Symptoms of Metastasis

Prostate cancer is the second most commonly diagnosed cancer, and it’s not always detected at an early stage. To better identify symptoms associated with advanced prostate cancer and explore decision-making between patients and clinicians, a global survey was conducted. The International Prostate Cancer Symptoms Survey was commissioned by the International Prostate Cancer Coalition (IPCC) with the support of Bayer HealthCare. Men in ten countries in North America, Europe, and Asia participated. In the United States, 410 patients with advanced prostate cancer and 95 of their caregivers were surveyed online and via phone by Harris Poll between February 12 and April 13, 2015. This data was the first to be reported.

Although 97% of men with advanced prostate cancer reported that they are comfortable talking to their clinicians about their prostate cancer symptoms, less than half reported their complaints or concerns at each visit. About one-third (30%) of men with prostate cancer-related bone metastases experienced pain for seven months or more before they received a confirmatory diagnosis that their prostate cancer had metastasized to the bone. Nearly 7 in 10 men with prostate cancer (68%) admitted to sometimes ignoring symptoms such as pain. There are multiple factors that could contribute to this finding. For example, 55% acknowledged that they felt their daily pain and discomfort was just something they have to live with, 22% reported they felt mentioning their pain made them feel weak or depressed, and 71% of survey respondents said that they were not sure of the exact cause of their pain (cancer- or noncancerous-related).

Considering that the most common site of prostate cancer metastasis is the bone, and recognizing that not all patients self-report symptoms of metastasis, it may be helpful if clinicians routinely conduct an assessment for bone metastasis. Questions could include activity/functional status, a pain assessment, use of pain relievers, and quality of sleep. The IPCC and Bayer recently introduced “Men Who Speak Up” (www.menwhospeakup.com

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to increase awareness of the symptoms of advancing prostate cancer and provide tools and resources to help men take action.