What Does It Mean For Prostate Cancer To Spread
Cancer cells can spread to other parts of the body. If this occurs, doctors say the cancer has metastasized or spread.
Areas of the body to which prostate cancer can spread include:
- the bones
- the lungs
- the lymph nodes, usually those around the pelvis
A doctor will typically recommend imaging scans and tissue samples to test for the presence of cancerous cells.
According to the Prostate Cancer Foundation, age is the biggest contributing factor to the risk for prostate cancer. An estimated 65 percent of all prostate cancers are diagnosed in men older than 65 years of age.
Additional risk factors for prostate cancer include:
- Family history: Men who have a father or brother with prostate cancer are twice as likely to get prostate cancer as men who do not.
- Race: African-American men face the greatest risk of prostate cancer.
- Smoking: A history of smoking is associated with a higher risk of aggressive prostate cancer.
Researchers are also studying a link between diet and increased prostate cancer risk. Diets low in vegetables or high in calcium have been linked to an increased risk of aggressive prostate cancer.
The prostate is very close to the point at which urine drains from the body. As a result, many prostate cancer symptoms affect the urination process. Examples of these symptoms include:
Some of these symptoms are associated with aging and an enlarged prostate. As a result, some men may ignore these symptoms instead of seeking medical attention.
Treatments To Control Advanced Prostate Cancer
If youve just been diagnosed with advanced prostate cancer, you may be offered the following treatments:
- chemotherapy with hormone therapy
- clinical trials.
Chemotherapy with hormone therapy
Chemotherapy uses anti-cancer drugs to kill cancer cells, wherever they are in the body. It wont get rid of your prostate cancer, but it aims to shrink it and slow down its growth. You might be offered chemotherapy at the same time as, or soon after, you start having hormone therapy. This helps many men to live longer, and may help delay symptoms such as pain.
You need to be quite fit to have chemotherapy. This is because it can cause side effects that are harder to deal with if you have other health problems. Read more about chemotherapy.
Hormone therapy will be a life-long treatment for most men with advanced prostate cancer.
Prostate cancer usually needs the hormone testosterone to grow. Hormone therapy works by either stopping your body from making testosterone, or stopping testosterone from reaching the cancer cells. This usually causes the cancer to shrink, wherever it is in the body. Hormone therapy can also help control symptoms of advanced prostate cancer, such as bone pain.
Hormone therapy can cause side effects speak to your doctor or nurse about ways to manage these. Read more about hormone therapy, and its side effects.
What Symptoms Do I Need To Watch Out For
MSCC can cause any of the following symptoms.
- Pain or soreness in your lower, middle or upper back or neck. The pain might be severe or get worse over time. It might get worse when you cough, sneeze, lift or strain, go to the toilet, or lie down. It may wake you at night or stop you from sleeping.
- A narrow band of pain around your chest or abdomen that can move towards your back, buttocks or legs.
- Pain that moves down your arms or legs.
- Weakness or loss of control of your arms or legs, or difficulty standing or walking. You might feel unsteady on your feet or feel as if your legs are giving way. Some people say they feel clumsy.
- Numbness or tingling in your legs, arms, fingers, toes, buttocks, stomach area or chest that doesnt go away.
- Problems controlling your bladder or bowel. You might not be able to empty your bladder or bowel, or you might have no control over emptying them.
These symptoms can also be caused by other conditions, but its still important to get medical advice straight away in case you do have MSCC.
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Side Effects Of Prostate Surgery
The major possible side effects of radical prostatectomy are urinary incontinence and erectile dysfunction . These side effects can also occur with other forms of prostate cancer treatment.
Urinary incontinence: You may not be able to control your urine or you may have leakage or dribbling. Being incontinent can affect you not only physically but emotionally and socially as well. These are the major types of incontinence:
- Men with stress incontinence might leak urine when they cough, laugh, sneeze, or exercise. Stress incontinence is the most common type after prostate surgery. Itâs usually caused by problems with the valve that keeps urine in the bladder . Prostate cancer treatments can damage this valve or the nerves that keep the valve working.
- Men with overflow incontinence have trouble emptying their bladder. They take a long time to urinate and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage or narrowing of the bladder outlet by scar tissue.
- Men with urge incontinencehave a sudden need to urinate. This happens when the bladder becomes too sensitive to stretching as it fills with urine.
- Rarely after surgery, men lose all ability to control their urine. This is called continuous incontinence.
