Metastatic Prostate Cancer

Metastatic prostate cancer is cancer that has spread from the prostate gland to other parts of your body.

For example, it may show up as a tumor on your spine or as cancer in your lung. Bone is the most common place for it to spread. But lungs and liver are also common sites. It could also occur, though rarely, in other organs such as the brain.

Having metastatic cancer doesn’t mean you have a new kind of cancer. Metastatic prostate cancer in a bone in your hip is not bone cancer. The tumor will have the same type of cancerous prostate cells the original tumor had.

The same is true if the metastatic cancer is in your lung or some other organ. It is still prostate cancer, and your treatment options are the same as when cancer was only in the prostate gland.

Metastatic prostate cancer is an advanced form of cancer. But the term “advanced” has different meanings depending on how it is used.

“Advanced” usually refers to cancer that can’t be cured. That doesn’t mean it can’t be treated and controlled. Most men with advanced prostate cancer live a normal life for many years.

Treatment can be effective to:

  • Manage symptoms
  • Slow the rate your cancer grows
  • Shrink the tumor

Some cancers are called “locally advanced.” That means the cancer has spread from the prostate to nearby tissue. This is not metastatic cancer, which is cancer that has spread to other parts of the body. Many locally advanced prostate cancers are curable.

How Prostate Cancer Spreads

For cancer to become metastatic, individual cancer cells need to break away from the original tumor and move to a blood or lymph vessel. Once there, they circulate through the body. The cells finally stop in capillaries — tiny blood vessels — at some distant location.

The cells then break through the wall of the blood vessel and attach to whatever tissue they find. They then need to multiply and grow new blood vessels to supply nutrients to the new tumor. Prostate cancer prefers to grow in specific areas, such as lymph nodes or in the ribs, pelvic bones, and spine.

Most cancer cells that break away form new tumors. Many don’t survive in the bloodstream. Some die at the site of the new tissue. Others may lie inactive for years or never become active.

Chances of Developing Metastatic Prostate Cancer

About 50% of men diagnosed with local prostate cancer will develop metastatic cancer during their lifetime. Finding cancer early and treating it can help reduce that rate.

A small percentage of men aren’t diagnosed with prostate cancer until it has become metastatic, either because they have no symptoms or the symptoms have been ignored. Doctors can tell it’s metastatic cancer by doing a biopsy of the tissue and studying the cells.

How Metastatic Prostate Cancer Is Found

If you’ve been diagnosed with prostate cancer, your doctor will order additional tests such as:

  • X-rays
  • CT scans
  • MRI scans

These tests may focus on your skeleton and abdominal and pelvic areas. That way doctors can check for signs of the cancer’s spread.

If you have symptoms such as bone pain and fractures for no reason, your doctor may order a bone scan. The bone scan can show if you have metastatic cancer in the bones.

Your doctor will also ask for blood tests, including a check of PSA levels, to look for other signs of the cancer’s progression.

PSA is a protein normally made by the prostate gland. It can be measured with a simple blood test. A rise in PSA is one of the first signs of the progression of prostate cancer. PSA levels can be high without there being cancer, such as if you have an enlarged prostate or a prostate infection.

But if you’ve been treated, especially if your prostate has been surgically removed, PSA levels should become undetectable. The presence of any PSA after surgery is a concern. Any rise in PSA after radiation or hormone treatment suggests the possibility of the cancer spreading. In that case, the doctor will order the same tests used to diagnose the original cancer, including a CT scan, MRI, or bone scan.

Though very rare, it’s possible to have metastatic prostate cancer without an elevated PSA. And it’s possible to have an elevated PSA without cancer.

The average length of time from original diagnosis to the discovery of metastatic cancer is eight years. If you have had prostate cancer, work with your doctor to determine your risk and determine a schedule for routine PSA checks.


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