Prostate cancer can spread to the lungs. While bone and lymph nodes are typically the first areas where prostate cancer spreads, lung involvement can occur as the disease advances. This spread, known as metastasis, signifies a more advanced stage of the disease.
How Prostate Cancer Spreads
Prostate cancer originates when cells within the prostate gland begin to grow uncontrollably. These cancer cells can acquire the ability to detach from the primary tumor and travel to other parts of the body. This process, called metastasis, allows cancer to spread from its initial site to distant organs.
The primary ways prostate cancer cells spread are through the bloodstream (hematogenous spread) or the lymphatic system. Cancer cells can invade small blood vessels or lymphatic vessels, entering these circulatory systems. Once in the blood or lymph, they can travel throughout the body, eventually lodging in distant tissues or organs.
Common sites for prostate cancer to spread include the bones, lymph nodes, liver, and lungs. Bone metastasis is the most frequent, often affecting the spine, hips, and pelvis. Lymph nodes, particularly those near the prostate, are also common initial sites for spread.
The ability of cancer cells to metastasize involves changes that allow them to break away from the primary tumor, survive in the circulation, and establish new tumors in distant organs. This includes the formation of new blood vessels to support the growing tumor at the new site.
Prostate Cancer in the Lungs
While prostate cancer most commonly spreads to the bones and lymph nodes, it can also metastasize to the lungs. Lung metastasis is less frequent than bone metastasis but still a recognized possibility, particularly in advanced stages of the disease.
When prostate cancer spreads to the lungs, it can manifest with various respiratory symptoms. These may include a persistent cough that does not resolve, shortness of breath, and chest pain. In some instances, individuals might experience coughing up blood or the accumulation of fluid between the lung and chest wall, known as a pleural effusion.
Other general symptoms that may accompany metastatic prostate cancer, including lung involvement, are fatigue, unexplained weight loss, and a general feeling of being unwell. These symptoms arise as the cancer progresses and affects bodily functions more broadly.
Diagnosing prostate cancer lung metastasis typically involves a combination of imaging tests and sometimes a biopsy. Imaging techniques used to detect lung metastases include chest X-rays, computed tomography (CT) scans, and positron emission tomography (PET) scans. If imaging suggests lung involvement, a biopsy is often performed to confirm the presence of prostate cancer cells.
Treatment and Outlook
Treatment for prostate cancer that has spread to the lungs focuses on managing the disease, alleviating symptoms, and enhancing the patient’s quality of life. Since metastatic prostate cancer is generally not curable, therapies aim to control its growth and spread.
Hormone therapy is a primary treatment approach for metastatic prostate cancer because prostate cancer cells often rely on male hormones, particularly testosterone, to grow. This therapy works by reducing the amount of testosterone in the body or blocking its effects on cancer cells. It can shrink tumors and slow their growth, even in distant sites like the lungs.
Chemotherapy uses anti-cancer drugs that circulate throughout the body to destroy cancer cells. Docetaxel and cabazitaxel are common chemotherapy agents used for metastatic prostate cancer, often employed when hormone therapy is no longer fully effective or in combination with it. These treatments can help manage the cancer and improve symptoms.
Targeted therapy and immunotherapy represent additional treatment modalities. Targeted therapies focus on specific molecules involved in cancer cell growth and survival, while immunotherapy aims to boost the body’s immune system to fight cancer. Radiation therapy may also be used to target specific metastatic lesions in the lungs to help manage symptoms.
The outlook for individuals with prostate cancer that has spread to the lungs can vary significantly. Factors influencing prognosis include the extent of the spread, the patient’s overall health, and how the cancer responds to treatment. While visceral metastases, including those in the lungs, can indicate more advanced disease, survival rates for metastatic prostate cancer vary.