Prostate cancer is the most common cancer after skin cancer in men in the US and the second leading cause of cancer death. Prostate-specific antigen (PSA) testing has made the detection of prostate cancer easier in its early stages. Ninety-two out of 100 men get diagnosed when the cancer is limited to the prostate.
Most men are diagnosed with prostate cancer in their senior years and only 1 out of 36 men die from it. Death from prostate cancer most often happens when cancer has spread (metastasized) to other organs in the body. This is known as the advanced stage of prostate cancer.
The chances of survival decrease as cancer spreads beyond the prostate. If cancer has metastasized to other parts of the body, only three out of 10 men will survive for five years after the diagnosis.
Advanced stage prostate cancer or metastasized prostate cancer
Cancerous cells may spread to organs other than the site of origin. In the case of prostate cancer, this tendency is decreased, but it can happen. Advanced stage prostate cancer is defined based on the Gleason score, which is based on the TNM staging of cancer. T stands for tumor size, N stands for lymph node involvement and M stands for metastasis.
Prostate cancer can kill in the end through metastases that can develop in
- Lymph nodes
- Bones (particularly lower spine, pelvis, and femur)
- Brain
- Liver
- Lungs
Metastasis to the bone can cause too much bone calcium to be released into the blood. The condition is known as hypercalcemia. Hypercalcemia can disrupt the functioning of organs, such as the kidney and heart. In severe cases, high calcium levels can lead to death.
Metastasis to the lungs can cause the affected lung to collapse or cause a lung infection that becomes difficult to treat. This can severely decrease the affected person’s ability to draw oxygen into the body.
Metastasis to the liver can affect the liver’s ability to filter out toxins from the body. This can eventually lead to jaundice, nausea, loss of appetite and weight loss.
Paraneoplastic syndrome associated with prostate cancer may cause symptoms such as neuropathy, difficulty walking, loss of muscle tone, loss of fine motor coordination, memory loss, seizures, sensory loss in the limbs and vertigo or dizziness. Paraneoplastic syndromes are a group of rare disorders that are triggered by an abnormal immune system response to cancerous cells. These cells mostly attack the nerve and the muscle cells throughout the body.
Advanced stage cancer leads to malnutrition, which can cause muscle wasting, weight loss and fatigue. It may even repress the healthy immune system to an extent that the person develops fungal infections and sepsis.
How is advanced prostate cancer treated?
The primary treatment of prostate cancer is prostatectomy, which is a surgery to remove a part of the prostate gland or the entire prostate gland in younger patients.
Androgen deprivation therapy (ADT) is usually the choice of treatment of metastatic prostate cancer. Also known as hormone therapy, it is also used for treating patients who are unfit or unwilling to undergo surgery or/and radiation therapy.
Examples of hormone therapies for advanced prostate cancer include
- Abiraterone
- Enzalutamide
Other treatment options for prostate cancer are
Radiation therapy
- Radiation therapy involves the use of high-energy waves to destroy cancer cells. It is the most preferred cancer therapy for older men or those with other coexisting conditions.
Chemotherapy
- This is a treatment involving anticancer medications that kill rapidly multiplying cells. Examples of chemotherapy medications in advanced prostate cancer include
- Mitoxantrone
- Paclitaxel
- Docetaxel
Immunotherapy
- Also known as biologic therapy, immunotherapy involves using the immune system to fight cancers. Examples include
- Colony-stimulating factors
- Interferon
- Interleukin
- Monoclonal antibodies
Patients with advanced prostate cancer may decide to stop the medications because of the severe side effects that come with the treatment. They may opt for hospice or palliative care, which is available in many hospitals. Palliative care is a special kind of treatment reserved for people with a terminal illness. It aims to alleviate the symptoms as well as provide them comfort and better quality of life.
Alternative practices, such as yoga and meditation, also help people affected with cancer feel relaxed and enable them to take control of their situation.
Participating in a prostate cancer support group can also help the affected person to deal with their cancer effectively. They can ask their doctor or search online for such support groups.
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- incontinence, pain,
- blood in the urine,
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- Watchful waiting,
- surgery,
- radiation,
- cryotherapy, and
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- Research and clinical trials strive to find new and better treatments for prostate cancer.
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