Sunday, February 25, 2024

Low Psa Metastatic Prostate Cancer

What If You Have Metastatic Hormone

PSA Recurrence: When Should You Treat? | Ask a Prostate Expert, Mark Scholz, MD

If your doctor tells you that you have this type of metastatic prostate cancer, it means your cancer responds to hormone therapy

Most prostate cancer cells need male sex hormones, including androgens like testosterone, to grow. A type of hormone therapy like androgen deprivation therapy could slow the growth of mHSPC by lowering the level of these hormones.

You could also ask your doctor if youââ¬â¢re eligible for any clinical trials.

Still, some people with mHSPC prefer to avoid or delay getting treatment with an option called active surveillance. Thatââ¬â¢s when your doctor keeps close tabs on your health but doesnââ¬â¢t give you treatment unless test results show your cancer is getting worse.

You could ask your doctor if watchful waiting is an option for you.

How Do Doctors Find Metastatic Prostate Cancer

When you are diagnosed with prostate cancer, your doctor will order tests such as:

These tests may focus on your skeleton and in your belly and pelvic areas. That way doctors can check for signs that the cancer has spread.

If you have symptoms such as bone pain and broken bones for no reason, your doctor may order a bone scan. It can show if you have signs of cancer spreading to your bones.

Your doctor will also ask for blood tests, including a check of PSA levels, to look for other signs that the cancer is spreading.

PSA is a protein made by the prostate gland. A rise in PSA is one of the first signs your cancer may be growing. But PSA levels can also be high without there being cancer, such as if you have an enlarged prostate, a prostate infection, trauma to the perineum, or sexual activity.

More Men Diagnosed With Advanced Prostate Cancer As Psa Screening Declines

More men are being diagnosed with advanced prostate cancer that is less likely to respond to treatments, a new study from the American Cancer Society suggests.

Prostate cancer, which is the second leading cause of cancer death in men in the U.S., rose by 3% yearly from 2014 to 2019 after two decades of decline, with the increase mostly driven by diagnoses of advanced disease, researchers reported Thursday in CA: A Cancer Journal for Clinicians.

The increases are worrisome, said the studys lead author, Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society. Thats because prostate cancer that has spread to distant sites beyond the organ is extremely difficult to treat, Siegel said. There is no durable cure for those with metastatic disease, she added.

The rise in cases of deadly prostate cancer may be partly linked to recommendations against prostate-specific antigen, or PSA, screening for healthy men, experts suggest.

In the new report, Siegel and her colleagues found that the diagnosis of advanced stage prostate cancer increased by 4% to 5% annually since 2011.

In 2019, 8% were diagnosed at a distant stage, as compared to 4% in 2011, and 14% were diagnosed at a regional stage, versus 11% in 2011, for a total of 22% advanced stage, Siegel told NBC News.

Once prostate cancer has spread far from the original tumor, the prognosis is grim. The five-year survival rate for these cancers is 32%, according to Siegel.

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During Treatment For Advanced Prostate Cancer

When treatments such as hormone therapy, chemotherapy, or immunotherapy are used for more advanced prostate cancer, the PSA level can help show how well the treatment is working or when it might be time to try a different treatment.

Treatments should lower the PSA level , although in some cases they may just help keep it from rising further, or even just slow the rise. Of course, other factors, such as whether youre having symptoms from your cancer and whether imaging tests show it is growing, are also important when deciding if it might be time to change treatments.

If the cancer has spread outside the prostate, the actual PSA level is often not as important as whether it changes, and how quickly it changes. The PSA level itself does not predict whether or not a man will have symptoms or how long he will live. Many men have very high PSA levels and feel just fine. Other men with low PSA levels can have symptoms.

Demographics And Pathological Characteristics

Solitary pulmonary metastasis from prostate sarcomatoid cancer

A total of 22,604 mPCa patients who met the inclusion criteria were identified from the SEER database. There were 5,505 patients in the radiotherapy group and 17,099 participants in the control group. Patient characteristics are shown in Table 1.

Table 1 Clinicopathological characteristics of the cohort by treatment groups.

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What If You Have Metastatic Castration

This means you have a type of metastatic prostate cancer thatââ¬â¢s able to grow and spread after you had hormone therapy to lower your testosterone levels.

Still, most people with mCRPC stay on androgen deprivation therapy because it might still be effective against some prostate cancer cells.

