The information that prostate cancer has spread or metastasised can be challenging. This is because it means that the cancer has spread from the prostate gland to other parts of the body, generally the bones, lymph nodes, or sometimes to other organs. While it might seem troubling, it is essential to note that there is now so much that can be done to minimise the disease, its symptoms, and how to live with it.
For metastatic prostate cancer, it is mostly about the balance between treatment and living one's daily life. While the treatment will halt cancer spread, the side effects will also need to be controlled to ensure that the patient continues enjoying life. It is similar to learning to drive on a bumpy road. You may need to slow down and change gears, but with some effort, you will still be able to reach your destination.
Metastatic Prostate Cancer stems from the spread of cancer cells through the bloodstream or lymphatic system to different body parts. The bones are the most common sites for the initial spread, which can result in pain and increase the risk of fractures. It can also spread to lymph nodes as well as, though rather infrequently, the lungs or liver.
Managing the condition becomes the foremost priority, and the immediate focus of treatment is symptom management, life extension, cancer control, and palliating the disease as best as possible. Personalisation is crucial, as each patient's cancer and treatment response is different.
At more advanced stages, a more aggressive multi-prong approach will be taken for treatment, which includes symptom reduction, improvement of the patient's quality of life and wellbeing, and deceleration of the cancerous cells.
The treatment of prostate cancer is centred around androgens, as the cancer is primarily sustained by the male hormones. Therefore, a reduction of testosterone levels is necessary, and thus, hormone therapy, also known as androgen deprivation therapy (ADT), is required. ADT can be achieved via medication or via surgical orchiectomy, though the surgical approach is less favoured today.
Although hormone therapy can help manage the cancer, it is not a cure. Eventually, cancer cells can become a stage known as "castration-resistant prostate cancer," where they adapt and continue to grow, even with low testosterone.
Chemotherapy is a treatment that utilises drugs to kill fast-growing cells, including cancer cells. It is often used when hormone therapy is ineffective. While supporting care during chemotherapy can help relieve fatigue, nausea, and hair loss, which are common side effects, it has become a great deal easier because of advancements in supporting care.
Some treatments are directed at cancer cells' specific exploitable battling points. For instance, some men with specific genetic mutations may be treated with targeted therapies that restrict the cancer's ability to self-repair. These methods can be more inaccurate than traditional methods, but in some cases, they may have fewer side effects.
It can provide treatment through external methods or through brachytherapy, where small radioactive seeds are inserted into the body.
Living with the burdens of metastatic prostate cancer entails managing the treatment side effects, which, as with most chronic illnesses, result in a diminished quality of life. These side effects are influenced by the type of therapy employed, the cancer's progression, and the patient's general health.
Feeling tired is a general side effect that comes with almost any form of treatment, be it hormonal or chemotherapeutic. Effective fatigue management includes maintaining a healthy, balanced diet and hydration, as well as a healthy balance of physical activity and rest. Walking or stretching, both of which are low-impact, can help improve energy over time.
Since the metastatic form of prostate cancer usually metastasises to the bones, it can cause osteolytic pain or increase the possibility of fractures. Medications such as bisphosphonates or denosumab can help improve bone density. It is recommended that such patients with osteoporosis also maintain a regimen of weight-bearing exercises along with adequate calcium and vitamin D.
Menopause-like symptoms such as hot flashes, changes in mood, and a decrease in libido may occur with a decrease in testosterone levels. These symptoms may be alleviated by a combination of relaxation techniques, medication, and cooling techniques.
Prostate cancer that has spread beyond the prostate may trigger anxiety, depression, and stress, presenting emotional challenges. It's crucial to give equal attention to one's mental health alongside physical health, especially during treatment.
In addition to medical treatment, daily activities can have a profound impact on the quality of one's wellbeing.
Balanced diet: It's best to consume whole fruits and vegetables, and indeed clean the diet of unhealthy food.
Regular activity: Mental and physical wellbeing can be significantly aided by any physical activity, even walking.
Staying connected: Combat mental and emotional isolation by maintaining friendships and family.
Mind-body practices: Sleep can be improved and stress alleviated through yoga, meditation, and controlled breathing exercises.
The cumulative impact of small changes in daily routines can be considerable over time, both in body and mind.
In managing metastatic prostate cancer, there is often a multifaceted approach that involves treatment changes. Close monitoring with your care team ensures that any emerging symptoms or issues that arise are dealt with in a timely manner. Side effects should be reported honestly, even if they seem trivial, because many times there are ways to improve your comfort and quality of life.
Despite the many challenges that metastatic prostate cancer poses, it is not the end of a patient's journey. The treatment options available today mean many men are able to lead and actively participate in meaningful and purposeful lives for years after they are diagnosed. The approach that works best is one that combines medical treatment with supportive care, a balanced diet, an active lifestyle, and the ability to stay emotionally strong.
Every patient's journey may vary, and be different for each individual, but the right strategies and support can help a patient learn to live with the disease and the treatment side effects. The right balance of education, dialogue, and self-care is your greatest strategy for getting through this phase of prostate cancer.
1. Is metastatic prostate cancer curable?
Prostate cancer is one of the most prevalent cancers and remains a lethal disease. The UCLA Health suggests that though it is not curable when it spreads, there are ways to control the disease and alleviate symptoms for many years.
2. How long can someone live with metastatic prostate cancer?
Life expectancy can differ from person to person based on factors like pre-existing medical conditions, cancer stage, and the way the cancer is treated. With appropriate treatment, many men can live for many years after being diagnosed.
3. Can lifestyle changes really make a difference?
Healthy habits do make a difference. Though these changes do not substitute for medical care, eating well, exercising, managing stress, and receiving emotional support can make a difference during medical treatment and enhance life.