Metastatic Prostate Cancer: Symptoms, Treatment

Prostate cancer is metastatic if it has spread to distance tissue and organs. Prostate cancer often spreads to the bones, lymph nodes, liver, and lungs and rarely moves to other organs.

A range of therapeutic options including hormone ablation, chemotherapy, autologous immunotherapy, and radiation therapies are offered to affected patients and show marginal benefits.

Despite sharing cancer cells with the original prostate tumor, metastatic prostate cancer is resistant to conventional treatments, posing questions about its chances of spreading and responding to therapies. Unfortunately, there is currently no cure for metastatic prostate cancer post-radical treatment or hormone ablation therapy.

To address the challenges of prostate cancer spreading, patients and healthcare providers may consider exploring natural supplements and lifestyle changes. Preliminary studies suggest potential benefits from pomegranate, lycopene, and Omega-3 fatty acids in managing prostate health, aiming to halt or slow the progression of prostate cancer.

Understanding the signs and sites of prostate cancer metastasis is essential for effective management. While current therapies offer limited benefits, research on natural interventions continues, emphasizing the need for further exploration into their efficacy.

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Prostate Cancer Spreading Illustration

Metastatic prostate cancer, marked by the spread of cancer to distant tissues and organs such as bones, lymph nodes, liver, and lungs, poses significant challenges. Understanding the selective spread remains crucial, and exploring mechanisms may hold the key to prevention.

metastatic prostate cancer
Prostate cancer is metastatic if it has spread to distance tissue and organs.

How is metastatic prostate cancer diagnosed?

Prostate Biopsy

A prostate biopsy is required to confirm the presence of and determine the aggressiveness of the cancer cells. The pathologist will give a Gleason score to your prostate cancer.

High scores above eight indicate aggressive cancer that is likely to spread to other organs.

Further, recent advancement in cancer detection and monitoring makes it possible to use genetic tests to determine the risk of your prostate cancer spreading quickly more accurately.  

Additional Tests

Once the prostate cancer stage has been determined, your doctor works to assess the presence of metastasis. If your medical team suspects your cancer has spread to other organs, they will offer you additional tests like;

•    Bone scan 

•    Computerized (CT) or positron emission (PET) tomography scans 

•    Ultrasound 

Getting these scans will depend on individual cases, and your medical provider will help you determine the best scan.

Treatments for metastatic prostate cancer

Localized prostate cancer typically undergoes radical prostatectomy or radiation therapy. However, the progression to locally advanced or metastatic stages often necessitates hormone or radiation therapy.

Hormone Therapy and its Challenges

Hormone therapy, reducing androgen levels to inhibit prostate cancer cell growth, may be coupled with external beam radiation therapy for advanced disease post-chemical or surgical castration. However, the emergence of metastatic castration-resistant prostate cancer (CRPC) remains a challenge, with patients often requiring second-line therapies like anti-androgens (enzalutamide) and CYP17 inhibitors, each with distinct side effects requiring careful management.

Chemotherapy and Emerging Therapies

Chemotherapeutic agents like docetaxel and cabazitaxel offer limited benefits in metastatic CRPC, emphasizing the ongoing pursuit of less toxic options. Sipuleucel-T, a personalized immune therapy, shows modest improvements in overall survival, while radium-223 dichloride and zoledronic acid address bone metastasis but with specific limitations.

Towards Novel Approaches

With limitations and side effects inherent in current therapies, there is a growing emphasis on identifying novel natural therapies for metastatic prostate cancer. The need for continued research and innovative treatment options is underscored by the challenges presented by the adaptation of prostate cancer cells to low androgen levels, leading to the development of metastatic CRPC.

Symptoms of metastatic prostate cancer

The progression of prostate cancer to advanced metastatic disease can cause many health problems depending on the site and how quickly the cancer is spreading.

Localized Cancer Spread Signs

  • urinary problems such as urinary retention and associated infection.
  • Further, bowel problems often develop when prostate cancer spreads to the bowel and rectum. Complications like constipation and diarrhea can reduce your quality of life.   

