Thursday, May 7, 2015

Webinar: Prostate Cancer Metastasis: circulating tumour cells

Prostate Cancer Metastasis: Tracking and Targeting an Elusive Enemy

Overview: 

- The majority of prostate cancer deaths are cause by the spread of tumour cells from the original prostate tumour to distant sites in the body, a process called metastasis. 
- The ability to find, track and understand metastasis in cancer patients remains one of the greatest challenges in cancer treatment. 

These are my notes from the webinar, which help me to clarify the information I learned. 
Circulating tumour cells, from prostate cancer are what causes death, not the primary cancer in most cases. Metastasis is responsible for more than 90% of all prostate cancer deaths. Prostate cancer has excellent 10-yr. survival rates. Dr. Alan studies deadly prostate cancer.

Cancer is when our own cells turn against us. The battle terminology is ridiculous, as our own bodies are going mad and creating these cells. It irks me. These are my drawings from another source. It clarifies 'cancer'.
 


It is fairly straightforward to remove the prostate, and hereby remove the cancerous cells. My husband had his radical prostatectomy in Jan., 2014. He has been monitored since. The key is to determine if the cells have metastasised, or spread to other parts of the body. We know his have spread, since he has a PSA (prostate-specific antigens) reading above 0.0. It has been rising slowly. I've made a graph of his results post-surgery. 
PSA reading vertical (X) axis
Time across the Y axis
Even if there are cells nearby, radiation or chemotherapy can eradicate these cells. If the cells have migrated, and/or mutated (which is likely), it is more difficult to track them and kill them off.

What determines which prostate cancer metastasizes?

This they don't know. The cancer cells can go into circulatory system or the lymphatic system.
The cells encounter the capillary bed, in distant sights, such as in the bones, liver or lungs. These cancer cells can be arrested by size restrictions in the capillaries.  Micrometastases (teeny cancer cells) may die off or remain dormant, or go on to proliferate. 


 Problem is that cancer cells do not remain the same. Metastatic cells figure out how to survive in the body and mutate. This, they call Darwinisation. They evolve, mutate, and figure out how to survive in different organs, and become moving targets for cancer therapy. 
bone scan, 2014

Part of the issue is pinpointing the cancerous cells, finding where they are and determining whether
they are still prostate cancer cells, or if they have become different. Prostate cancer can be treated with antigen therapy, removing the testosterone hormone they require to keep on living.
There are many ways to track, and tests that are available. They are tracking Circulating Tumour Cells (CTCs), through various methods. Hubby has had a CT, bone scan, two MRIs, and biopsies.

Biopsies of distant organs can be risky. Poking anything, opening it up to a needle biopsy, can be a risk for infection.  They always give him antibiotics before the biopsy. There is concern about affecting a new tumour by testing and tracking it.
Prior to surgery: Jan. 28, 2014

All metastases were different from the primary prostate tumour.
The promise of blood-based biomarkers is to find the homogeneity in cells.
Multiple or serial biopsies can be taken from blood samples and do molecular characterization of them. Track how they change, ID treatment targets.

Circulating Tumour Cells: CTC tracking them is important when giving specific therapies, to determine if therapy is working. 
 

As long as the metastatic tumour hasn’t Darwinised too much, it can be treated with antigen therapy. This has proven quite successful. 
They are currently doing national testing on a user-pay system. Requirement = physician cooperation. Your physician can contact them and order the tests.

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