Why does prostate cancer metastasize to bones

Course of the disease in prostate cancer

In the early stages, when the cancer is inside the prostate, the cancer is curable. 93% of all sick people are still alive after 5 years.

If the PSA value rises during the follow-up checks, this can be a sign that the tumor is growing again (relapse). Now it has to be clarified whether one should wait further, whether a renewed local therapy (e.g. radiation therapy after surgery or vice versa) makes sense or a drug treatment (usually anti-hormonal therapy) should be started.

If the tumor is discovered late or if the disease cannot be stopped despite treatment, the tumor spreads to neighboring tissue and develops metastases - first in the lymph nodes of the pelvis, then in other organ systems of the body. By far the most frequently affected are the bones (spine, rib and pelvic bones). But metastases can also occur in the liver and lungs. At this advanced stage, surgery or radiation alone is insufficient. Now therapies are used that work throughout the body, e.g. B. hormone or chemotherapy.

A cure is no longer possible at this point. Palliative therapy therefore focuses on combating pain caused by metastases. The aim of treatment is to stop the progression of the disease for as long as possible and to maintain the patient's quality of life.

How long a patient with metastatic prostate cancer can survive depends on the malignancy of the tumor and the type of metastasis. That is why life expectancy after the first appearance of metastases varies greatly from person to person. Quite a few men survive for many years to come despite advanced prostate cancer.

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[1] Prostate cancer guidelines of the European Association of Urology, status 2014, http://uroweb.org/guideline/prostate-cancer/
[2] S3 quality interdisciplinary guideline for early detection, diagnosis and therapy of the various stages of prostate cancer, long version. Online at http://leitlinienprogramm-onkologie.de/uploads/tx_sbdownloader/LL_Prostata_Langversion_3.1.pdf
[3] H.-J. Pout. K. Höffken, K. Possinger (Eds.): Compendium of internal oncology, Springer Verlag 2006


Expert advice
Prof. Dr. Kurt Miller
Clinic for Urology, Charité - University Medicine Berlin

Prof. Dr. Jürgen Gschwend
Universitätsklinikum rechts der Isar, Munich

Last content update on: 09.01.2018


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