Signs of Prostate Cancer spreads to bones and lymph nodes

Beyond local metastases, prostate cancer often spreads to the bones, lymph nodes, liver, brain, and lungs. Men with metastatic castration-resistant prostate cancer have an increased risk of distant metastasis, which is associated with debilitating complications.

Bone metastasis and Bone Marrow

This accounts for 85% of metastasis sites. The bone matrix is a very common target organ. It attracts cancer cells as a blood and nutrient-rich area where they can easily thrive.

Significant pain and increased risk of fracture are common because cancer cells weaken the bone.

The bone marrow is the production house of blood cells; thus, the spread of prostate cancer cells to the bone marrow can reduce oxygen-carrying red blood cells (Anaemia).


Excessive calcium in the blood can also develop following bone metastasis, leading to vomiting, dehydration, and loss of appetite. 

Cancer-associated anemia

Cancer-associated anemia can cause fatigue, breathing complications, and in severe cases, organ failure due to lack of oxygen. 

Some of these complications can also occur when prostate cancer spreads to the liver, while the complications associated with lung metastasis are commonly confounded with other factors.

Spread of Prostate Cancer to Lymph Nodes

Finally, the spread of prostate cancer to lymph nodes not only increases the risk of further spread to other organs but can also block the transport of lymph and cause swelling. 

When to go to doctors 

Common Symptoms

In many patients, early-stage prostate cancer presents with no symptoms and are only identified through PSA informed tests. For men with symptoms, this will usually include;

•   Frequent urination

•   Blood in either urine or seminal fluid 

•  Erectile dysfunction 

•    Sitting discomfort caused by an enlarged prostate

Though other non-cancerous conditions such as enlarged prostate and prostate inflammation can cause similar symptoms, it is better to get checked by your doctor if you experience the above symptoms.

These conditions are also linked with prostate cancer development, requiring you to treat them to avoid further complications.

Rare Cases Symptoms

In rare cases, patients will have advanced prostate cancer which may have symptoms of metastatic prostate cancer including;

•    Swelling in the legs

•    Weight loss and fatigue 

•    Bowel problems

It is important to note that some therapies for managing prostate cancer can cause these symptoms.

For instance, Zoledronic acid used to treat high blood calcium, and bone breakdown can also cause diarrhea and fatigue. You should speak to your doctor about your symptoms.

How important is it to catch metastatic prostate cancer early?

It is important to consult with your doctor if you experience any of these changes mentioned above.

This will help your doctor detect prostate cancer early and stop it from developing to advanced lethal disease.

Early cancer detection is central to the management of all cancers, including prostate cancer.

Currently, the treatment goal of advanced and metastatic prostate cancer is to slow cancer growth and spread.

In the absence of a definitive cure, it is critical to detect metastatic prostate cancer early to increase the usefulness of current management approaches.

Supplements and lifestyle changes may help you enhance the effectiveness of those therapies. 

Best supplements to treat metastatic prostate cancer

Several natural supplements, including lycopene, pomegranate, omega-3 fatty acids, and green tea have shown anti-metastatic properties and promising results in clinical trials.

Plant phenolic compounds can help you fight prostate cancer and help slowing down the development of metastasis. (Dagogo-Jack and Shaw, 2018).

1.    Lycopene

Anti-Cancer Properties: Lycopene demonstrates significant anti-cancer activity, reducing the risk of various cancers, including skin, breast, lung, prostate, and liver cancers. This is achieved through the reduction of oxidative stress and inflammation (Coates et al., 2004; Khan et al., 2008).

Modulation of Disease Progression: Studies on advanced prostate cancer reveal that lycopene effectively modulates markers associated with disease progression and recurrence.

Inhibition of Tumor Growth: Pre-clinical trials on mice with androgen-independent metastatic prostate cancer cells demonstrate that lycopene can decrease tumor growth, showcasing its potential in treating metastatic prostate cancer (Tang et al., 2011; Yang et al., 2011, 2012).

Cell Adhesion Enhancement: Lycopene metabolites released during breakdown enhance cell adhesion, promoting attachment and communication between cells. This mechanism is crucial in preventing metastatic prostate cancer cells from detaching and invading distant organs (Mein et al., 2008).

