P

rostate cancer tends to be the tortoise of tumors, growing and spreading slowly. When cancerous cells escape the golf ball-sized prostate, they can lodge in various places throughout the body. New research shows that where these cells go can affect how long a man survives.

When prostate cancer spreads, or metastasizes, about three-quarters of the time it takes up residence in the bones. Less common locations are the lungs, liver, and lymph nodes.

An international team of researchers pooled information from nine clinical trials to estimate the average survival times for men with prostate cancer that had spread to four different tissues. Metastasis to the lymph nodes was linked to the longest survival; metastasis to the liver led to the shortest.

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“This important study confirms that one size does not fit all when it comes to metastatic prostate cancer,” said Dr. Marc Garnick, a prostate cancer specialist at Beth Israel Deaconess Medical Center in Boston.

The new study, led by Susan Halabi, a professor of biostatistics at Duke University School of Medicine, suggests that prostate cancer that skips the bones and spreads to the liver and lungs may represent a different disease than prostate cancer that invades bones or lymph nodes. The results were published Monday in the Journal of Clinical Oncology.

Median survival for metastatic prostate cancer is affected by metastasis site.
Median survival for metastatic prostate cancer is affected by metastasis site. Mark Dubowski for Duke Health

“A better understanding of how metastatic prostate cancer behaves in different locations is letting us tailor diagnostic approaches and treatments that we hope will improve outcomes,” Garnick said.

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