After surgery for prostate cancer, normal bladder control usually returns within several weeks or months. This recovery usually occurs slowly over time.
There are several options for treating erectile dysfunction:
How Is Prostate Cancer Diagnosed
If you have symptoms of prostate cancer, your provider will perform a digital rectal exam and a PSA blood test. If either of those two tests are abnormal, then most likely your provider will recommend that you have a prostate biopsy. A biopsy is the only way to know for sure if you have cancer, as it allows your providers to get cells that can be examined under a microscope.
The most common way that a biopsy is done is with a trans-rectal ultrasound . A trans-rectal ultrasound is a thin cylinder that puts out sound waves and monitors them when they bounce off of tissue. It is inserted into your rectum, and allows the provider performing the biopsy to view your prostate and choose where to remove the tissue for further evaluation. Any suspicious areas are biopsied. In addition, some tissue will be removed from all of the different parts of the prostate . The procedure is done while you are awake, with the help of some numbing medicine. Unfortunately, a trans-rectal ultrasound isnât a perfect tool. Even though many samples are taken, it can occasionally miss the area of the cancer. If this happens, and your PSA remains elevated, you may need to have the procedure repeated.
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What Questions Should I Ask My Healthcare Provider
If you have prostate cancer, you may want to ask your healthcare provider:
- Why did I get prostate cancer?
- What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
- Has the cancer spread outside of the prostate gland?
- What is the best treatment for the stage of prostate cancer I have?
- If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
- What are the treatment risks and side effects?
- Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
- Am I at risk for other types of cancer?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.
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Receiving Treatment For Prostate Cancer That Has Spread
At Moffitt Cancer Center, the experts within our Urologic Oncology Program treat patients with all stages of prostate cancer, including advanced-stage cancers that have metastasized to other areas of the body. Our multispecialty team collaborates as a tumor board, ensuring each patient receives a treatment plan tailored to his unique needs. For individuals with metastatic prostate cancer, treatment plans aim to alleviate symptoms, slow the rate of cancer growth and shrink tumors to help improve quality of life.
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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. Youll 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 youre feeling and if you have any symptoms, such as pain or tiredness. This will help them understand how youre 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.
Problems Emptying Your Bladder
If the cancer is pressing on your urethra or the opening of your bladder, you may find it difficult to empty your bladder fully. This can sometimes cause urine retention, where urine is left in your bladder when you urinate. There are several things that can help, including the following.
- Drugs called alpha-blockers. These relax the muscles around the opening of the bladder, making it easier to urinate.
- A catheter to drain urine from the bladder. This is a thin, flexible tube that is passed up your penis into your bladder, or through a small cut in your abdomen .
- An operation called a transurethral resection of the prostate to remove the parts of the prostate that are pressing on the urethra.
Bladder Cancer Clinical Trials
What about Clinical Trials?
You may hear about clinical trials for your bladder cancer. Clinical trials are research studies that test if a new treatment or procedure is safe and effective.
Through clinical trials, doctors find new ways to improve treatments and the quality of life for people with disease. Trials are available for all stages of cancer. The results of a clinical trial can make a major difference to patients and their families. Please visit our clinical trials research webpage to learn more.
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Eating Problems And Weight Loss
Some men with advanced prostate cancer have problems eating, or dont feel very hungry. You might feel or be sick. These problems may be caused by your cancer or by your treatments. Being worried about things can also affect your appetite.
Problems eating or loss of appetite can lead to weight loss and can make you feel very tired and weak. Advanced prostate cancer can also cause weight loss by changing the way your body uses energy.
What can help?
If you feel sick because of your treatment, your doctor can give you anti-sickness drugs. Steroids can also increase your appetite and are sometimes given along with other treatments.
Try to eat small amounts often. If youre struggling to eat because of nausea , try to avoid strong smelling foods. Cold foods tend to smell less, or it may help if someone cooks for you. Try to eat when you feel less sick, even if its not your usual mealtime. Fatty and fried foods can make sickness worse. Drink plenty of water, but drink slowly and try not to drink too much before you eat.
Tell your doctor if you lose weight. They can refer you to a dietitian who can provide advice about high calorie foods and any supplements that might help. It can be upsetting for your family to see you losing weight, and they may also need support. Macmillan Cancer Support and provide support and information about eating problems in advanced cancer.
