Posted 7/31/2017 8:06 PM (GMT 0)
I'm not a doctor, but my thinking is that the likelihood of if/when prostate cancers "mets" may spread might be more associated with the vascular pathways that might spread tumor cells into wider circulation, rather than whether the specific environment of bone, lymph tissue, or other soft tissues are places where "mets" might grow slower or faster.
It's fairly well documented as to the relative frequency of mets, by site in the body. The spinal vertebrae and lower pelvis are pretty high up there, around the 75% range, among places not directly adjacent to the prostate. This might be due to how the veins draining the prostate, bladder, and rectal area work. All commonly share the tendency to have mets that spread into the spine.
"Venous drainage of the prostate is via the prostatic venous plexus, draining into the internal iliac veins. However, the prostatic venous plexus also connects posteriorly by networks of veins, including the Batson venous plexus, to the internal vertebral venous plexus."
On the other hand, once bone "mets" are diagnosed, the drugs Zometa (zoledronic acid) and Xgeva (denosumab) have been approved to try to help slow/prevent the further destruction of bone by cancer cells. As I once heard it described by a doctor in oversimplified terms, ..."to help make the bones less favorable for the growth of cancer mets", once treatment is started.
Bone mets can also cause changes in Alkaline Phosphatase levels and serum Calcium levels. Once diagnosed, my guess is that a good Oncologist would stir together the entire mix of PSA trends, bone scan comparisons, (possibly PSMA or other advanced scans), Alk Phos levels, Calcium levels, and patient Symptoms while making treatment decisions.
Just one guy's thoughts,
Charles