Metastatic prostate cancer is when prostate cancer spreads beyond your prostate gland. This is considered an advanced form of prostate cancer.

Prostate cancer is one of the most commonly diagnosed types of cancer worldwide.

Sometimes, prostate cancer could spread outside of the prostate gland to other parts of your body, such as nearby tissue, lymph nodes, bones, and distant organs.

There’s no cure for metastatic prostate cancer, but treatments can help relieve symptoms and slow its progression.

Keep reading to learn more about the symptoms, causes, and treatments of metastatic prostate cancer.

Language matters

Sex and gender exist on spectrums. In this article, we use “male” to refer to someone’s sex assigned at birth determined by their chromosomes. Click here to learn more.

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

Your lymphatic system is involved in fighting off diseases, and lymph nodes act like filters within this system. When cancer cells are filtered by a lymph node, they’re usually destroyed.

However, sometimes they pass through and travel through your body until they attach somewhere else.

According to the Prostate Cancer Foundation, up to 90% of metastatic prostate cancers spread to the bones. Prostate cancer may also affect distant organs, such as your lungs, liver, or brain.

Prostate cancer often doesn’t have any obvious symptoms in the early stages.

Some of the symptoms you might experience with prostate cancer include:

Symptoms of metastatic prostate cancer may vary depending on where the cancer spreads.

For instance, if prostate cancer spreads to your bones, you may experience bone pain in your spine, pelvis, hips, ribs, or upper thighs.

Other symptoms of metastatic prostate cancer may include:

  • pelvic pain and swelling
  • leg swelling and fluid retention
  • abdominal swelling, pain, or cramping
  • unexplained weight loss
  • yellowing of the skin (jaundice)
  • loss of bladder or bowel control
  • changes in urine frequency
  • blood in your stools
  • fatigue
  • bone injuries, including fractures

Metastatic prostate cancer is generally divided into two types, according to the American Urology Association.

Metastatic hormone-sensitive prostate cancer (mHSPC) is a type that responds to hormone therapy treatments. It’s generally the default diagnosis of metastatic prostate cancer because, in most cases, you haven’t undergone hormone therapy yet.

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

Anyone who has a prostate is at risk of having prostate cancer.

According to the Centers for Disease Control and Prevention, 13 in 100 males will develop prostate cancer at some point in their life.

Prostate cancer is uncommon for people younger than 45 years old. However, the risk increases as you get older.

Other risk factors for developing prostate cancer include being African American and having close relatives who have had prostate, breast, or ovarian cancer.

Prostate-specific antigen (PSA) screening can help reduce your risk of developing metastatic prostate cancer. Research suggests that PSA screening has resulted in a 72% decrease in metastatic prostate cancer diagnoses.

According to data compiled by the National Cancer Institute in the Surveillance, Epidemiology, and End Results Program, nearly 12 out of 100,000 new prostate cancer diagnoses in 2021 occurred when the cancer had already metastasized.

Research suggests that diagnoses of metastatic prostate cancer in the United States increased by 18% between 2008 and 2016.

This may be because in 2012, the United States Preventive Services Task Force, a nongovernmental advisory group, recommended against PSA screening in individuals with a prostate who do not have any symptoms and who are not at high risk for prostate cancer. They advised that false positives caused more harm than early diagnoses prevented.

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

Consider speaking with a healthcare professional about whether prostate cancer screening is right for you. They could help you understand the benefits and risks.

Complications of metastatic prostate cancer may vary based on where the cancer spreads.

Prostate cancer that metastasizes to the bones in your spine may cause spinal cord compression. Spinal cord compression, in turn, can sometimes lead to neurological issues.

Other complications that may occur due to treatments like surgery and chemotherapy include:

  • nerve damage
  • erectile dysfunction
  • urinary incontinence
  • loss of blood
  • toxicity
  • future malignancies

A doctor may use several tests to diagnose metastatic prostate cancer, but they’ll first need to confirm if you have prostate cancer.

They’ll perform a physical examination of your prostate using a gloved finger to look for lumps or other signs of prostate cancer in your rectum.

A doctor may also do a PSA test to check for levels of the prostate-specific antigen in your blood. 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.

To confirm a diagnosis of prostate cancer, a doctor will perform a biopsy. This involves taking tissue samples from your prostate to be examined under a microscope.

Once it’s determined you have prostate cancer, the following tests can help see if it’s metastasized:

Your treatment plan for metastatic prostate cancer will depend on several factors, such as:

  • where the cancer has spread
  • the severity and type of symptoms you experience
  • your PSA blood levels
  • previous treatment you’ve received, if any, and how you responded to it

Several treatment options are available, which may be used alone or in combination. Some treatments directly target the cancer cells to stop or slow the progression of the cancer. These may include:

A healthcare professional may also recommend other treatments to help treat specific symptoms depending on where the cancer has metastasized.

For example, you may need hormone treatment or pain relievers if symptoms affect your bones. On the other hand, you may require a urinary catheter if your bladder is affected.

The relative survival rate for prostate cancer compares how long people with cancer are likely to live compared to people without prostate cancer. It’s only an average and doesn’t take into account your own unique circumstances.

According to the American Cancer Society, people who received a diagnosis of metastatic prostate cancer have a 5-year relative survival rate of 34%.

What is end stage prostate cancer with metastasis?

According to the National Cancer Institute, end stage cancer is when cancer no longer responds to treatment and cannot be cured, which leads to death.

What is the first place prostate cancer spreads to?

If prostate cancer metastasizes, it most commonly spreads to the bones or nearby lymph nodes.

Is metastasized prostate cancer curable?

Advanced metastatic prostate cancer may not be cured. However, treatments could help slow the progression of the disease and relieve symptoms.

Metastatic prostate cancer is a type of cancer that begins in your prostate and has 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, some treatments may help slow the progression and relieve symptoms.

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