Despite the fact that the prognosis of prostate cancer is mainly determined by the presence or absence of metastases little is known about the actual metastatic pathways in prostate cancer.
To better describe the pathways taken by prostate cancer researchers evaluated 1,589 routine autopsies performed from 1967 to 1995 on men older than 40 years of age who had prostate cancer.
They found that the most frequent metastatic involvement in prostate cancer was in bone (90%), lung (46%), blood (35%), liver (25%), pleura (21%), and adrenals (13%). There was also evidence suggesting the existence of a backward metastatic pathway through veins from the prostate to the spine in addition to classical hematogenous tumor spread via the vena cava.
The researchers also determined that there was an inverse relationship between spine and lung metastases, suggesting that the development of metastasis to the spine is independent of lung metastasis. Second, the maximum frequency of spine involvement occurred in smaller tumors (4 to 6 cm) as compared with the maximum spread to the lung (6 to 8 cm) and liver (> 8 cm), suggesting that spine metastases precede lung and liver metastases in many prostate cancers.
They also found that there was a gradual decrease in spine involvement from the lumbar to the cervical level (97% v 38%), which is consistent with an upward metastatic spread along spinal veins after initial lumbar metastasis.
The results of this study show that bone, lung, and liver are the most frequent sites of distant prostate cancer metastases.
Understanding the metastatic pathways taken by prostate cancer can assist us in better understanding the development of tumors, which are the actual killers in prostate cancer.
Joel T. Nowak, MA, MSW wrote this Post. Joel is the CEO/Executive Director of Cancer ABCs. He is a Cancer Thriver diagnosed with five primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma, and the rare cancer Appendiceal cancer