Anti-Migratory Effect: Lycopene’s anti-migratory effect, combined with its antioxidant properties, may aid in combating metastatic prostate cancer, offering better outcomes for individuals with localized prostate cancer compared to those with advanced disease.

PSA Level Reduction: Clinical trials, including a phase II trial, demonstrate that lycopene supplementation can reduce prostate-specific antigen (PSA) levels in men with prostate cancer. This reduction in PSA levels suggests potential benefits in fighting metastatic prostate cancer (Zhang et al., 2014; Barber et al., 2006; Kucuk et al., 2002).

Combination Therapy Potential: Combining lycopene supplementation with radical treatment, such as orchiectomy, shows promising results in reducing PSA levels and primary and secondary tumors in patients with metastatic prostate cancer (Ansari and Gupta, 2003).

Dosage Consideration: Studies emphasize the importance of considering patient heterogeneity and lycopene dosage, with variations in clinical benefits observed at different doses (Schwenke et al., 2009; Bunker et al., 2007; Gann et al., 2015).

Markers Modulation: The available evidence from pre-clinical and clinical trials indicates that lycopene supplementation can effectively modulate markers associated with metastatic prostate cancer, potentially reducing the risk of its development.

Personalized Cancer Prevention: While further trials are needed to address dosage discrepancies, the collective findings suggest that incorporating lycopene into supplementation regimens can be beneficial in personalized cancer prevention strategies.

For more information on prostate supplements, click here.

2.    Pomegranate

Anti-Oxidant and Anti-Cancer Activities: Pomegranate fruit is rich in bioactive polyphenolic ellagitannins, exhibiting potent anti-oxidant and anti-cancer properties (Coates et al., 2004; Khan et al., 2008).

Inhibition of Prostate Cancer Growth: Phenolic compounds derived from pomegranate inhibit the growth of prostate cancer cells, similar to lycopene (Gasmi and Sanderson, 2010).

Testosterone-Stimulated Cell Inhibition: Pomegranate extract effectively kills testosterone-stimulated prostate cancer cells and induces cell-cycle arrest in various prostate cancer cells (Koyama et al., 2010; Turrini et al., 2015).

Modulation of Metastasis: Pomegranate extract can modulate key aspects of cancer metastasis, impacting cell adhesion and the epithelial-to-mesenchymal transition (Rocha et al., 2012).

Reduction of Inflammatory Mediators: Globally, pomegranate extracts reduce pro-inflammatory mediators, potentially inhibiting the establishment of new metastatic niches.

Inhibition of Cell Migration and Invasiveness: Studies demonstrate that pomegranate juice significantly reduces the migratory and invasive properties of prostate cancer cells, achieved by reducing an enzyme crucial for prostaglandin production (Lansky et al., 2005; Kessenbrock et al., 2010).

Increased PSA doubling time: Clinical trials involving pomegranate juice show a significant increase in the doubling time of prostate-specific antigen (PSA), indicating a potential slowdown in prostate cancer progression (Pantuck et al., 2005).

Slowing PSA Increase in Recurrent Prostate Cancer: Recent randomized trials of multicomponent food supplements containing pomegranate extract show a slowing of PSA increase in men experiencing prostate cancer recurrence (Paller et al., 2017).

Clinical Benefits Without Adverse Effects: Extract/juice of pomegranate demonstrates clinical benefits, such as increased PSA doubling time, without inducing adverse effects in patients with rising PSA and no metastases (Paller et al., 2013).

3.  Multicomponent dietary supplements

Various studies have explored the potential benefits of multi-component supplements, incorporating plant-based ingredients, in potentially slowing the progression of prostate cancer to a more advanced stage.

For instance, a placebo-controlled and randomized trial assigned 199 men with localized prostate cancer to either a food supplement containing pomegranate, green tea, broccoli, and turmeric or placebo control for 6 months (Thomas et al., 2014).

The study reported a significant reduction in PSA in the food supplement group compared to the placebo.

These ingredients were derived from raw and dried plant materials and cause no adverse events.

Similarly, a mixed daily supplementation with 35 mg lycopene, 55 ug selenium, and 600 mg green tea catechins showed some clinical benefits, albeit to a lesser extent (Gontero et al., 2015).

