth of prostate cells. Hormone therapy is often combined with the use of radiotherapy and helps to reduce the size of a cancerous tumor, inhibits its growth and metastasis.
  • Chemotherapy is aimed at using the patient drugs that block the development of cancer and inhibit the process of metastasis in it. But unfortunately, chemotherapy has a lot of negative consequences, such as weakening immunity and the body as a whole, hair loss and nail dropping, and it is used in cases where cancer cells are very active and divide at a rapid rate (which is not typical for prostate cancer).
  • Radioactive preparations have the property of accumulating in cancer cells and contributing to their destruction by the release of dangerous chemical elements - strontium and samarium. In some cases, these drugs are combined with chemotherapy.
  • Radiation therapy consists in the direction of the radioactive ray on the area of the metastasis. It has the property of killing cancer cells and, accordingly, reducing pain. This method of therapy is most often used to treat metastases in the bones.

Do not forget that timely metastases in the prostate give a high chance of recovery, even the most minor symptoms should not be ignored. Annual preventive examination with a doctor will help diagnose the disease and prevent it from developing.

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