Your doctor may recommend adding other treatments like:

  • Treatments to ease symptoms like pain

You could also find out if a clinical trial might be right for you.

Some people with mCRPC simply choose to try active surveillance or watchful waiting.

Stage 4 Prostate Cancer Substages

Stage 4 prostate cancer is classified into substages, and the subcategory the oncologist assigns helps guide the treatment options:

  • Stage 4A: Cancer cells have been found in nearby lymph nodes and may have spread into local tissue.
  • Stage 4B: Cancer has spread to areas farther away from the prostate, such as distant lymph nodes or bones.

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Remission And The Chance Of Recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.

A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someone’s risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.

When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA recurrence or biochemical recurrence.

Surgery For Metastatic Prostate Cancer

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Unlike with localized prostate cancer, surgery isnt usually used to treat metastatic cancer. However, it may be used in some cases if it can help improve a patients quality of life, often to resolve urinary problems or stop bleeding.

If prostate cancer is locally advanced and hasnt spread far, a radical prostatectomy may still be an option. A radical prostatectomy is a surgical procedure in which the prostate is removed, along with any nearby tissue that contains prostate cancer cells.

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Prediction Of Metastatic Prostate Cancer By Prostate

  • Roles Formal analysis, Writing review & editing

    Affiliations Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden, Department of Mathematics, Uppsala University, Uppsala, Sweden

  • Hans Garmo,

    Roles Conceptualization, Formal analysis, Methodology, Writing review & editing

    Affiliations Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden, Kings College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom

  • Roles Data curation, Writing review & editing

    Affiliation Department of Urology, Ryhov Hospital, Jönköping, Sweden

  • Affiliation Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden

  • Hans David Ulmert,

    Roles Writing review & editing

    Affiliations University of California Los Angeles, Department of Molecular and Medical Pharmacology, Los Angeles, CA, United States of America, Ahmanson Translational Imaging Division, David Geffen UCLA School of Medicine, Los Angeles, CA, United States of America, Jonsson Comprehensive Cancer Center, David Geffen UCLA School of Medicine, Los Angeles, CA, United States of America

  • Roles Conceptualization, Data curation, Methodology, Resources, Writing review & editing

    Affiliation Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden

Where Can I Get Support

Being diagnosed with any kind of prostate cancer can be frightening and overwhelming. If you are told you have a rare prostate cancer you may worry about what this means and feel frustrated that there isnt much information available about your diagnosis and treatment.

No matter what youre feeling or thinking, there is support available if you want it. You can speak to our Specialist Nurses, in confidence or chat with them online. Our Dealing with prostate cancer page looks at things you can do to help yourself and people who can help.

Visit our wellbeing hub for information to help support you in looking after your emotional, mental, and physical wellbeing. If you are close to someone with prostate cancer, find out more about how you can support someone with prostate cancer and where to get more information.

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What Should You Ask Your Doctor About Treatments

The American Cancer Society recommends that you ask questions like these:

  • What treatment might be best for me?
  • What are the possible benefits of getting it?
  • How soon would I need to start treatment?
  • Will I need to get surgery as part of my treatment? If so, what will it be like and who will do it?
  • Will I need other treatments, too? If so, how might they benefit me?
  • What side effects could my treatments cause? And what should I do if I get them?
  • Is there a clinical trial that might be a good option for me?
  • Can you review any vitamins or diet Iââ¬â¢m on to make sure it wonââ¬â¢t interfere with my cancer treatment?

Low Psa Metastatic Androgen Independent Prostate Cancer

PET/CT for Prostate Cancer: From Diagnosis to Metastasis

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How We Treat Prostate Cancer

The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.

Ethics Approval And Consent To Participate

As the data used was extracted from SEER dataset , Ethics approval and Consent to participate could be checked in SEER. We were permitted to have Internet access after our signed data-use agreement was approved by the SEER administration . The date collected from the Second Affiliated Hospital of Zhejiang University School of Medicine was approved by the Ethics Committee of Zhejiang University .

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Signet Ring Cell Prostate Cancer

You might also hear this called signet cell prostate cancer or signet ring cell adenocarcinoma. Signet ring cell cancer can be very aggressive and spread to other parts of the body.

Like common prostate cancer, signet ring cell prostate cancer can produce high levels of PSA. This means a PSA test can be used to help diagnose signet ring cell prostate cancer. But a biopsy is needed to confirm it is a signet ring cell cancer.

