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Prostate cancer grows and spreads via three routes.
The first route is through local growth.
As the tumor grows, it can get large enough to compress the urethra, making it difficult
to urinate.
In the days before we had blood tests for prostate cancer, this difficulty was often
what led to the diagnosis of prostate cancer.
Local tumor growth can also spread upward, invading the bladder and seminal vesicles.
Or it can grow toward the back and invade the ***.
The reason we perform *** examinations is to see if we can feel any lumps that may
be pushing against the ***.
A prostate tumor may also break out of either side of the prostate through the capsule that
surrounds it, and spread into the normal tissue nearby.
All of those forms of growth are considered local growth.
The second way that the cancer can spread is by sending out cells through the lymphatic
system.
The lymphatic system consists of tiny vessels, smaller than blood vessels, that run through
tiny little organs called lymph nodes.
These lymph nodes act as filtering devices that help our bodies fight infection.
If you have children and your children ever had swollen glands when they were young, those
swellings in their neck were actually lymph nodes.
Lymph nodes are normal and beneficial structures.
But when a person has cancer, cells can enter the lymph nodes and spread via the lymph system
to other parts of the body.
The average male pelvis has fifty to eighty lymph nodes.
The third and most dangerous way that cancer can spread is by sending out cancerous cells
in the blood supply.
These cells can go anywhere the blood supply goes.
They prefer to go first to the bones, and that’s why we’ll often do bone scans to
see if there’s any evidence of cancer showing up there.
Keep in mind that bone scans will not necessarily reveal microscopic areas of disease.
In the later stages of the disease, the prostate cancer cells can go anywhere -- lung, liver,
skin, brain.
We’d clearly like to pickup the disease before it’s had a chance to spread via the
blood. But even with the advance technology available
today we’re not very good and picking up microscopic evidence of spread of the disease.
We can only estimate what the chances are that the cancer has spread to other parts
of the body.
There are a number of factors that are used as predictors of the chance that the tumor
has spread beyond the confines of the prostate gland.
More factors will be identified in the future, as this is a rapidly progressing area of research.
Currently, there are three main factors that help us predict the chance of spread.
It is important for you to know what those factors are in your own case.
Let’s review them now.