What are some supplements that can help you prevent prostate cancer? 

Though genetic/epigenetic changes can influence the development and progression of prostate cancer, diet and nutrition are very important in the development of many cancers.

Inadequate levels of important antioxidants and dysfunctions in the body’s detoxification systems can increase your risk of developing prostate cancer. 

In addition to lycopene and pomegranate, other supplements like Vitamin D and Omega-3 fatty acids can reduce your risk of developing prostate cancer.

Vitamin D has been shown to reduce the risk of prostate cancer development and progression by reducing oxidative stress and inflammation (Posadzki et al., 2013).

Similarly, polyunsaturated Omega-3 fatty acids can reduce oxidative stress and inflammation (Berquin et al., 2007), reducing the risk of prostate cancer development.

These supplements not only protect you from prostate cancer but also cancers occurring in other organs.


The causes of prostate cancer remain largely unknown, making it difficult to prevent its development. However, diet, supplements, and physical activity are natural ways to reduce your risk.

It’s important to note that a diet high in red meat and dairy products may increase the risk of prostate cancer, while incorporating tomato products and fatty fish into your diet may have a potential protective effect.

The accumulating evidence suggests that you can use lifestyle changes to modify the risk of prostate cancer. 

Specifically, high body mass index (BMI) is strongly associated with cancer development and progression. Prostate cancer patients with high BMI are more likely to progress to lethal/metastatic prostate cancer independent of clinical factors.

Consistently, a low-fat diet rich in fruit and vegetables can lower your risk of prostate cancer. Consider reducing your consumption of meat, oils, and dairy products.

For more information on the best prostate diet, click here.

Reducing your BMI can reduce your prostate cancer-specific mortality and recurrence by more than 20% (Cao and Ma, 2011). The importance of healthy BMI is highlighted in the observation that weight gain after a prostate cancer diagnosis is associated with poor patient outcome (Bonn et al., 2014).

An active lifestyle can positively modify key components of prostate cancer development, including oxidative stress, inflammation, and immune function.

Indeed, studies have consistently shown that an active lifestyle can reduce your risk of developing prostate cancer. Preventing prostate cancer development is perhaps the best way to prevent metastatic prostate cancer.

You should aim to maintain a healthy weekly activity level to reduce your risk of developing lethal prostate cancer.

Activities that increase your heart and respiratory rates such as cycling, jogging, and swimming can reduce your prostate cancer risk by up 65% compared to men with lower weekly activity (Kenfield et al., 2011). 

You can find information on natural products that can help you maintain a healthy prostate by reducing your risk of prostate inflammation at

Explore More

what are the signs that prostate cancer has spread

Signs That Prostate Cancer Has Spread.


