Treatments To Control And Prevent Symptoms Caused By The Spread Of Prostate Cancer To The Bones
Palliative External beam radiotherapy
Radiopharmaceuticals: Strontium-89 , samarium-153
Radium-223 dichloride is now licensed and called Xofigo. This is not widely available in the UK but BPC is one of a relatively small number of specialist centres using this treatment.
Zolidronic acid a bisphosphonate given by a 15 minute intravenous infusion every 34 weeks. It reduces the risk of bone complications, including pain and fractures.
Xgeva : this is a newly licensed drug available at BPC.
Surgery may be undertaken to treat bone fractures or to relief the pressure on the spinal cord by bone metastases.
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How Long Will You Live With Stage 4 Liver Cancer
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Tests For Bladder Cancer
Your doctor may do some tests to check for bladder cancer:
- internal examination the doctor may check inside your bottom or vagina with their finger, using gloves
- urine tests your urine will be checked for signs of bladder cancer
- blood tests to check your general health
- ultrasound a scan on the outside of your abdomen to check for cancer
- cystoscopy the doctor puts a small camera into your bladder to see inside
- biopsy the doctor takes a small sample of the cells from the bladder to check for signs of cancer.
Your doctor might ask you to have further tests. These can include:
- CT scan and x-rays scans that take pictures of the inside of the body, sometimes also called a CT-IVP or a triple phase abdominal-pelvic CT scan
- MRI scan a scan that uses magnetism and radio waves to take pictures of the inside of the body
- bone scan a scan that uses dye to show changes in your bones
- FDG-PET scan a scan that uses an injection of liquid to show cancer cells.
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Stage 4 Cancer Symptoms
The symptoms of metastatic cancer depend on the type of cancer. In some cases, there are no symptoms at all.
Most of the time, a cancer that reaches stage 4 will affect not only the part of the body where it originated, but the areas it has spread to as well.
|Common Symptoms of Metastatic Cancer|
|When cancer spreads to:|
Stage 4 cancer also can cause more general symptoms, such as extreme fatigue and lack of energy. Some people become so tired and weak they have trouble doing everyday things. They may even need help with getting dressed or other routine tasks.
Hearing your doctor call a liver tumor “breast cancer” may sound strange. But stage 4 cancer is diagnosed based on where the original cancer is located, not where it has spread. So, breast cancer that has spread to the liver will be called stage 4 breast cancer with liver metastasisnot stage 4 liver cancer.
Understanding Prostate Cancers Progression
To determine the appropriate treatment, doctors need to know how far the cancer has progressed, or its stage. A pathologist, the doctor trained in analyzing cells taken during a prostate biopsy, will provide two starting pointsthe cancers grade and Gleason score.
- Cancer grade: When the pathologist looks at prostate cancer cells, the most common type of cells will get a grade of 3 to 5. The area of cancer cells in the prostate will also be graded. The higher the grade, the more abnormal the cells.
- Gleason score: The two grades will be added together to get a Gleason score. This score tells doctors how likely the cancer is to grow and spread.
After a biopsy confirms prostate cancer, the patient may undergo additional tests to see whether it has spread through the blood or lymph nodes to other parts of the body. These tests are usually imaging studies and may include a bone scan, positron emission tomography scan or computed tomography scan.
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Can Bladder Cancer Be Cured
When detected at an early stage, bladder cancer can usually be treated successfully whereas later-stage cancers may present greater challenges for the patient and their healthcare team. As discussed later, people who have had bladder cancer are at risk for recurrence for the best chance of successfully treating recurrent cancer, early detection is again important.
Combination With Conventional Treatments
Far safer ground is to use phytotherapy to support the cancer patient undergoing conventional treatments. Phytotherapy may be given prior to conventional treatments to help the patient prepare for them . They may also be given during conventional treatments to improve treatment outcomes, QOL and reduce side effects. They may be given after conventional treatment for all the above reasons, but also to prevent cancer recurrence and improve survival prospects. This is the most active area of research for phytotherapy in cancer and some relevant clinical studies will be reviewed.
Twenty-five patients with a variety of very advanced cancers of the gastrointestinal tract undergoing palliative radio- or chemotherapy received up to 3 g/day of GLA as evening primrose oil . They were matched to 25 controls.45 The group receiving EPO exhibited highly statistically significant and clinically relevant survival differences and fewer adverse effects were noted from concurrent conventional treatment. Cancer markers also fell in some patients .
