RE: Prostate Cancer in Bones

[Guest guest]

Someone may correct me but as I understand

it once the cancer gets to the lymph nodes it starts to spread through the rest

of the body. The bones are one of the most common places to show up next.

Have you had radiation yet? I would assume that if you had cancer in the

lymph nodes then most likely you also had positive margins. If that is

the case then the next step is radiation to catch it before it spreads.

At least that is the way it is with me. I am still on Eliguard (hormones)

and my PSA is 0.05 and I am starting radiation on the 9th. Radiation

typically starts 3-6 months after surgery. I also had another bone scan

to make sure nothing has developed in the past 6 months.

From:

ProstateCancerSupport [mailto:ProstateCancerSupport ]

On Behalf Of Ray Hoetger

Sent: Monday, June 28, 2010 2:03

PM

To:

ProstateCancerSupport

Subject:

Prostate Cancer in Bones

With the Prostate

removed and PCa in the Lymph nodes is it possible or what is the

possibility for the cancer to go into the bones? I am only 9 months from

my operation and still at Less than 0.05

[Guest guest]

Ray Hoetger wrote:

> With the Prostate removed and PCa in the Lymph nodes is it

> possible or what is the possibility for the cancer to go into

> the bones? I am only 9 months from my operation and still at

> Less than 0.05

Ray,

My understanding is that cancer that was not removed during the

surgery is potentially dangerous. Whether it is actually

dangerous depends on the aggressiveness of the cancer (higher

Gleason scores are usually more aggressive), your age (if you are

old enough, you'll likely die before the cancer can show any

symptoms), and other factors that are not well understood.

If I were you and I expected to live another 10 or more years,

I think I'd want to talk to a radiation oncologist. The lymph

nodes and all of the area surrounding the prostate can be

radiated, possibly killing off any cancer that's there.

Radiation is not a guaranteed solution. As I understand it, the

odds of a complete cure are in the neighborhood of 50/50.

However, once the cancer has gone further into the body there is

no currently known cure.

Radiation is not side effect free. A good, experienced, rad onc

will give you a better chance at both a cure and reduced side

effects than a poor one, so choose as carefully as you can.

I wouldn't delay with this.

Best of luck.

Alan

[Guest guest]

Ok Alan,

Related to the same issue. I have Prostrate and my prostrate bed was radiated. It started clibing again after three years.

They found swelling in a node near where my blood vessels split and go to the legs. I met others when having radiation that wer getting their nodes radiated. Why can I get the same for me? The answer I get it is outside the prostrate so will not do any good. Is there a blood test they ran to tell them it has gone further in the body.

I have asked them to radiate it and they say no.

Frustrated,

Tom W

To: ProstateCancerSupport Sent: Mon, June 28, 2010 3:51:50 PMSubject: Re: Prostate Cancer in Bones

Ray Hoetger wrote:> With the Prostate removed and PCa in the Lymph nodes is it> possible or what is the possibility for the cancer to go into> the bones? I am only 9 months from my operation and still at> Less than 0.05Ray,My understanding is that cancer that was not removed during thesurgery is potentially dangerous. Whether it is actuallydangerous depends on the aggressiveness of the cancer (higherGleason scores are usually more aggressive), your age (if you areold enough, you'll likely die before the cancer can show anysymptoms), and other factors that are not well understood.If I were you and I expected to live another 10 or more years,I think I'd want to talk to a radiation oncologist. The lymphnodes and all of the area surrounding the

prostate can beradiated, possibly killing off any cancer that's there.Radiation is not a guaranteed solution. As I understand it, theodds of a complete cure are in the neighborhood of 50/50.However, once the cancer has gone further into the body there isno currently known cure.Radiation is not side effect free. A good, experienced, rad oncwill give you a better chance at both a cure and reduced sideeffects than a poor one, so choose as carefully as you can.I wouldn't delay with this.Best of luck.Alan

[Guest guest]

The only blood test they have is the PSA

test. Cat scans only show where tumors have started to grow. Best I

can tell is they don’t have any way of telling how things are spreading

without looking at it with a microscope. That is why I chose surgery

first. With the removed tissue they can test it and see how far the cancer

has spread and make decisions based on that. Maybe at the time you were

getting radiations they felt it was all contained inside the prostate. If

it was then there would be no reason to radiate the lymph nodes and open the

possibilities of more side effects. I am not sure why they won’t do

it now. It may be that it won’t get it all and a different course

of treatment it required.

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Tom

Sent: Tuesday, June 29, 2010 7:58

AM

To:

ProstateCancerSupport

Subject: Re:

Prostate Cancer in Bones

Ok Alan,

Related to the same issue. I have Prostrate and my prostrate bed was

radiated. It started clibing again after three years.

