Metastatic Prostate Cancer Diagnosis & Treatment: Metastatic prostate cancer is a type of cancer that has spread beyond the prostate gland to other parts of the body, such as the bones or lymph nodes. It is a serious condition that requires prompt diagnosis and treatment.
How is a Diagnosis of Metastatic Prostate Cancer Made?
Diagnosing metastatic prostate cancer requires a combination of medical history, physical examination, imaging tests, and laboratory tests.
Medical History
The first step in diagnosing metastatic prostate cancer is taking a thorough medical history. The urologist will ask about the patient’s symptoms, such as pain or discomfort in the prostate area, difficulty urinating, or bone pain. They will also ask about any risk factors for prostate cancer, such as age, family history, or ethnicity.
Physical Examination
After taking a medical history, the urologist will perform a physical examination. They will check the prostate gland for any abnormalities, such as any nodules, consistency by performing a digital rectal exam (DRE) to feel for any irregularities in the prostate. The doctor may also check for any signs of metastatic cancer, such as swollen lymph nodes or bone tenderness.
Imaging Tests
Imaging tests are used to visualize the prostate gland and surrounding tissues and to detect any signs of metastatic cancer. The most common imaging tests used to diagnose metastatic prostate cancer include:
Ultrasound : Ultrasound is a non-invasive diagnostic tool that uses sound waves to create images of the body’s internal organs and tissues. In the case of metastatic prostate cancer, ultrasound can be used to detect abnormalities in the prostate gland and surrounding tissues, as well as any signs of metastatic spread to other parts of the body like liver or other abdominal organs.
Transrectal ultrasound (TRUS) is the most common type of ultrasound used to diagnose and monitor prostate cancer. During a TRUS procedure, a small ultrasound probe is inserted into the rectum to obtain images of the prostate gland. The images are then used to identify any abnormalities, such as tumors or nodules, that may be indicative of prostate cancer.
Ultrasound can also be used to monitor the progression of the disease and assess the effectiveness of treatment. For example, ultrasound can be used to measure the size of the prostate gland and detect any changes or growths that may be indicative of cancer progression. It can also be used to monitor the effectiveness of treatments, such as chemotherapy or radiation therapy, by visualizing any changes in the size or location of cancerous tissue.
Therefore, ultrasound is a valuable tool for diagnosing and monitoring metastatic prostate cancer. It is non-invasive, safe, and effective, and can be used to detect abnormalities in the prostate gland and surrounding tissues, monitor cancer progression, assess treatment effectiveness, and guide biopsies.
Magnetic resonance imaging (MRI): This non invasive test uses a magnetic field and radio waves to create detailed images of the prostate gland and surrounding tissues. It can help detect any tumors or abnormalities in the prostate or nearby tissues. The biggest benefit of MRI is that there is no exposure to any radiation in an MRI Scan.
MRI can detect abnormalities that may not be visible on other imaging tests, such as X-rays or ultrasound. MRI can also provide more detailed images of the prostate gland and surrounding tissues, allowing us urologists to better visualize any tumors or abnormalities that may be indicative of prostate cancer.
One type of MRI commonly used to diagnose metastatic prostate cancer is a multiparametric MRI (mpMRI). This type of MRI uses multiple imaging sequences to create detailed images of the prostate gland and surrounding tissues. mpMRI can be used to identify any suspicious areas that may require further investigation, such as areas with high levels of cell activity or blood flow.
MRI can also be used to detect metastatic spread of prostate cancer to other parts of the body, such as the bones or lymph nodes. For example, a bone MRI can be used to detect any abnormalities in the bones, such as bone lesions or fractures, which may be indicative of metastatic prostate cancer.
Computed tomography (CT) scan: This test uses uses X-rays and computer technology to create detailed cross-sectional images of the body’s internal organs and tissues. CT scan is a valuable tool for diagnosing and monitoring metastatic prostate cancer. It is non- invasive, safe, and effective, and can provide detailed images of the prostate gland and surrounding tissues, as well as detect metastatic spread to other parts of the body.
Bone scan: This test uses a small amount of radioactive material to detect any abnormalities in the bones. It can help detect any signs of metastatic cancer in the bones. We will discuss about Bone Scan and Bone Pain related to Metastatic Prostate Cancer in our next blog post.
PSMA PET Scan: PSMA (prostate-specific membrane antigen) is a protein that is highly expressed on the surface of prostate cancer cells, and has emerged as a promising target for imaging and therapy in prostate cancer.
Traditional imaging modalities, such as CT and bone scans, may not always accurately detect the extent of the disease, particularly in cases of low-volume disease or early-stage metastases. PSMA-PET (positron emission tomography) is a novel imaging technique that uses a radiolabeled ligand that binds specifically to PSMA on the surface of prostate cancer cells. This allows for highly sensitive and specific detection of prostate cancer, even in cases of low-volume disease or early-stage metastases. PSMA-PET is rapidly gaining popularity as a powerful tool for guiding treatment decisions and monitoring response to therapy in prostate cancer.
Laboratory Tests for Metastatic Prostate Cancer
Laboratory tests are used to detect any abnormalities in the blood or urine that may be indicative of prostate cancer. The most common laboratory tests used to diagnose metastatic prostate cancer include:
Prostate-specific antigen (PSA) test: This test measures the levels of PSA in the blood. PSA is a protein produced by the prostate gland, and high levels may be indicative of prostate cancer. PSA is one of the most important tools
PSA levels can also be used to monitor the progression of metastatic prostate cancer and assess the effectiveness of treatment. In general, PSA levels are expected to decrease after treatment, such as surgery or radiation therapy, and an increase in PSA levels may be indicative of cancer recurrence or progression.
