Prostate Cancer, Advanced or Metastatic

Topic Overview

Is this topic for you?

This topic is about prostate cancer that has spread or come back after treatment. For information on early cancer of the prostate gland, see the topic Prostate Cancer.

What is prostate cancer?

Prostate cancer is a group of cells that grows faster than normal in a man's prostate gland. It can spread into other areas and kill normal tissue.

The prostate gland sits just below a man's bladder. It makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. It usually grows larger as you grow older.

The cancer may be one of these types:

• Locally advanced prostate cancer. This is cancer that has grown through the outer rim of the prostate and into nearby tissue.
• Metastatic prostate cancer. This is cancer that has spread, or metastasized, to the lymph nodes or other parts of the body.
• Recurrent prostate cancer. This is cancer that has come back after it was treated. The cancer can come back in the prostate, 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.

What causes prostate cancer?

Experts don't know what causes prostate cancer. But they believe that getting older and having a family history of prostate cancer raise your chance of getting it.

What are the symptoms?

Sometimes there are no symptoms of either locally advanced or metastatic prostate cancer.

When they do appear, symptoms of locally advanced prostate cancer include:

• Waking up many times during the night to urinate.
• Having trouble starting your urine stream, having a weaker-than-normal stream, or not being able to urinate at all.
• Having pain or a burning feeling when you urinate.
• Having blood in your urine.
• Having a deep pain or stiffness in your lower back, upper thighs, or hips.

Symptoms of metastatic prostate cancer may include:

• Bone pain.
• Weight loss.
• Swelling in your legs and feet.

How is prostate cancer diagnosed?

Your doctor will do a digital rectal exam, in which he or she puts a gloved, lubricated finger in your rectum to feel your prostate. You may also have a blood test called a prostate-specific antigen (PSA) test. These tests will help find out if you have prostate cancer or if your prostate cancer has come back.

Your doctor also may do a biopsy. In this test, your doctor takes a sample of tissue from your prostate gland or from the area where the cancer may have spread and sends the sample to a lab for testing. A biopsy is the only way to know for sure that you have prostate cancer.

If you have had prostate cancer before, your doctor may also order a bone scan, CT scan, or MRI to see if it has come back or spread.

Finding out that you have cancer can be scary. It may help to talk with your doctor or with other people who have had cancer. Your local American Cancer Society chapter can help you find a support group.

How is it treated?

Choosing treatment for prostate cancer can be confusing. Your choices depend on your overall health, how fast the cancer is growing, and how far it has spread.

Locally advanced prostate cancer may be treated with surgery, radiation therapy, or hormone therapy.

Treatment of metastatic cancer focuses on slowing the spread of the cancer and relieving symptoms, such as bone pain. It also can help you feel better and live longer. Treatment may include hormone therapy, radiation therapy, or chemotherapy.

Frequently Asked Questions

Learning about prostate cancer:	What is advanced prostate cancer? What is recurrent prostate cancer? What is metastatic prostate cancer? What causes prostate cancer? Can it be prevented? What are the symptoms? What increases my risk?
Being diagnosed:	How will my doctor diagnose prostate cancer? What does "stage" mean? What does "grade" mean? What is a prostate-specific antigen (PSA) test? What is a biopsy?
Getting treatment:	What type of treatment will I have? Which medicines are used to treat prostate cancer? What is radiation therapy? Will I need surgery? What are clinical trials?
Ongoing concerns:	What can I do about nausea and vomiting? Is cancer treatment painful?
Living with prostate cancer:	Are there steps I can take at home to manage my prostate cancer? How will prostate cancer affect my daily life?
End-of-life issues:	How can I prepare for end-of-life issues?

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Author:	Kathe Gallagher, MSW	Last Updated July 24, 2006
Medical Review:	Martin Gabica, MD - Family Medicine Christopher G. Wood, MD, FACS - Urology/Oncology
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