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Confused about spreading

User
Posted 19 May 2020 at 16:13

Question, can PC spread if it is still confined in the prostate or does it have to break the outer capsule before spreading? 

User
Posted 19 May 2020 at 16:28

As I understand it, PCa may remain contained in the Prostate for years but there is also the possibility of it beginning to bulge gradually at any time at the edge of the capsule and then escape. Timing is all important with identifying the cancer before it spreads but this does not happen overnight.

PCa tends to go to bone and lymph nodes in the pelvic area but due to the very close proximity can also spread to the seminal vesicles if the cancer is located near that area.

Edited by member 19 May 2020 at 16:43  | Reason: Not specified

Barry
User
Posted 19 May 2020 at 16:33
It can spread without breaking out of the capsule; they are two different things.

Imagine your prostate is an orange in a fruit bowl. The inside of the orange goes bad but the outer skin still looks absolutely fine - that would be a T1 or a T2 depending how bad it is inside. If the orange gets really bad, there may be black marks on the skin or it may even break down so you can see some of the inside badness - that is a T3. If the orange goes bad and the skin goes mouldy, the mould spreads to the apple next to it in the fruit bowl - that is a T4.

Now imagine that the orange was on top of the fruit bowl, with other fruit below it. It looks fine on the outside but the rotten flesh turns to liquid and seeps into the bottom of the bowl and from there to some grapes which now also go mouldy - that is N1

If you stick a syringe into the bad orange and draw off the juice to put into a cake, the cake is going to taste pretty bad and will quickly turn mouldy. The outer skin of the orange might still be intact but the inside has ruined a nice cake - that is M1.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 19 May 2020 at 16:40

Thank you Lyn. Excellent description. Thanks Barry. 

User
Posted 19 May 2020 at 17:27

Great description from Lyn.

fundamentally it’s cancer so can metastasise at any point. Usually type 3 cells don’t as early stage but some research has shown it can happen at early stages although generally  it stage 4 or 5 type cells that tend to migrate over time.

when I was diagnosis with stage 1 Gleason 6 (dominant cell type 3 + non-dominant type 3) I went away and with the help of my good lady who is an immunologist I read some of the latest papers on the subject. That made me decide not to go down the route of active surveillance. For me survival intervention made more sense at an early stage and given my age of 52. As it turned out was a prudent move as the cancer was more extensive than had been seen on a 3T mpMRI and was upgraded by Histology to Gleason 7 (3+4). So hopefully we got it out before some of the cancer cells had embarked on a grand tour. Only time will yield an answer to that but gave it the best chance possible at the time.

Wish you all the best with the journey and outcome.

Simon

Edited by member 19 May 2020 at 20:01  | Reason: Not specified

User
Posted 20 May 2020 at 10:46

Thanks to all for replying regarding my question. Later this afternoon I have to phone the GP surgery for the latest results of my PSA (my 2nd one, previous one was taken last October and was 0.5, also GP did a DRE and confirmed my prostate was enlarged. I went because of urinary symptoms and sciatica symptoms.The Dr put me on a course of Tamsulosinwwhich I am still taking. She then referred me to the Urinologist at ARI which I got an appointment for in December. We had a urine flow test and then a DRE x 2, a 2nd nurse confirmed my prostate was enlarged and firm.)which was taken last Friday. I will also tell the receptionist to get the Dr to call me regarding pushing for an mpMRI and query pain relief and a new symptom. See ye later guys. 

User
Posted 20 May 2020 at 16:22
If you are already in the hands of urology, your GP won't be able to push for anything - you need to talk to the urology nurse.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 20 May 2020 at 16:52

Afternoon all. Lyn you are quite right regarding the Urologist. I am not long off the phone to the Dr, who said she cannot make that decision. I have to chase up Urology and discuss with them. During this conversation with the Dr I found out that I have Osteoarthritis (which sums up the lower back pain) and has prescribed Amitriptyline. Back in March I was told by the Physician ware and tear. Anyway my PSA is still sitting at 0.5. I will chase up Urology tomorrow. 

User
Posted 21 May 2020 at 10:57

Morning all, I contacted the Urinologist this morning and I have another DRE to get before deciding if an mp MRI is required. Tuesday 9am. He was happy with my PSA. 

 
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