They found swelling in a node near where my blood vessels split

and go to the legs. I met others when having radiation that wer getting their

nodes radiated. Why can I get the same for me? The answer I get it is outside

the prostrate so will not do any good. Is there a blood test they ran to tell

them it has gone further in the body.

I have asked them to radiate it and they say no.

Frustrated,

Tom W

From: Alan Meyer

<ameyer2>

To: ProstateCancerSupport

Sent: Mon, June 28, 2010 3:51:50

PM

Subject: Re:

Prostate Cancer in Bones

Ray Hoetger <rayhoet>

wrote:

> With the Prostate removed and PCa in the Lymph nodes is it

> possible or what is the possibility for the cancer to go into

> the bones? I am only 9 months from my operation and still at

> Less than 0.05

Ray,

My understanding is that cancer that was not removed during the

surgery is potentially dangerous. Whether it is actually

dangerous depends on the aggressiveness of the cancer (higher

Gleason scores are usually more aggressive), your age (if you are

old enough, you'll likely die before the cancer can show any

symptoms), and other factors that are not well understood.

If I were you and I expected to live another 10 or more years,

I think I'd want to talk to a radiation oncologist. The lymph

nodes and all of the area surrounding the prostate can be

radiated, possibly killing off any cancer that's there.

Radiation is not a guaranteed solution. As I understand it, the

odds of a complete cure are in the neighborhood of 50/50.

However, once the cancer has gone further into the body there is

no currently known cure.

Radiation is not side effect free. A good, experienced, rad onc

will give you a better chance at both a cure and reduced side

effects than a poor one, so choose as carefully as you can.

I wouldn't delay with this.

Best of luck.

Alan

[Guest guest]

Tom wrote:

> Related to the same issue. I have Prostrate and my prostrate

> bed was radiated. It started clibing again after three years.

>

> They found swelling in a node near where my blood vessels split

> and go to the legs. I met others when having radiation that wer

> getting their nodes radiated. Why can I get the same for me?

> The answer I get it is outside the prostrate so will not do any

> good. Is there a blood test they ran to tell them it has gone

> further in the body.

>

> I have asked them to radiate it and they say no.

>

> Frustrated,

Tom,

I'm not an expert on this but I'll give you some ideas that may

help explain what's going on.

When tumor cells leave their original location they first spread

into surrounding tissue, like the lymph nodes and seminal

vesicles attached to the prostate and then, eventually, they

spread through the blood stream to more distant parts of the

body.

When the cancer has spread into the surrounding tissue, it may

not yet have become systemic and might still be killed with

radiation. However it is my understanding (remember, I'm not an

expert) that once the tumor cells have started to spread through

the blood stream they are likely to be in many different places.

It is possible to damage or destroy the cells in some of those

places using radiation, but it is not possible to reach every

place and not always possible to destroy every cell in the places

that are radiated - partly because some of those places have

vital organs that would be damaged from any significant

radiation.

I know that there has been research on this. When I was in the

hospital getting getting HDR radiation for PCa, the guy in the

bed next to me had just had an operation on his lungs to remove

PCa from the lung tissue. He was in a clinical trial to try to

find out if that helped. I don't know the results of that trial,

but I suspect they were negative. At any rate, we haven't heard

about the medical world adopting the practice of giving more

surgery or radiation in such metastatic cases.

So what I think the doctors are telling you is that they have

found cancer in tissue that couldn't have cancer unless it had

spread there through the blood stream. They believe that the

cancer is now systemic and must be in other places in your body

too. They could radiate the area showing the lesion they found,

but it wouldn't get the cancer in any other area and would expose

you to radiation damage without likely extending your life.

Again, as I understand it, the best hope for life extension once

the cancer has metastasized is not to go after spots with tumors

using radiation or surgery, but to use systemic drug therapies -

first and foremost, hormone therapy. None of those therapies is

a cure, but they give more life extension than surgery or

radiation once the cancer has spread around the body.

If, in the longer term future, your cancer spreads into the bones

and becomes very painful, radiation might be used in that

specific case to kill the cancer in the painful spots and

alleviate the pain. That works well, but it provides little or

no life extension. As I understand it, the total amount of

radiation that your body can stand is limited, so the docs don't

want to give radiation that won't help. They'll wait and only

give it in specific spots that really need it in the future in

order to improve your quality of life.

I understand your frustration. It's horrible knowing that you

have cancer in your body and there's no way to kill it. But

don't despair. ADT and other drug treatments might hold it at

bay for many years.

Best of luck.

Alan