Codonopsis is a widely prescribed adaptogen in China, used in conjunction with conventional cancer therapies to reduce side effects and support immunity.58 It was used as an adjuvant in 76 cancer patients during radiotherapy and reduced its immunosuppressive effect.59 Pharmacological studies suggest it can help both white and red blood cell production.60
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What Are The Stages Of Bladder Cancer
Bladder cancer can be either early stage or invasive .
The stages range from TA to IV . In the earliest stages , the cancer is confined to the lining of the bladder or in the connective tissue just below the lining, but has not invaded into the main muscle wall of the bladder.
Stages II to IV denote invasive cancer:
- In Stage II, cancer has spread to the muscle wall of the bladder.
- In Stage III, the cancer has spread to the fatty tissue outside the bladder muscle.
- In Stage IV, the cancer has metastasized from the bladder to the lymph nodes or to other organs or bones.
A more sophisticated and preferred staging system is known as TNM, which stands for tumor, node involvement and metastases. In this system:
- Invasive bladder tumors can range from T2 all the way to T4 .
- Lymph node involvement ranges from N0 to N3 .
- M0 means that there is no metastasis outside of the pelvis. M1 means that it has metastasized outside of the pelvis.
Subtleties And Future Questions
Several factors have to be carefully considered in interpreting the trial results, explained Dr. Apolo.
A major one is that the study did not directly compare survival between people who got avelumab immediately versus when their cancer progressed. Only about half of the participants who initially received supportive care alone went on to receive immunotherapy after their cancer got worse. There could be many reasons for this, including lack of access to these drugs in different countries, Dr. Apolo said.
But it also might be that, for some people, the cancer was progressing too rapidly, she added. When these tumors start growing, they start growing very quickly. So if you wait to start at the time of progression, maybe its too late, added Dr. Apolo.
Not all patients will be caught by the second-line safety net, agreed Dr. Plimack.
So, for now, said Dr. Balar, the takeaway message from the JAVELIN study is after chemotherapy, dont wait to give immunotherapy.
But more and more, studies are looking at whether some patients should receive immunotherapy as first-line treatment, he continued. Immunotherapy is one of the most important advances weve made in the last 30 years, Dr. Balar said.
The JAVELIN results cant provide any insight into which patients benefit from first-line treatment with a platinum-based chemotherapy, he added. This trial wasnt designed to ask: Is chemotherapy necessarily the best choice for every patient? he explained.
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Castrate Refractory Prostate Cancer: A Wider Range Of Options
In this section, we explain the treatments available at Birmingham Prostate Clinic for patients once their disease becomes resistant to hormone treatment, called castrate refractory prostate cancer. Two types of treatments are needed to:
- Control the cancer and preventing further spread of cancer
- Control or prevent the symptoms caused by the spread of prostate cancer to the bones
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Life Expectancy Of Stage 4 Kidney Disease Patients
Without treatment in the form of kidney dialysis, stage 4 kidney disease patients will be subjected to several negative symptoms that will not only cause pain, but also an overall decrease in quality of life. It is expected that stage 4 patients will not survive more than a year without dialysis treatment.
With dialysis, however, patients are expected to increase survivability considerably, allowing them to extend their prognosis by an additional 25 years. By allowing a dialysis machine to perform the work normally done by the kidneys, your body can perform optimally again. However, it is important to note that every patient is different and may have additional circumstances that may affect survival.
Dialysis should only be considered as a temporary measure to help get rid of harmful toxins and wastes from the body. All efforts are geared toward promoting kidney treatment and recovery that help repair diseased cells and tissues so that eventually a patients kidney function is sufficient enough to do the job on its own. This will require the dedication and vigilance of the patient to adhere strict dietary plans and treatments prescribed by the doctor.
However, some cases of kidney disease are beyond what can be treated with modern medicine, with the only resort left being kidney transplantation.
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How Do Bladder Cancer Survival Rates Differ By Disease Stage
Staging of bladder cancer provides information on the extent of cancer in the body and whether the cancer has spread beyond the bladder this information helps predict how likely the cancer will respond to treatment.
Approximately half of bladder cancers are found at an early stage, when the cancer is in the surface layer of the bladder only .12 About one third of bladder cancers have spread to the deeper layers of the bladder wall but are still only in the bladder the remainder of cancers have spread into nearby tissues or lymph nodes or, rarely, to distant parts of the body.
