Metastatic Prostate Cancer

Sometimes, cancer cells can break away from the prostate and rapidly grow, spreading to nearby tissues, a process known as metastasis. The lymph nodes closest to the prostate are often the first places where cancer spreads. If prostate cancer has reached the lymph nodes at the time of diagnosis, there is a higher likelihood that it may have also spread to other parts of the body.

When prostate cancer cells enter the bloodstream, they can travel to various sites throughout the body. They most commonly spread to bones and, less frequently, to other organs such as the liver, lungs, or brain. In 85% to 90% of metastatic prostate cancer cases, bone metastases are observed.

Regardless of where cancer appears in the body, it is always classified by its original tissue type. Thus, even when prostate cancer spreads to other organs, the metastatic cells are still prostate cancer cells and require prostate cancer-specific treatment.

Men diagnosed with metastatic prostate cancer, meaning their cancer has already spread beyond the prostate at the time of diagnosis, typically do not undergo surgery to remove the prostate. Instead, their treatment often begins with hormone therapy, which may be combined with other medications like androgen receptor pathway inhibitors and/or docetaxel chemotherapy. Radiation therapy targeting the primary tumor may be an option for certain patients.

Symptoms of Metastatic Prostate Cancer :

Metastatic prostate cancer refers to a prostate cancer that has extended to other regions of the body. This condition is also known as advanced prostate cancer.

If your prostate cancer has metastasized, you may experience:

– Bone pain

– Extreme tiredness (fatigue)

– A general sense of feeling unwell

– Unexplained weight loss

You might also have particular symptoms depending on where the cancer has spread. These symptoms can be indicative of other medical issues as well, so they may not necessarily mean that the cancer has spread.

You should contact your doctor if you’re concerned about any symptoms.

Prostate cancer primarily spreads to the bones, but it can also metastasize to lymph nodes, the liver, lungs, and, less commonly, the bladder and bowel. Here’s an overview of where prostate cancer tends to spread and the associated symptoms:

Bone Metastasis

Prostate cancer cells frequently spread to the bones, especially in the spine, pelvis, ribs, and skull. Symptoms can include persistent bone pain, particularly at night, as well as an increased risk of fractures due to weakened bones. When the spine is affected, it may lead to spinal cord compression, which can cause back pain, numbness, or weakness in the legs. This condition is an emergency that requires immediate medical attention.

Lymph Node Metastasis

Lymph nodes near the prostate, especially in the pelvic region, are common sites for the spread of cancer. This can cause swelling and pain in the affected area. Obstruction of lymph fluid drainage may lead to lymphoedema, resulting in swelling of the legs or genital area.

Liver Metastasis

When prostate cancer spreads to the liver, symptoms may include:

Pain or discomfort in the upper right abdomen
Nausea and loss of appetite
Weight loss
Swelling of the abdomen (ascites)
Jaundice (yellowing of the skin and eyes)
Itchy skin

Liver metastasis is associated with a poorer prognosis.

Lung Metastasis

Lung involvement can lead to:

Persistent cough
Shortness of breath
Coughing up blood
Pleural effusion (fluid accumulation around the lungs)

Lung metastasis is less common and typically occurs in advanced stages.

Bladder and Bowel Involvement

Large prostate tumors can press on nearby structures:

Bladder: May cause urinary symptoms such as frequent urination, nocturia, urgency, difficulty urinating, and blood in urine or semen.
Bowel: Rarely, cancer can spread to the rectum, leading to constipation, abdominal pain, or blood in the stool.

Rare Metastatic Sites

Less commonly, prostate cancer may spread to:

Brain
Adrenal glands
Kidneys
Salivary glands
Pancreas.

Such occurrences are rare and often indicate advanced disease.

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Metastatic Prostate Cancer