If your biopsy shows that you have signet ring cell cancer, you may need further tests to check whether it started in your prostate or somewhere else. If your cancer started in another part of the body, it will affect the type of treatment you have. For example, if the cancer spread to the prostate from your stomach, you will be offered treatment for stomach cancer, not prostate cancer.

Your treatment will depend on how much the cancer has grown and whether it has spread to other parts of the body. You may be offered:

  • or a combination of these treatments.

Your doctor or nurse will tell you what treatment options are available to you.

What Are The Treatments For Metastatic Prostate Cancer

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It mainly depends on the stage of your cancer. Metastatic prostate cancer is stage IV, and doctors divide it into two types: IVA and IVB.

If you have stage IVA prostate cancer, that means the disease has spread to nearby lymph nodes but not to distant parts of your body. If youââ¬â¢re healthy enough to get treatment, or if youââ¬â¢re having symptoms from the cancer, your doctor may recommend one of these treatment options:

External beam radiation treatment with androgen deprivation therapy . During EBRT, a machine outside your body sends beams of radiation to your prostate gland. Radiation destroys cancer cells.

ADT is a type of hormone therapy. It involves taking medications to lower the levels of male sex hormones that your testicles make, or getting surgery to remove the testicles. Androgens, like testosterone, often fuel the growth of prostate cancer cells.

Along with ADT, your doctor might also have you take a drug called abiraterone . It helps stop cells in other parts of your body, like your adrenal glands, from making androgens.

ADT with or without abiraterone. If your doctor recommends this option, you wonââ¬â¢t need to get external beam radiation treatment along with it.

If you have stage IVB prostate cancer, the disease has spread to distant organs, like your bones. Your doctor can give you treatments that help keep your cancer under control for as long as possible and improve your quality of life.

Some treatment options are:

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Low Rates Of Psa Screening Metastatic Prostate Cancer

A study of men treated in Veterans Health Administration facilities suggested that lower prostate-specific antigen screening rates were associated with subsequent increased rates of metastatic prostate cancer.

Across 128 facilities, PSA screening rates declined from 47% in 2005 to 37% in 2019, which was observed across all ages and races, reported Brent S. Rose, MD, of the University of California San Diego, during a press briefing at the American Society for Radiation Oncology annual meeting. The study was also published in JAMA Oncology.

The long-term non-screening rate, representing patients not receiving a PSA test in the previous 3 years, increased from a low of 20.9% in 2009 to a high of 33.2% in 2019.

What is PSA used as a screening test for?Two tests that are commonly used to screen for prostate cancer are described below. A blood test called a prostate specific antigen test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer.At the same time, age-adjusted metastatic prostate cancer incidence rates rose from 4.6 cases per 100,000 men in 2008 to a high of 8.2 cases per 100,000 in 2017, with that increase driven by men in the 55-69 and over-70 age groups.

###Mike Bassett is a staff writer focusing on oncology and hematology. He is based in Massachusetts.

Rose reported no disclosures. Several co-authors reported relationships with industry.

Metastatic Stage 4 Prostate Cancer Prognosis

The metastatic prostate cancer prognosis varies from person to person, as every situation is different.

According to the American Cancer Society, regional cancer , has a five-year relative survival rate of more than 99 percent.

For distant cancer , the five-year relative survival rate drops to 31 percent.

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Stage Iv Prostate Cancer Prognosis

Prostate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate. This average survival rate represents stage IV prostate cancers that have metastasized beyond nearby areas to lymph nodes, organs or bones in other parts of the body.

Diagnosing Rare Prostate Cancers

Metastatic Prostate Adenocarcinoma Posing as Urothelial Carcinoma of ...

Rarer prostate cancers can be harder to diagnose. For example, some dont cause your prostate specific antigen level to rise. This means theyre not always picked up by a PSA test. Because of this, some rare cancers may not be diagnosed until they have already spread outside the prostate. Read more about the PSA test and other tests used to diagnose prostate cancer.

Some rare prostate cancers may only be picked up after having a biopsy to check for prostate cancer, or surgery called transurethral resection of the prostate to treat an enlarged prostate. The tissue removed during the biopsy or TURP is looked under a microscope to see if you have common prostate cancer or a rare type of prostate cancer. Rare cancers arent always given a Gleason score after a biopsy. This is because they can behave differently to common prostate cancer and cant be measured in the same way.

Because rare cancer can be aggressive and spread outside the prostate, you will probably have more tests to see if they have spread. These include:

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