Prostate cancer metastasis may be suspected if you have specific symptoms such as new lower back pain or elevated liver enzymes. These may be signs your cancer has spread to your spine or your liver, respectively. If your prostate-specific antigen (PSA) levels continue to rise despite treatment, especially if they are rising particularly fast, this may be a sign that cancer is metastasizing somewhere in your body. Show
Prostate-Specific Antigen (PSA) Test Types of Imaging StudiesIf your healthcare provider suspects your cancer might be spreading, they will likely order more imaging tests. A common imaging workup may include a bone scan and a CT scan of the abdomen and pelvis. An MRI might be done as well. Some research centers are also using magnetic MRIs or PET scans to further refine the staging of prostate cancer.
Prostate Cancer Doctor Discussion GuideGet our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Advanced prostate cancer is cancer that has spread from the prostate to other parts of the body. It develops when prostate cancer cells move through the blood stream or lymphatic system. Watch our video about advanced prostate cancer. You might hear cancer that has spread described as metastatic prostate cancer, secondary prostate cancer, secondaries, metastases or mets. It is still prostate cancer, wherever it is in the body. Prostate cancer can spread to any part of the body, but most commonly to the bones and lymph nodes. Lymph nodes (sometimes called lymph glands) are part of your lymphatic system, which is part of the body’s immune system. Lymph nodes are found throughout the body including in the pelvic area, near the prostate. Advanced prostate cancer can cause symptoms, such as fatigue (extreme tiredness), bone pain, and problems urinating. The symptoms you have will depend on where the cancer has spread to. Speak to your doctor or nurse if you have any symptoms. There are treatments available to help manage them. It’s not possible to cure advanced prostate cancer. But treatments can help keep it under control and manage any symptoms. Read more about symptoms and treatments to help manage them. Download or order advanced prostate cancer fact sheet How is advanced prostate cancer diagnosed?Advanced prostate cancer is diagnosed using the results of some or all of the following tests:
What do my test results mean?Your results will give your doctor an idea of where your cancer has spread to. This will help you and your doctor to discuss which treatments might be suitable for you. Read more about what your test results might mean. What treatments are available?If you have advanced prostate cancer, treatment won’t cure your cancer. But it can help keep it under control and manage any symptoms. If you’ve just been diagnosed with advanced prostate cancer, you may be offered the following treatments:
Research has found that having radiotherapy together with one of the main treatments listed above can help some men with advanced prostate cancer to live longer. But radiotherapy isn’t suitable for all men with advanced prostate cancer. If you live in Scotland, you may also be offered a type of hormone therapy called abiraterone acetate (Zytiga®) together with standard hormone therapy. In the rest of the UK, abiraterone is currently only given to men with advanced prostate cancer that has stopped responding to other types of hormone therapy. The National Institute for Health and Care Excellence (NICE) is currently deciding whether to make it available for men who have just been diagnosed with advanced prostate cancer. Before you start treatmentBefore you start any treatment, make sure you have all the information you need. It’s important to think about how you would cope with the possible side effects. Speak to your doctor or nurse about this. It can help to write down any questions you want to ask at your next appointment. It may also help to take someone with you, such as your partner, a family member or friend. It can also help to write down or record what’s said to help you remember it. You have the right to record your appointment because it’s your personal data. You could use your phone or another recording device to do this. Let your doctor or nurse know why you are doing this, as not everyone is comfortable being recorded. If you have any questions, speak to our Specialist Nurses. If you don’t have any symptoms and want to avoid or delay treatment and its side effects, you might be able to have your cancer monitored instead. This is known as watchful waiting. It isn’t usually recommended for men with advanced prostate cancer, because it won’t control the cancer and it won’t stop the cancer from growing or spreading. Your doctor or nurse can help you think about the advantages and disadvantages. How will my cancer be monitored?Your doctor will talk to you about how often you should have check-ups. At some hospitals, you may not have many appointments at the hospital itself. Instead, you may talk to your doctor or nurse over the telephone. You might hear this called self-management. You will have regular PSA tests. This is often a useful way to check how well your treatment is working. You’ll also have