When prostate cancer spreads beyond your prostate gland, it’s called metastatic prostate cancer. This is considered an advanced form of prostate cancer.

The prostate is a gland in the male reproductive system located beneath your bladder. Prostate cancer is one of the most commonly diagnosed types of cancer worldwide.

When prostate cancer spreads, it metastasizes to your bones from 85–90% of the time. It can also spread to your lungs, liver, or brain, as well as other organs in some cases.

There’s no cure for metastatic prostate cancer today, but it’s treatable.

Language matters

In this article, we use “male” to refer to someone’s sex as determined by their chromosomes.

Sex is determined by chromosomes, and gender is a social construct that can vary between time periods and cultures. Both of these aspects are acknowledged to exist on a spectrum both historically and by modern scientific consensus.

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When prostate cancer spreads beyond your prostate gland, it often ends up in nearby your lymph nodes.

Your lymphatic system is involved in fighting off diseases, and your lymph nodes act like filters within this system. When cancer cells are filtered by a lymph node, they’re usually destroyed. But sometimes they might pass through and travel through your body until they attach somewhere else.

Prostate cancer cells can travel through your lymph fluid or your blood stream in order to spread.

Prostate cancer often doesn’t have any obvious symptoms in the early stages. Some of the symptoms you might experience with prostate cancer include:

Because metastatic prostate cancer generally spreads to your bones, you might experience more specific symptoms such as:

Anyone who has a prostate is at risk of having prostate cancer. In the United States, about 13% of people with a prostate develop prostate cancer at some point in their life.

Prostate cancer is uncommon for those younger than 45 years, and the risk continues to increase with age.

People with close relatives who have had prostate, breast, or ovarian cancer have an increased risk of developing prostate cancer.

African Americans are at a higher risk of prostate cancer than other groups and tend to have more advanced prostate cancer at the time of diagnosis and at younger ages.

Metastatic prostate cancer is generally divided into two types.

The first type is metastatic hormone-sensitive prostate cancer. This type responds to hormone therapy treatments. When you first receive a diagnosis of metastatic prostate cancer, this is generally the default diagnosis because, in most cases, you haven’t undergone any hormone therapies yet.

The second type is metastatic castration-resistant prostate cancer. This type doesn’t respond to hormone therapy, meaning that the cancer continues to grow or spread even after these treatments are used.

Prostate cancer is very common. Close to 13% of all people with a prostate in the United States are expected to have prostate cancer at some point in their lives.

The United States Preventive Services Task Force, a nongovernmental advisory group, recommended against a type of prostate cancer preventive screening called a prostate-specific antigen (PSA) test in 2012, advising that false positives were causing more harm than early diagnoses were preventing.

Since that time, the likelihood that prostate cancer is metastatic at the time of diagnosis has increased significantly.

Because metastatic prostate cancer often interacts with your bones, and especially the bones in your spine, one complication is spinal cord compression. Spinal cord compression, in turn, can sometimes lead to neurological issues.

Other complications may occur as a result of treatments such as surgery, each of which carries its own risks.

The main way a doctor will diagnose metastatic prostate cancer is with a biopsy.

This means that a doctor will take tissue samples from your prostate to be examined under a microscope. A biopsy may be guided by imaging techniques such as MRI scan or ultrasound, but not always. This will show whether you have prostate cancer.

Once it’s determined you have prostate cancer, additional tests will be needed to see if it’s spread, or metastasized. If it has, you’ll receive a diagnosis of metastatic prostate cancer. These tests could include:

There are many treatments for metastatic prostate cancer, and they made be used alone or in combination. Let’s briefly review the main types.

Androgen deprivation therapy (ADT)

Prostate cancer cells use male hormones like testosterone to grow. ADT medications prevent the cancer cells from accessing these hormones.


Chemotherapy is a type of medication that aims to destroy cancer cells directly.


Surgical procedures used to treat prostate cancer include removal of the testicles to lower the amount of hormones that make the cancer grow and spread, or in some cases, the prostate.

Other treatments

There are many other treatments that might be used depending on your genetics, where your cancer has metastasized, and how you respond to other treatments.

A relative survival rate compares how long a group of people with a disease is likely to live as compared with a similar group of people without prostate cancer. It’s only an average and doesn’t take into account your own unique circumstances.

People who received a diagnosis of metastatic prostate cancer have a 5-year relative survival rate of 32%.

Let’s briefly look at some other questions related to metastatic prostate cancer.

What are the TNM stages of metastatic prostate cancer?

The TNM method stages cancer by providing three different scores. Lower numbers generally mean less advanced cancer than higher numbers. The three scores relate to:

  • Tumor: A score from 0–4 describes the size of the primary tumor.
  • Nodes: A score from 0–1 describes whether the cancer has spread to nearby lymph nodes.
  • Metastasis: A score from 0–1 describes whether the cancer has metastasized to other parts of the body.

Metastatic prostate cancer will have any T or N number with an M number of 1.

What are the PSA levels in metastatic prostate cancer?

PSA is a protein made by your prostate. Prostate cancer cells can also make PSA.

If a PSA test reveals that you have high PSA levels, it could be a sign of prostate cancer. There are other conditions that can also raise your PSA, though. So elevated PSA levels are usually not enough evidence to diagnose prostate cancer on their own.

A PSA level above 4 indicates about a 25% chance of having prostate cancer, and a PSA level above 10 indicates about a 50% chance of having prostate cancer.

Is metastatic prostate cancer terminal?

Metastatic prostate cancer isn’t necessarily terminal. While there isn’t a known cure, it can respond to treatment and be controlled in many cases.

Metastatic prostate cancer is a type of cancer that begins in your prostate and has then spread to other parts of your body. The most common place for prostate cancer to metastasize is your bones.

While metastatic prostate cancer is an advanced stage of cancer, there are also many treatments available.

If you believe you might have a higher risk of prostate cancer, consider talking with a doctor about whether prostate cancer screening might be a good option for you.