The 5-year survival rate for bladder cancer varies by stage of the disease at diagnosis, which emphasizes the importance of detecting bladder cancer at an early stage.13
Note: In situ = cancer is confined to the surface layer of the bladder Localized = cancer has not spread outside of the bladder Regional = cancer has spread to nearby structures or lymph nodes Distant = cancer has spread to distant parts of the body
Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for bladder cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the bladder.
- Regional: The cancer has spread from the bladder to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.
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What To Expect From Your Doctor
Some patients seek very limited information about how long they may be able to live with stage 4 colon cancer. Other patients do not prefer to know such information. Even if you desire as many details as possible, do not forget that it cannot be accurately predicted as to how long a person can survive with stage 4 colon cancer.
You can expect from your doctor to make you aware of a duration of time as he/she predicts you to live. This is the optimum guess for your doctor. It is based on your specific condition and the medical experience of the doctor. Every patient and his/her case are different.
Apart from that, always keep in mind that situations change. Some colon cancer patients may end up living much longer than the doctors have expected. Other patients might survive for a shorter time than expected. Some doctors may totally avoid giving any predictions regarding how long a patient will survive to have stage 4 colon cancer simply since they may not know.
The most significant thing to know is that it is up to you to learn as little or as much regarding your prognosis. Only make sure that what you know or not is absolutely clear to and verified by your doctor.
When Is The Right Time To Use Hospice Care
Many people believe that hospice care is only appropriate in the last days or weeks of life. Yet Medicare states that it can be used as much as 6 months before death is anticipated. And those who have lost loved ones say that they wish they had called in hospice care sooner.
Research has shown that patients and families who use hospice services report a higher quality of life than those who dont. Hospice care offers many helpful services, including medical care, counseling, and respite care. People usually qualify for hospice when their doctor signs a statement saying that patients with their type and stage of disease, on average, arent likely to survive beyond 6 months. More information about hospice can be found below in the Related Resources section of this fact sheet.
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How Long Can You Live With Prostate Cancer With No Treatment
Studies have shown that between 86% and 98% of men with LPC do not die from their cancer in all age groups, the researchers wrote. In fact, more than 95% of patients with LPC live at least 10 years after their diagnosis, whereas only 25% of patients in this study expected to live more than 10 years.
Psa And Gleason Score
Two other important factors that doctors and specialists use to assess cancer cells are the prostate specific antigen and the Gleason score.
PSA levels: PSA is a protein that appears in higher levels in the bloodstream when there is a problem with the prostate. Normally, PSA levels in the blood are very low, and a test cannot detect them. However, in some circumstance, such as prostate cancer, PSA levels start to rise.
Screening for prostate cancer uses a blood test for PSA. If PSA levels are high, the doctor may recommend further tests to see if prostate cancer is present.
There are various other reasons why PSA levels may rise, including sexual stimulation or an infection.
The grade and Gleason score: Different types of cancer cell act differently. Some types, or grades, are more aggressive and can spread more easily. The Gleason score and grade are different measures, but they both reflect how likely it is that a tumor will spread, and how quickly it will do so. Either a biopsy or surgery can determine the types of cancer cells present in the prostate tissues.
Nearly 50% of males have a condition known as prostatic intraepithelial neoplasia by the time they are 50 years old. PIN is when there are changes in the cells that line the prostate gland.
High grade PIN is not cancer, but the cells can become cancerous in the future. For this reason, a doctor may recommend treatment to remove the cells.
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Treatment Of Invasive Bladder Cancer In The Elderly And Frail Patient
I think this is a very contemporary topic because we are living in an aging society. If you look here, and you know if you really want to look at the life expectancy you should look at charts of the insurance company and governmental agencies rather than medical reports. And this is the life expectancy nowadays where in North America. So, you can see that if you are at the octogenarians, octogenarians for the sake of this talk is 80 years old, 80 to 90, and nonagenarians are 90 and plus. And you see so when you hit 80 you still have at least seven years as a male, and nine years or more as a female. So, we are actually talking about increased population that, and Ill show you data, has more bladder cancer, and theyre actually destined to live quite long if they are in the average risk. So, if you live for example to 90 years old youre expected to live about four years if youre a male and four and a half or five years if youre a female. So, we have to bear these figures in mind.
But once its diagnosed we have a very poor, we poorly address that. This is a paper by Gore et al, and it shows that only 21% of muscle invasive bladder cancer patients over the age of 65 here actually received radical cystectomy. He shows also that there was a better overall survival, but obviously this is biased by selection.
Partial cystectomy there is very few data, none in octogenarian. This is just a series from Wes Kassouf, so I will omit that because we really dont have enough data.