The "mothership" and pca spread.

Can I get some clarification on this idea please? Is this suggesting that there can still be some cancer left after RT or that even if there's no cancer present in the prostate it can still act as a "mothership"?

I asked this question first up and Dave repeated it later in the thread. I get the impression from later posts that this is not the case, so the "mothership" isn't always a "mothership" and indeed any met. might equally be classified as a "mothership", though if it comes down to the more basic ability of cancer to spread mets, then you could say that cancerous lymph glands [for example] are a bigger threat to spread than the prostate.

Personally, I don't like the term "mothership" and I don't know who came up with it but it's a loaded term that could lead people into believing the prostate is an irrespressible monster. The clear beneficiaries of that thinking are urologists who back surgery.

Jules

Edited by member 20 Sep 2023 at 23:57  | Reason: Not specified

Mothership is irrelevant for curative treatments (at least RT and RP) because they both zap it, so not a consideration for anyone offered such a choice of treatments.

It only comes into play for people with mets, and then yes, STAMPEDE showed there was an effect on delaying progression when fewer than 5 bone mets, and as a result those diagnosed metastatic with fewer than 5 bone mets are now offered RT on the prostate as standard of care.

To Pratap 

As previously stated (and I have no idea why the moderators remove thr names of the Drs when these names are readily accessed on the internet ) there have been papers written on the subject and there is now an ongoing trial .Its up to each individual to make  their own choice of treatment but new ways of treating cancer  are always being investigated .It may be unfortunate for some men that have gone down the RT route to eventually dscover that their choice may not be the one that offers the best outcome .But as recently as 5 years ago the treatments for prostate cancer were not in the same league as the new treatments coming online  today. I know from personal experience that I was very happy to be rid of my cancerous prostate (I was classed as high risk after the prostectomy altered my Gleason score to 4 ,3  5 ) and so far 7 years on from diagnosis and three years on from removal I am still here to shout about it with an undetectable PSA and very few side effects from the treatment .

Ok I know somebody who had his prostrate removed and was fine for 11 years but just recently I spoke to him and cancer has come  back and spread all over his body...

Cheers Tonyc01 

It is difficult to remove all the prostate cells in a prostatectomy. There will probably be some left in the case nerve sparing, hopefully not cancerous, and at the apex (bottom) of the prostate, it diffuses into the surrounding tissues and aggressive removal here (which is necessary if the cancer is in the apex) reduces the chances of being continent afterwards.

This means you are likely to be left with some prostate cells after a prostatectomy, but hopefully not cancerous ones.

In cases where you are in remission for 10+ years and it then recurs, I do wonder if that's a new cancer forming in some remaining cells. After all, prostate cancer is usually a multi-focal cancer (springing up in several places, and not just one.

As mentioned, if someone is suddenly discovered to be heavily metastatic 10+ years after a prostatectomy, that might be lack of monitoring. It may be that the cancer was a non-secreter (doesn't generate PSA), but in that case, monitoring is via scans, although I don't know how long those go on for - probably not 10 years.

Edited by member 03 Oct 2023 at 12:07  | Reason: Not specified

This make me wonder, regardless of whether you do or don't still have a prostate, where is recurrence likely to occur after say 7-10 years?

Is it going to come from the prostate bed, the seminal vesicles, local nerves or does it perform a nightmare trick and turn up in bones or remote locations where it's going to be hard to treat? I ask because it relates to the dreaded micro-mets that have rated a few mentions in this topic.

Jules