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Bone Metastases In Patients With Metastatic Crpc
In approximately 80% of PCa patients bone metastases represent the initial and main metastatic site and are an important prognostic factor . About half of PCa patients with untreated bone metastases will experience at least one SRE over the period of 2 years .
The knowledge of the mechanisms underlying the development of bone metastases and the correlation between bone and cancer cells is of special importance with regard to the different therapeutic options for the management and prevention of SREs. Bone metastases in PCa are frequently osteoblastic, however an osteolytic element has also been confirmed in various reports , and the majority of lesions tend to be heterogeneous .
In clinical trials of bone-modifying agents for the treatment of bone metastases, the incidence of SREs was used as a composite primary endpoint , and they are recognized by the US Food and Drug Administration as a suitable endpoint to assess the efficacy of agents for the treatment of bone metastases in patients with cancer .
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Heres What Specific Stages Mean:
Stage 1 Prostate Cancer: The cancer cannot be found during a digital rectal exam. It is found as a result of prostate biopsies for a high or rising PSA, or discovered by chance when surgery is done for another reason, usually for lower urinary tract symptoms.
Stage 2 Prostate Cancer: The cancer can be felt during a prostate exam, but it has not spread outside the prostate.
Stage 3 Prostate Cancer: The cancer has spread outside the prostate. It may be in the tissues near the prostate, or it may have invaded the tissues around the prostate or seminal vesicles. It has not spread to the lymph nodes.
Stage 4 Prostate Cancer: This stage is called metastatic cancer, because it has metastasized, or spread, to distant parts of the body. The cancer may be in nearby pelvic muscles or organs . It may have spread to the lymph nodes. It may have spread to other parts of the body.
Accurate staging provides your medical team with information that will be very important for creating the best treatment plan for you.
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Should I Make Any Lifestyle Changes Including In My Diet Or Physical Activity
Achieving and maintaining a healthy weight by eating a balanced diet with plenty of fruits, vegetables, and whole grains, and staying physically active, can help your overall health. These lifestyle changes can also have a positive effect for men with bone metastases, Tagawa says. Both diet and exercise, he says, are things that are under a mans direct control.
A healthy lifestyle can help you better manage side effects from treatment as well. Try setting small but realistic goals for yourself when it comes to eating a healthy diet and getting plenty of exercise.
While no single food is likely to have a benefit for prostate cancer, smart food choices may help you feel better day to day. Start by cutting out foods high in sugar, saturated fat, and added flavorings and preservatives.
If youre not sure which healthy foods to choose, ask your doctor for a referral to a dietitian. This specialist can help you develop a meal plan that includes foods that offer the best chance of slowing the cancers growth and keeping you as healthy as possible.
As an oncologist, Tagawa says he concentrates on treating the cancer itself, but hes aware that many of the men he sees with advanced prostate cancer are older and more likely than younger men to have health problems that can benefit from diet and exercise.
And if youre on hormone therapy, talk to your doctor about investing in some weights or elastic resistance bands to support your bone strength too.
Where Does Metastatic Bladder Cancer Spread To
Bladder cancer spreads when cancerous cells reproduce and invade surrounding healthy tissues. This is known as metastasis. Usually, metastatic bladder cancer refers to cancer that has spread to distant organs, but metastasis can occur locally in the muscles and connective tissues that are directly adjacent to the bladder as well.
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Can I Lower My Risk Of Getting A Second Cancer
There are steps you can take to lower your risk and stay as healthy as possible. For example, prostate cancer survivors should do their best to stay away from all tobacco products and tobacco smoke. Smoking can increase the risk of bladder cancer, as well as increase the risk of many other cancers.
To help maintain good health, prostate cancer survivors should also:
- Get to and stay at a healthy weight
- Keep physically active and limit the time you spend sitting or lying down
- Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and limits or avoids red and processed meats, sugary drinks, and highly processed foods
- Not drink alcohol. If you do drink, have no more than 1 drink per day for women or 2 per day for men
These steps may also lower the risk of some other health problems.
See Second Cancers in Adults to learn a lot more about the causes of second cancers.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Bostrom PJ, Soloway MS. Secondary cancer after radiotherapy for prostate cancer: Should we be more aware of the risk? Eur Urol. 2007 52:973-982.
Moon K, Stukenborg GJ, Keim J, Theodorescu D. Cancer incidence after localized therapy for prostate cancer. Cancer. 2006 107:991-998.
Last Revised: June 9, 2020
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