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Home > Health Library > Prostate Cancer, Advanced or Metastatic
Prostate cancer is the abnormal growth of cells in the prostate gland. The prostate is part of the male reproductive system. Locally advanced prostate cancer means that the cancer has spread beyond the prostate and into nearby tissue. Metastatic prostate cancer means that the cancer has spread, or metastasized, to the lymph nodes or other parts of the body.
Recurrent prostate cancer means that the cancer has come back after it was treated. The cancer can come back in the prostate. Or it can come back near the prostate or in another part of the body. If it comes back in another part of the body—often the bones—it is still called prostate cancer because it started in the prostate.
Possible symptoms of locally advanced prostate cancer may include trouble urinating or pain when you urinate. Symptoms of metastatic prostate cancer may include bone pain, weight loss, or swelling in your legs and feet. Sometimes there are no symptoms of locally advanced or metastatic prostate cancer.
Advanced and metastatic prostate cancer are diagnosed using a combination of a physical exam, blood tests, imaging tests, and sometimes biopsies. If you've had prostate cancer before, you'll likely be having regular PSA tests. Other tests to see if the cancer has come back or spread include bone scans, PET-CT scans, and MRI scans.
Advanced or metastatic prostate cancer may be treated with hormone therapy, radiation therapy, chemotherapy, targeted therapy, or immunotherapy. Some of these treatments may be combined. Other options may include surgery or observation. For either type of cancer, your doctor may suggest a clinical trial.
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Sometimes there are no symptoms of locally advanced or metastatic prostate cancer.
When there are symptoms of locally advanced prostate cancer, they may include urinary problems, such as:
Less common symptoms of locally advanced prostate cancer may include:
These symptoms also may be caused by an enlarged prostate, an infection in the prostate (prostatitis), or a urinary tract infection.
Symptoms of metastatic prostate cancer may include:
Prostate cancer is usually a very slow-growing cancer. It may take years to grow large enough to cause any symptoms. Sometimes it never causes problems. But sometimes it grows quickly and may cause complications or death.
Prostate cancer may grow beyond the prostate and into nearby tissues, such as the nearby seminal vesicles. This is called locally advanced prostate cancer.
Prostate cancer may spread to the lymph nodes or other parts of the body. This is called metastatic prostate cancer. Most often, prostate cancer spreads to the bones. It also may spread to the lungs or other organs.
Prostate cancer begins inside the prostate gland. Usually this cancer grows so slowly that it may never cause a problem during a person's life. But in some cases, it grows more quickly, spreading into nearby tissues, such as the lymph nodes or seminal vesicles, and to other areas of the body.
Be sure to follow your doctor's instructions about calling when you have problems, new symptoms, or symptoms that get worse.
Call your doctor now if you:
Call your doctor to schedule an appointment if you have unexplained:
Watchful waiting is a wait-and-see approach. If you are older and have other serious health problems, you may choose only those treatments that keep you comfortable (palliative care).
Locally advanced and metastatic prostate cancer are diagnosed through physical exams and tests. These include:
If you've had prostate cancer before, other tests can help your doctor see if your cancer has come back or spread. These tests may include:
Treatment for advanced prostate cancer is based on the stage of the cancer, your Gleason score, and other things, such as your age and overall health. It may include:
Other treatment options may include targeted therapy or immunotherapy. In some cases, a clinical trial may be a good choice.
Your doctor will talk with you about your options and then make a treatment plan.
Treatment for metastatic prostate cancer is based on many things. These include your age and overall health, the location of the cancer, and whether you had treatment before. Options may include hormone therapy, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. These treatments may be combined. Your doctor may suggest a clinical trial.
Your doctor will talk with you about your options and then make a treatment plan. Some people choose to focus on treating their symptoms instead of the cancer (observation).
Some people use complementary therapies along with medical treatment. Therapies like acupuncture or massage may help you cope with the symptoms and stress of cancer. Talk with your doctor about any of these options you would like to try.
Hormone therapy uses medicine or surgery to lower the level of androgens in your body. This can slow the growth of prostate cancer and even shrink the tumors. It's also called androgen deprivation therapy (ADT).
Over time, hormone therapy may no longer keep the cancer from growing. This is called castration-resistant prostate cancer (CRPC). Hormone therapy may be continued, but other medicines are added. Examples include:
This uses high-energy X-rays to kill cancer cells and shrink tumors. Radiation may be used to treat the cancer or to ease symptoms. It may be used alone or given with hormone therapy.
To treat prostate cancer, radiation is usually given by a machine outside the body. (This is called external radiation.) It may also be given by placing substances inside the body. (This is called internal radiation, or brachytherapy.)
These may include:
Clinical trials are an option for many people who have cancer. These research studies test promising new treatments or improvements to existing treatments. People in clinical trials may have access to the latest treatments before they're available to others.
Your medical team can tell you if there's a clinical trial that might be right for you.
This is a wait-and-see approach to treatment. You have regular visits with your doctor, but the focus is on treating any symptoms that bother you rather than treating the cancer. Some people choose this because it lets them avoid or delay treatments that can have serious side effects.
You can change your mind and start treatment at any time.
Palliative care is a type of care for people who have a serious illness. It's different from care to cure your illness, called curative treatment. Palliative care provides an extra layer of support that can improve your quality of life—not just in your body, but also in your mind and spirit. Sometimes palliative care is combined with curative treatment.
The kind of care you get depends on what you need. Your goals guide your care. You can get both palliative care and care to treat your illness. You don't have to choose one or the other.
Palliative care can help you manage symptoms, pain, or side effects from treatment. It may help you and those close to you better understand your illness, talk more openly about your feelings, or decide what treatment you want or don't want. It can also help you communicate better with your doctors, nurses, family, and friends.
It can be hard to live with an illness that cannot be cured. But if your health is getting worse, you may want to make decisions about end-of-life care. Planning for the end of your life does not mean that you are giving up. It is a way to make sure that your wishes are met. Clearly stating your wishes can make it easier for your loved ones. Making plans while you are still able may also ease your mind and make your final days less stressful and more meaningful.
Some people use complementary therapies along with medical treatment. They may help relieve the symptoms and stress of cancer or the side effects of cancer treatment. Therapies that may be helpful include:
Talk with your doctor about any of these options you would like to try. And let your doctor know if you are already using any complementary therapies. They are not meant to take the place of standard medical treatment. But they may help you feel better and cope better with treatment.
Relationships take on new importance when you're faced with cancer. Your family and friends can help support you. You may also want to look beyond those who are close to you.
Remember that the people around you want to support you, and asking for help isn't a sign of weakness.
Your friends and family want to help, but some of them may not know what to do. It may help to make a list. For example, you might ask them to:
Places to turn for support include:
Current as of:
May 4, 2022
Author: Healthwise StaffMedical Review: E. Gregory Thompson MD - Internal MedicineKathleen Romito MD - Family MedicineChristopher G. Wood MD, FACS - Urology, Oncology
Current as of: May 4, 2022
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD - Internal Medicine & Kathleen Romito MD - Family Medicine & Christopher G. Wood MD, FACS - Urology, Oncology
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