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Pulmonary metastases from prostate cancer
S J Fabozzi1, P F Schellhammer, A M el-Mahdi
1Department of Urology, Eastern Virginia Medical School, Norfolk.
Cancer
|June 1, 1995
Summary
Pulmonary metastases are uncommon in prostate cancer but respond well to androgen deprivation therapy, especially in hormone-naive patients. This treatment offers objective responses and does not necessarily indicate a worse prognosis compared to other metastatic sites.
Area of Science:
- Oncology
- Urology
- Medical Research
Background:
- Prostate cancer typically spreads via lymphatics, often with bone metastases.
- Pulmonary metastases are infrequent and historically considered refractory to treatment.
- Previous studies indicated limited efficacy of androgen deprivation for lung metastases.
Observation:
- A retrospective review identified 47 (3.6%) prostate cancer patients with pulmonary metastases.
- Pulmonary metastases were often lymphangitic and occurred at initial diagnosis in 2.0% of patients.
- A unique case demonstrated isolated pulmonary metastases with hemoptysis responding dramatically to androgen deprivation.
Findings:
- 76.5% of hormone-naive patients showed improved pulmonary lesions with androgen deprivation.
- Objective responses to androgen deprivation were common in hormone-naive patients.
- Survival was longer in hormone-naive patients with pulmonary metastases, though not statistically significant.
Implications:
- Androgen deprivation therapy is the most effective treatment for prostate cancer pulmonary metastases.
- Hormone-naive patients with pulmonary metastases may have a comparable prognosis to those with metastases at other sites.
- Pulmonary metastases should be considered in prostate cancer management, with androgen deprivation as a key therapeutic strategy.