regular blood tests to see whether your cancer is affecting other parts of your body, such as your liver, kidneys or bones. You might have more scans to see how your cancer is responding to treatment and whether your cancer is spreading. Your doctor or nurse will also ask you how you’re feeling and if you have any symptoms, such as pain or tiredness. This will help them understand how you’re responding to treatment and how to manage any symptoms. Let them know if you have any side effects from your treatment. There are usually ways to manage these. What happens if my cancer starts to grow again?Your first treatment may help keep your cancer under control. But over time, the cancer may change and it may start to grow again. You will usually stay on your first type of hormone therapy, even if it’s not working so well. This is because it will still help to keep the amount of testosterone in your body low. But there are other treatments that you can have alongside your usual treatment, to help control the cancer and manage any symptoms. Other treatments include:
Which treatments are suitable for me?Which treatments are suitable for you will depend on many things, including your general health, how your cancer responds to treatment, and which treatments you’ve already had. Talk to your doctor or nurse about your own situation, or speak to our Specialist Nurses. Treatments to help manage symptomsAdvanced prostate cancer can cause symptoms, such as bone pain. Speak to your doctor or nurse if you have symptoms – there are treatments available to help manage them. The treatments above may help to delay or relieve some symptoms. There are also specific treatments to help manage symptoms – you may hear these called palliative treatments. They include:
Your multi-disciplinary team (MDT)This is the team of health professionals involved in your care. It is likely to include:
Your MDT will meet to discuss your diagnosis and treatment options. You might not meet all the health professionals straight away. Your main point of contact might be called your key worker. This is usually your clinical nurse specialist (CNS), but might be someone else. The key worker will co-ordinate your care and help you get information and support. You may also have close contact with your GP and the practice nurses at your GP surgery. What is my outlook?If you’re diagnosed with advanced prostate cancer, you may want to know how well your treatment is likely to control your cancer and for how long it will control it. This is sometimes called your outlook or prognosis. But not all men will want to know this. While it isn’t possible to cure advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain. No one can tell you exactly what your outlook will be, as it will depend on many things such as where the cancer has spread to, how quickly it has spread, and how well you respond to treatment. Some men may not respond well to one treatment, but may respond better to another. And when your first treatment stops working, there are other treatments available to help keep the cancer under control for longer. Speak to your doctor about your own situation and any questions or concerns you have. Questions to ask your doctor or nurse
ReferencesUpdated: May 2022|To be reviewed: May 2023 List of references
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You may also be interested in...Choosing a treatmentYou may have a choice of treatments. Your doctor or specialist nurse will explain all your treatment options, and help you to choose the right treatment for you. Learn MoreDealing with my diagnosisHow you might feel, how you can help yourself, and who can support you. Learn MoreLiving with prostate cancerDealing with side effects of prostate cancer, practical tips and how to manage. Learn MoreAdvanced prostate cancer fact sheetThis fact sheet is for people who have been diagnosed with advanced prostate cancer. It explains what advanced prostate cancer is, what your test results mean, and the treatments available. How do I know if my prostate cancer is spreading?Prostate cancer can spread to the lymph nodes in the groin area, or to other parts of the body. The most common symptoms are swelling and pain around the area where the cancer has spread. Cancer cells can stop lymph fluid from draining away. This might lead to swelling in the legs due to fluid build up in that area.
Where is the first place prostate cancer spreads to?In theory, prostate cancer cells can spread anywhere in the body. In practice, though, prostate cancer metastasis occurs most often in the lymph nodes and the bones.
How fast does prostate cancer usually spread?This is because, unlike many other cancers, prostate cancer usually progresses very slowly. It can take up to 15 years for the cancer to spread from the prostate to other parts of the body (metastasis), typically the bones. In many cases, prostate cancer won't affect a man's natural life span.
What are the symptoms of the last stages of prostate cancer?Signs and symptoms of stage 4 prostate cancer may include:. Painful urination.. Decreased force in the stream of urine.. Blood in the semen.. Bone pain.. Swelling in the legs.. Fatigue.. |