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Metastatic Prostate Cancer

Metastatic prostate cancer refers to cancer that originated in the prostate and has spread to other areas of the body. This condition is also known as advanced prostate cancer.

The testicles

The testicles are two small, oval-shaped organs located below the penis, enclosed in a skin pouch called the scrotum.

Image of the testicles (cruk)

Starting from puberty, the testicles begin producing sperm. Inside the testicle, small tubes come together to form the epididymis, a single tube that becomes wider as it exits the testicle. This wider tube is known as the spermatic cord.

The spermatic cord leads to a short passage called the ejaculatory duct, which opens into the urethra, the tube that carries urine and semen out of the body through the penis.

 Testosterone:

 The testicles produce the hormone testosterone, which is responsible for developing male characteristics such as:
  1. A deeper voice
  2. Facial hair growth
  3. Increased muscle mass
  4. The ability to achieve an erection
  5. Male sexual drive (libido)

Where does testicular cancer start:

 The testicles consist of various cell types, and the kind of cancer you have depends on the specific cell where it begins. Most testicular cancers arise from germ cells, which are responsible for producing sperm. Doctors classify germ cell cancers into two main types:
  • Seminoma
  • Non-seminoma
Testicular cancer and the lymph nodes:  Lymph nodes are a part of the lymphatic system that spans the entire body. They, along with lymph vessels, contain a yellow fluid known as lymph. This fluid circulates through the lymphatic system, collecting waste products and draining into veins for waste removal. Cancer can spread to lymph nodes, causing them to enlarge. In testicular cancer, it’s common for the disease to spread to lymph nodes located at the back of the abdomen, known as retroperitoneal lymph nodes. These retroperitoneal lymph nodes are situated behind the intestines and in front of the spine. They lie next to the main blood vessels in the abdomen, the aorta, and the inferior vena cava. Image of the lymph nodes with testicles Who gets it: Younger men are more likely to get testicular cancer. Trans women can also develop testicular cancer if they haven’t had an operation to remove their testicles (orchidectomy). Men in their early 30s are the most likely to get it. It then becomes less common as men get older.

4.1:What is Metastatic Prostate Cancer :

Metastatic prostate cancer indicates that the cancer has extended beyond the prostate to other regions of the body. It is also referred to as advanced prostate cancer. Typically, it spreads to lymph nodes, bones, and occasionally to organs like the lungs.

4.2: Locally Advanced Prostate Cancer:

Locally advanced prostate cancer differs from advanced prostate cancer.

Locally advanced cancer indicates that the cancer has extended into nearby tissues and lymph nodes surrounding the prostate. It may involve:

– The tissue surrounding the prostate.

– The seminal vesicles, which are the tubes that transport semen.

– Nearby organs such as the rectum or bladder.

– Lymph nodes situated near the prostate gland.

4.3:Where Does Prostate Cancer Spread:

Prostate cancer has the potential to spread to various parts of the body, with the most frequent sites being:

– Bones

– Lymph nodes

– Liver

– Lungs

If you experience symptoms suggestive of metastatic prostate cancer, your doctor will conduct scans and tests to assess the extent of the disease. Additionally, they will perform a physical examination and discuss your overall health and symptoms with you.

4.4: Symptoms of Metastatic Prostate Cancer:

Metastatic prostate cancer occurs when cancer originating in the prostate gland spreads to other areas of the body. This advanced stage of prostate cancer is characterized by:

– Bone pain

– Persistent fatigue

– General feelings of unwellness

– Unexplained weight loss

Symptoms can vary depending on the specific location to which the cancer has spread. It’s important to note that these symptoms may also be indicative of other medical conditions, so they do not necessarily confirm the spread of cancer.

4.5: Symptoms of the prostate cancer spread to the bones:

Prostate cancer often metastasizes to the bones, commonly affecting the:

– Spine

– Pelvis

– Ribs

– Skull

When prostate cancer spreads to the bones, the most common symptom is persistent bone pain, which can disturb sleep and may feel like a dull ache or sharp pain.

The bones may also weaken, increasing the risk of fractures.

If the cancer reaches the spine, it can exert pressure on the spinal cord, leading to spinal cord compression. This condition impairs nerve function and typically starts with back pain.

Spinal cord compression is a medical emergency.

If you suspect you have it, contact your healthcare team immediately.

4.6: Symptoms of the prostate cancer spread to the Lymph Nodes:

Lymph nodes are part of a network of tubes and glands that filter bodily fluids and combat infections.

There are numerous lymph nodes in the pelvic region, near the prostate gland. Prostate cancer can metastasize to these lymph nodes or spread to other areas of the body. The primary symptoms of this spread are swelling and pain in the affected regions.

Cancer cells can block the drainage of lymph fluid, causing fluid accumulation and resulting in swelling in the legs. This condition is known as lymphoedema.

4.7: Symptoms of the Prostate Cancer spread to the Liver:

If your cancer has spread to the liver, you may experience the following symptoms:

– Discomfort or pain on the right side of your abdomen

– Nausea

– Loss of appetite and weight loss

– Abdominal swelling (ascites)

– Yellowing of the skin and the whites of the eyes (jaundice)

– Itchy skin

4.8: Symptoms of the Prostate cancer spread to the Lungs:

If cancer has spread to your lungs, you might experience any of the following symptoms:

– A persistent cough

– Shortness of breath

– Coughing up blood

– Accumulation of fluid between the chest wall and the lung (pleural effusion)

4.9: Symptoms of the Prostate Cancer that has spread to or near the Bladder:

Large prostate tumors can exert pressure on the urethra and extend to the bladder. You might experience the following symptoms:

– Increased frequency of urination

– Waking up at night to urinate

– Difficulty in urinating

– A strong, urgent need to empty your bladder

– Presence of blood in your urine or semen

4.10 Symptoms of the prostate cancer that has spread to the bowel:

The rectum, a section of the bowel located near the prostate, can rarely be affected by the spread of prostate cancer. Symptoms may include:

– Constipation

– Abdominal pain

– Blood in your stool or from your rectum

Daignosis

If you have any symptoms, your first step is usually to visit your GP. They will discuss your symptoms with you and conduct an examination. Based on their findings,

Treatment options

A team of healthcare professionals (multidisciplinary team) will determine your treatment plan. Most people undergo surgery to remove the affected