Definition of metastatic versus non-m... - Advanced Prostate...

Advanced Prostate Cancer

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Definition of metastatic versus non-metastatic

davebliz
davebliz

Hi, I'm confused. I was told that once the cancer leaves the prostate, it's metastatic. I've also heard that it's non-metastatic until it metastasizes to bones. My PC has spread to my lymph nodes but not my bones (according to scans), what am I? Thanks.

17 Replies
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If the lymph nodes are only in the pelvis below the aorta bifurcation the cancer is not considered metastatic. If the lymph nodes are outside the pelvis, the cancer is classified as metastatic. PC with lymph nodes positive for cancer located only in the pelvis could have a good response with whole pelvis radiation associated with androgen deprivation.

Whimpy-p
Whimpy-p in reply to tango65

True tango! That’s what I did with four years now skating on the center thin ice.

tango65
tango65 in reply to Whimpy-p

Best of luck on the journey and the skating!!

Whimpy-p
Whimpy-p in reply to tango65

Thanks tango although We all know , sooner or later the ice will melt. Pluck the day .

Staging is confusing. Broadly speaking, metastatic prostate cancer can spread locally to just the pelvic lymph nodes (Stage N1), or it can spread more distantly (Stage M1). M1 spread can be further subdivided according to whether metastases are detected in non-pelvic lymph nodes (M1a), bone (M1b) or visceral organs (M1c). Usually, when doctors use the term "metastasized," they mean M1. Sometimes, they use the term "locally advanced" to mean N1 only, but stage T4 (spread to bladder, rectum, or pelvic floor) is "locally advanced" too (but not metastatic). T3 means it has eaten its way through the prostate (Stage T3a) or into the seminal vesicles (Stage T3b) - "T" stages are not metastatic.

Whimpy-p
Whimpy-p in reply to Tall_Allen

Great explanation!

pwallace
pwallace in reply to Tall_Allen

thanks for breaking this down. it is so deeply confusing. 🙏🏻

Realize, these are diagnostic labels based on "clinical significance." If the cancer leaves the prostate, but remains undetectable by normal scans, it's not officially "metastatic." It will be called "non-metastatic" until it progresses to a point of being DETECTED as having metastasized to bones (or elsewhere, but bones are most common).

So while it is common to think in black and white terms of having either mPC or non-mPC, there are quite a few men who have "micro-metastases" that are below the threshold of easy detection, and only some of those men will see an aggressive growth and development that cancer.

Perhaps the bigger challenge is not so much to develop higher-resolution scanning that will find ANY and all cancer outside the prostate very early, in the tiniest amounts, but to figure out ways to determine which men might more greatly need early treatment of those micro-metastases.

I had Mets to the L side ureter lymph nodes in 2015 only with no other areas involved, so above the aorta bifurcation - If I remember my human anatomy class :-). Was told by MO in 2015 that it was metastatic, that may have been a Blessing to have aggressive treatments (ADT, 15 Taxotere chemos in 2015)

My best to y'all

Randy

Whimpy-p
Whimpy-p in reply to dockam

U dun good! 🏋🏻‍♂️

Hey davebliz, I was like you over five years ago. No bone Metz is great for you and I. You have great chances to put the pc to sleep for a good long time. Be well😷👍

Thanks all for the responses, they really helped.

I found this:

STAGE III PROSTATE CANCER

Overview

Prostate cancer is referred to as stage III if the cancer has extended through the capsule that encloses the prostate gland and may involve nearby tissues. Stage III prostate cancer is further divided into the following categories, depending on how extensive the cancer is:

T3a: The tumor has extended outside of the prostate on one side.

T3b: The tumor has extended outside of the prostate on both sides.

T3c: The tumor has invaded one or both of the seminal vesicles, which are small bag-like organs near the bladder.

texasoncology.com/types-of-...

This site also discusses some treatment options .... this is an Oncology site so I assume at least fairly up to date. Specific treatments are best discussed with your Medical Oncologist.

My understanding is:

T3c is important because authorities feel spread to the more vascular (very good blood supply) seminal vesicles indicates the possibility (not for sure, so uncertain but possible) the tumor may have entered the bloodstream and spread to the entire body.

T3a & T3b are more likely to have spread to the pelvic lymph nodes only (localized) and if the cancer is only in the pelvic and/or iliac lymph nodes it might still be curable.

Great question - I struggled with this same one 18 months ago.

I had positive lymph nodes identified only upon persistent PSA following RALP surgery (no margins or lymph nodes identified at time of surgery). Scans identified 2 avid pelvic nodes, but distant spread fortunately. Recall it being called N1, locally advanced, but not metastatic still with chance of cure.

EBRT and ADT+Z seem to have worked well so far, with some hope that the combination cleaned up remaining PCa in the prostate and nothing else was lurking. So far, so good.

Best of luck - if it is local there are many treatments available with generally good results.

Well one thing for sure that you're not is "you're not pregnant".....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 07/08/2020 2:28 PM DST

I have a couple of pelvic lymph nodes so we are microwaving the entire pelvic area and Lupron for 2 years, My oncologists are looking for a cure but I am 74 so a good remission is fine. Just get me to the 80’s and they can send the meat wagon. I reserve the right to change my mind.

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