Prostate cancer is oligometastatic when it has spread to only a few sites beyond your prostate. Doctors consider it stage 4, but oligometastatic prostate cancer usually has a better outlook than cancer that has spread to several places.

The prefix “oligo-” means “few” or “little.” “Metastatic” means that cancer has spread from the original tumor to other parts of your body. Oligometastatic prostate cancer means that cancer cells start in your prostate and travel to form new tumors in a few other parts of your body.

Doctors typically diagnose oligometastatic prostate cancer when cancer has spread to up to five other locations outside your prostate. However, there’s currently no standardized definition.

Even though doctors consider oligometastatic prostate cancer advanced or stage 4 cancer (the most advanced form), it’s typically easier to treat than metastatic cancer that has spread more widely throughout the body.

Improvements in diagnostic imaging have allowed doctors to better see the sites where cancer has spread. This also means they can target these sites with radiation therapy and other treatments.

Prostate cancer typically grows very slowly. So you might not experience any symptoms right away.

In oligometastatic prostate cancer, the cancer travels to a few places outside your prostate gland, such as your lymph nodes, bladder, or bones. Your symptoms will depend on where in your body the tumors have spread.

One common area for prostate cancer to spread is the bladder since it’s so close to the prostate. If there is a tumor in your bladder, symptoms may include:

If cancer has spread to your bones, symptoms may include:

  • pain in the hips, back, chest, or other areas of your body
  • weakness or numbness in the legs or feet if the tumor is in your spine
  • bones that break more easily than usual

Cancer that has spread to the lymph nodes near your groin might cause swelling, pain, or soreness in that area.

Doctors use diagnostic imaging tests, such as a PSMA PET scan, to find out if prostate cancer has spread to other parts of your body.

During a PSMA PET scan, a technician injects a special dye with a radioactive tracer into a vein. The tracer attaches to a protein called prostate-specific membrane antigen (PSMA). PSMA is found in high amounts in prostate cancer cells.

While you lie down in the machine, a special camera creates images of your body. The radioactive tracers make it easier for your doctor to see the location of the prostate cancer cells during the scan.

Your doctor may also order other imaging tests, such as CT, MRI, or bone scan, to help with diagnosis and staging.

What stage is oligometastatic prostate cancer?

Doctors classify oligometastatic prostate cancer as a subclass or early form of stage 4 cancer. Stage 4 means the cancer has spread to distant parts of the body.

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Researchers are still trying to understand how best to treat oligometastatic prostate cancer. Currently, treatment involves a combination of:

Newer research suggests that surgery to remove the prostate and a technique called stereotactic ablative body radiation (SABR) may help improve outcomes. SABR delivers very high doses of radiation to metastatic sites.

More clinical trials are needed to determine the best treatments or combination of treatments for oligometastatic prostate cancer. Talk with your doctor if you’re interested in joining a clinical trial.

The 5-year survival rate for all stage 4 prostate cancers is about 34%. Research suggests that Black men are more than twice as likely to die from prostate cancer as white men at almost every stage.

Research indicates that people with fewer metastases have a better outlook than those with more widespread metastatic disease.

Oligometastatic prostate cancer may even be curable with treatment. Your doctor might use the term “cured” if you show no signs of cancer for several years. But your overall outlook depends on several factors, including the location and the number of metastases and your overall health.

As time goes on, scientists will likely develop better ways to diagnose and treat oligometastatic prostate cancer and improve outcomes.

Resources for support

If you’ve recently received a diagnosis of prostate cancer, remember you’re not alone. Don’t hesitate to ask for help when you need it.

Your doctor or care team can refer you to a local support group, a counselor, or a social worker for you and your loved ones. Or you can reach out to the following organizations for support:

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If you receive a diagnosis of metastatic or stage 4 prostate cancer, ask your doctor if you qualify for oligometastatic treatments. Oligometastatic prostate cancer means the cancer has spread to five or fewer sites in your body. As you work with a doctor to decide on a treatment plan, you may also consider asking about the benefits and risks of participating in a clinical trial.