Prostate cancer - bone metastases
The main cause of mortality of patients with cancer of the prostate gland are metastases in bone tissue.Prostate cancer with bone metastasesis formed in parallel with the formation of a malignant focus in regional lymph nodes. The exact cause of these complications is not known, but scientists have recently advanced a new hypothesis, according to which the body tries to place cancer cells from the vessels into their niches (bone space).
Pathogenesis of formation of bone metastases
In the pathological process of bone metastasis, a key role is played by the close relationship between the venous system of the prostate and the pelvic bones and spine. Cancer cells initially move into the lymphatic system.
The formation of bone metastases in malignant lesions of the prostate gland goes through a number of stages:
- Decreased intercellular adhesion of cancer cells.
- Migration of cancer cells to the lymphatic and circulatory bed.
- Temporal arrest of growth of the original tumor with fixation of cancer cells in the bone system.
Prostate cancer with bone metastases
In healthy bone tissue, two opposing physiological processes constantly occur: resorption and the formation of new cellular elements. The balance of these two systems ensures the functioning of the bone.
During development of metastasis, healthy osteoid cells are displaced, which causes imbalance between osteoclasts (destroying elements) and osteoblasts (building cells).
SEE ALSO: Bone cancer
Prostate cancer, bone metastases - manifestations and diagnosis
The main clinical symptom of bone metastases is prolonged and painful pain. Pain sensations are not removed by traditional anesthetics. The pathogenetic cause of this syndrome is the formation of pathological fractures and microcracks of bone trabeculae. The formation of defects in the bones can be diagnosed by X-ray examination, in which the oncologist can detect even small foci of osteoblastic metastasis.
For the diagnosis of osteolytic metastases, which are rare enough, magnetic resonance imaging is used.
The extent of the spread of cancer metastasis makes it possible to evaluate scintigraphy. This method of investigation determines the exact size of the metastasis, so that bone complications of the prostate are classified:
- Normal scan.
- Metastases & l; .
- Metastases 6-20.
- Bone metastases & g; 0.
- Defeat more than 75% of the ribs, vertebrae and pelvic bones.
IMPORTANT TO KNOW: Treatment of cancer with metastases
Prostate cancer (metastasis in the bone) should imply the use of therapy for complications of prostate cancer, which has three main objectives:
- Slowing the pathological growth of cancer cells.
Bone tissue affected by an oncological neoplasm has an increased tendency to form a fracture. At the expressed risk of occurrence of a pathological deformation doctors recommend carrying out of surgical operation with an implantation of a bone prosthesis.
- Reduce the intensity of pain.
Coping of pathological attacks at the initial stages is performed with the help of non-steroidal anti-inflammatory drugs. At a late stage of bone cancer, doctors recommend the use of narcotic analeptics.
The development of the tumor is accompanied by a pain syndrome, the severity of which depends on the volume of the tumor. Excision of pathological tissues in the late stages of the disease leads to a reduction in pain.
- Avoiding complications of bone tissue due to weakening of its structure.
One of the symptoms of prostate tumor metastasis is hypercalcemia, which is an increased amount of calcium in the blood. This condition leads to a weakening of the internal structure of the bone and the thinning of the osteoid tissue.
Bone metastases are the most serious complication of prostate cancer, since this pathology is difficult to treat and the maximum indicator of postoperative survival is 5-8 years.
The effect of pharmaceuticals in the presence of bone complications is directed to:
- Prevention of the formation of skeletal complications.
- Prevention of osteoporosis and other pathologies.
- Palliative reduction of pain syndrome.
The current direction of bone metastasis treatment for prostate cancer in modern oncology is the use of bisphosphonates, which are capable of repairing bone tissue remodeling by reducing activity osteoclasts. The most effective drug is Zoledronate, which has a distinct protective effect against bone tissue.
READ ALSO: What should you eat to avoid cancer?
New developments in treatment
Among the new pharmacological agents used in therapy (if bone metastases were diagnosed in prostate cancer) oncologists give priority to Denosumab, which contains specific antibodies to the regulator of osteoclast formation (RANK ligand). Denosumab blocks the activity of resorption processes and thereby stimulates the formation of healthy bone tissue.
The main way to treat metastatic bone damage is radiation therapy, which consists in the use of highly active radiation to kill cancer cells..