localized prostate cancer can release malignant cells into the blood stream or lymphatic system and reach other parts of the body – this is called metastasis, or the spreading of cancerous cells. Lesions can appear in the hips, the spine and the pelvis before reaching other organs.

In cases of metastatic prostate cancer, the areas of the body most commonly affected by metastasis are bones and lymph nodes.

While in the past, in more advanced cases, there were few solutions, it is now possible to extend life during this metastatic stage, with this extension also meaning better quality of life for these men.

Better Control of Metastasis

As it mutates, cancer can react differently to treatment. Sometimes, it can become immune to hormonal therapy, one of the main treatments of the disease.

Before 2014, the only option for patients at this stage was to follow conventional hormonal therapy, which could eliminate the androgens feeding the tumours.

Today, second-generation hormonal treatments can bypass the defenses of the cancer cells that have become resistant to hormonal therapy and more effectively control their spreading.

“For many patients receiving first-generation hormonal treatment, we have learned that it can be more beneficial to use chemotherapy at the same time,” says Dr. Cristiano Ferrario, a medical oncologist at the Jewish General Hospital in Montréal. “Radiotherapy can also be applied locally to reduce the pain,” he adds.

External beam radiotherapy can be used locally, or systemic radiopharmaceuticals can be administered to target bone metastases.

Tangible Results

Dr. Guila DeLouya, a radio-oncologist at the Centre hospitalier de l’Université de Montréal (CHUM), says that patients with metastases who opt to receive this treatment have a better quality of life from the start.

“After the second or the third injection, we see a lot of improvement in patients. Some of them, who used to walk with a cane, no longer need to do so. There is a great response from patients,” she says.

“Patients live longer and their quality of life improves,” she adds.

This can inspire some men to start doing regular exercise, which helps to get back into a more active lifestyle.

“It’s rather encouraging, even though there is still a lot more work to do,” concludes Dr. Ferrario.