Biopsy: A Prostate biopsy involves taking a small tissue sample from the prostate gland and examining it under a microscope for detecting and confirming the type of prostate cancer.
How is Metastatic Prostate Cancer Treated?
Now, we will discuss the various treatment options available for metastatic prostate cancer, including chemotherapy, hormone therapy, and immunotherapy.
Early detection of metastatic prostate cancer is crucial for successful treatment and management of the disease. Men over the age of 50, or those with a family history of prostate cancer, should consider regular prostate cancer screening to detect any abnormalities early. It is important to work closely with a healthcare team and to undergo regular monitoring and testing to ensure early detection and effective treatment of metastatic prostate cancer.
Hormone Therapy for Metastatic Prostate Cancer
Hormone therapy is a type of cancer treatment that works by lowering the levels of male hormones in the body, such as testosterone. Prostate cancer cells rely on male hormones to grow and multiply, so by reducing the levels of these hormones, hormone therapy can slow down or stop the growth of cancer cells.
There are several types of hormone therapy for metastatic prostate cancer, including luteinizing hormone-releasing hormone (LHRH) agonists, LHRH antagonists, and anti-androgens. LHRH agonists and antagonists work by blocking the production of testosterone in the body, while anti- androgens work by blocking the effects of testosterone on prostate cancer cells.
Hormone therapy can cause side effects, such as hot flashes, decreased sex drive, impotence, and weight gain. However, newer hormone therapies have been developed that are more effective and cause fewer side effects.
Chemotherapy for Metastatic Prostate Cancer
Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells. It is often used in combination with other treatments, such as hormone therapy or immunotherapy, to treat metastatic prostate cancer. Chemotherapy drugs can be administered orally or through intravenous infusion.
The most common chemotherapy drugs used to treat metastatic prostate cancer are docetaxel and cabazitaxel. These drugs work by targeting and killing rapidly dividing cancer cells. Chemotherapy can cause side effects, such as nausea, vomiting, hair loss, fatigue, and an increased risk of infection. However, newer chemotherapy drugs have been developed that cause fewer side effects and can be given in shorter treatment cycles.
Immunotherapy for Metastatic Prostate Cancer
Immunotherapy is a type of cancer treatment that works by stimulating the body’s immune system to fight cancer cells. It can be used to treat metastatic prostate cancer that has become resistant to other treatments, such as chemotherapy or hormone therapy.
The most common type of immunotherapy used to treat metastatic prostate cancer is called sipuleucel-T. This treatment involves collecting immune cells from the patient’s blood and then genetically engineering them to recognize and attack prostate cancer cells. The modified immune cells are then infused back into the patient’s bloodstream.
Immunotherapy can cause side effects, such as fatigue, fever, and chills. However, these side effects are usually mild and temporary.
Other Treatment Options for Metastatic Prostate Cancer
In addition to chemotherapy, hormone therapy, and immunotherapy, there are other treatment options available for metastatic prostate cancer, including:
Radiation therapy: This treatment uses high-energy X-rays to kill cancer cells. It can be used to treat cancer that has spread to the bones or other parts of the body.
Surgery: In some cases, surgery may be recommended to remove the prostate gland or to remove cancerous tissue from other parts of the body.
Bone-strengthening drugs: Metastatic prostate cancer can weaken the bones and increase the risk of fractures. Bone-strengthening drugs, such as bisphosphonates and denosumab, can help prevent bone loss and reduce the risk of fractures.
Best Metastatic Prostate Cancer Treatment at Institute of Urology, Jaipur
Metastatic prostate cancer is a serious condition that requires prompt diagnosis and treatment. There are several treatment options available for metastatic prostate cancer, including chemotherapy, hormone therapy, and immunotherapy. Each treatment option has its own benefits and side effects, and the choice of treatment depends on the individual patient’s condition and medical history. Other treatment options, such as radiation therapy, surgery, and bone-strengthening drugs, may also be used to treat metastatic prostate cancer.
It is important for patients with metastatic prostate cancer to work closely with their healthcare team to determine the best treatment plan. Regular follow-up appointments and monitoring are also essential to track the effectiveness of treatment and detect any signs of cancer recurrence.
In addition to medical treatment, lifestyle changes, such as a healthy diet, regular exercise, and stress management, can also play a role in managing metastatic prostate cancer. Support from family, friends, and support groups can also help patients cope with the emotional and physical challenges of living with cancer.
In summary, while metastatic prostate cancer can be a daunting diagnosis, there are several treatment options available that can help manage the disease and improve quality of life. It is important for patients to work closely with their urologist and take an active role in their treatment plan to achieve the best possible outcomes.
At Institute of Urology, Jaipur we are equipped with very modern technology and instruments in order to arrive at a precise and quick diagnosis and with the help of our state of the art infrastructure, we are able to guide the patient through best possible treatments available for metastatic prostate cancer. If you have any further questions, do not hesitate to contact me at (0091) 9829013468 – Dr. M. Roychowdhury (Chief Consultant Urologist & Medical Director) or you can book an appointment at the same number prior to coming. We will be able to assist you within the shortest available wait time.
