Advanced prostate cancer

What is advanced prostate cancer?

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. The lymphatic system is part of the body’s immune 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. More than four out of five men (80 per cent) with advanced prostate cancer will have cancer that has spread to their bones.

Another common place for prostate cancer to spread to is the lymph nodes (sometimes called lymph glands). Lymph nodes are part of your lymphatic system. They are found throughout your body and some of the lymph nodes are in the pelvic area, near the prostate.

Some lymph nodes are near the prostate

Advanced prostate cancer can cause symptoms, such as fatigue (extreme tiredness), bone pain, and problems urinating. If you do get symptoms, the symptoms you might have will depend on where the cancer has spread to. Speak to your doctor or nurse if you have any symptoms. Read more about symptoms and treatments to help manage them.

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.

What treatments are available?

If you’ve just been diagnosed with advanced prostate cancer, you may be offered the following treatments:

Before you start any treatment, make sure you have all the information you need. It’s important to think about the possible side effects and how you would cope with them. Speak to your doctor or nurse about this. Or read more about choosing a treatment.

It can help to write down any questions you want to ask at your next appointment. And to write down or record what’s said to help you remember it. It can also help to take someone to appointments with you, such as a partner, friend or family member.

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. This is because watchful waiting won’t control the cancer or help manage symptoms. Your doctor can help you think about the advantages and disadvantages of watchful waiting.

How will my cancer be monitored?

You will have regular PSA tests. This is a useful way to check how well your treatment is working. If your PSA level rises, it could be a sign that the treatment isn’t controlling your cancer. If your PSA level falls this usually suggests the cancer is shrinking.

You’ll 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 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 too.

Treatment options 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. This is because the hormone therapy 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.

Your treatment options might include:

Treatments to help manage symptoms

Advanced 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. Read more about symptoms and what treatments are available.

What is my outlook?

If you’re diagnosed with advanced prostate cancer you may want to know how effective treatment is likely to be in controlling 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.

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.

Some men with advanced prostate cancer will die from prostate cancer. We have information about dying from prostate cancer that may help to answer some of your questions and get more support.

Speak to your doctor about your own situation and any questions or concerns you have.

References

Updated: November 2016｜To be reviewed: November 2018

List of references
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- Bubendorf L, Schöpfer A, Wagner U, Sauter G, Moch H, Willi N, et al. Metastatic patterns of prostate cancer: an autopsy study of 1,589 patients. Hum Pathol. 2000 May;31(5):578–83.
- Carlin BI, Andriole GL. The natural history, skeletal complications, and management of bone metastases in patients with prostate carcinoma. Cancer. 2000;88(S12):2989–2994.
- Kurzrock R. The role of cytokines in cancer-related fatigue. Cancer. 2001;92(S6):1684–1688.
- Mottet N, Bellmunt J, Briers E, Bolla M, Cornford P, De Santis M, et al. Guidelines on prostate cancer. European Association of Urology; 2016.
- National Institute for Health and Care Excellence. Prostate Cancer: diagnosis and treatment. Full guideline 175. 2014.