  1. Ansari, M., Gupta, N., 2003. A comparison of lycopene and orchidectomy vs orchidectomy alone in the management of advanced prostate cancer. BJU international 92, 375–378.
  2. Astigueta, J., Abad, M., Morante, C., Pow-Sang, M., Destefano, V., Montes, J., 2010. Characteristics of metastatic prostate cancer occurring in patients under 50 years of age. Actas Urológicas Españolas (English Edition) 34, 327–332.
  3. Barber, N., Zhang, X., Zhu, G., Pramanik, R., Barber, J., Martin, F.L., Morris, J., Muir, G., 2006. Lycopene inhibits DNA synthesis in primary prostate epithelial cells in vitro and its administration is associated with a reduced prostate-specific antigen velocity in a phase II clinical study. Prostate cancer and prostatic diseases 9, 407.
  4. Berquin, I.M., Min, Y., Wu, R., Wu, J., Perry, D., Cline, J.M., Thomas, M.J., Thornburg, T., Kulik, G., Smith, A., 2007. Modulation of prostate cancer genetic risk by omega-3 and omega-6 fatty acids. The Journal of clinical investigation 117, 1866–1875.
  5. Birtle, A.J., Freeman, A., Masters, J.R., Payne, H.A., Harland, S.J., Contributors to the BAUS Section of Oncology Cancer Registry, 2003. Clinical features of patients who present with metastatic prostate carcinoma and serum prostate‐specific antigen (PSA) levels< 10 ng/mL: The “PSA negative” patients. Cancer 98, 2362–2367.
  6. Bonn, S.E., Wiklund, F., Sjölander, A., Szulkin, R., Stattin, P., Holmberg, E., Grönberg, H., Bälter, K., 2014. Body mass index and weight change in men with prostate cancer: progression and mortality. Cancer Causes & Control 25, 933–943.
  7. Bunker, C.H., McDonald, A.C., Evans, R.W., De La Rosa, N., Boumosleh, J.M., Patrick, A.L., 2007. A randomized trial of lycopene supplementation in Tobago men with high prostate cancer risk. Nutrition and cancer 57, 130–137.
  8. Cao, Y., Ma, J., 2011. Body mass index, prostate cancer–specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer prevention research 4, 486–501.
  9. Coates, P.M., Paul, M.C., Blackman, M., Blackman, M.R., Cragg, G.M., Levine, M., White, J.D., Moss, J., Levine, M.A., 2004. Encyclopedia of Dietary Supplements (Online). CRC press.
  10. da Silva, F.C., da Silva, F.M.C., Gonçalves, F., Santos, A., Kliment, J., Whelan, P., Oliver, T., Antoniou, N., Pastidis, S., Queimadelos, A.M., 2014. Locally advanced and metastatic prostate cancer treated with intermittent androgen monotherapy or maximal androgen blockade: results from a randomised phase 3 study by the South European Uroncological Group. European urology 66, 232–239.
  11. Dagogo-Jack, I., Shaw, A.T., 2018. Tumour heterogeneity and resistance to cancer therapies. Nature reviews Clinical oncology 15, 81.
  12. Gann, P.H., Deaton, R.J., Rueter, E.E., Van Breemen, R.B., Nonn, L., Macias, V., Han, M., Ananthanarayanan, V., 2015. A phase II randomized trial of lycopene-rich tomato extract among men with high-grade prostatic intraepithelial
  13. neoplasia. Nutrition and cancer 67, 1104–1112.
  14. Gasmi, J., Sanderson, J.T., 2010. Growth inhibitory, antiandrogenic, and pro-apoptotic effects of punicic acid in LNCaP human prostate cancer cells. Journal of agricultural and food chemistry 58, 12149–12156.
  15. Giovannucci, E., 2002. A review of epidemiologic studies of tomatoes, lycopene, and prostate cancer. Experimental biology and medicine 227, 852–859.
  16. Gontero P., Marra, G., Soria, F., Oderda, M., Zitella, A., Baratta, F., Chiorino, G., Gregnanin, I., Daniele, L., Cattel, L., 2015. A randomized double‐blind placebo controlled phase I–II study on clinical and molecular effects of dietary supplements in men with precancerous prostatic lesions. Chemoprevention or “chemopromotion”? The Prostate 75, 1177–1186.
  17. Kantoff, P.W., Schuetz, T.J., Blumenstein, B.A., Glode, L.M., Bilhartz, D.L., Wyand, M., Manson, K., Panicali, D.L., Laus, R., Schlom, J., 2010. Overall survival analysis of a phase II randomized controlled trial of a Poxviral-based PSA-targeted immunotherapy in metastatic castration-resistant prostate cancer. Journal of Clinical Oncology 28, 1099.
  18. Kenfield, S.A., Stampfer, M.J., Giovannucci, E., Chan, J.M., 2011. Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. Journal of Clinical Oncology 29, 726.
  19. Kessenbrock, K., Plaks, V., Werb, Z., 2010. Matrix metalloproteinases: regulators of the tumor microenvironment. Cell 141, 52–67.
  20. Khan, N., Afaq, F., Mukhtar, H., 2008. Cancer chemoprevention through dietary antioxidants: progress and promise. Antioxidants & redox signaling 10, 475–510.
  21. Koyama, S., Cobb, L.J., Mehta, H.H., Seeram, N.P., Heber, D., Pantuck, A.J., Cohen, P., 2010. Pomegranate extract induces apoptosis in human prostate cancer cells by modulation of the IGF–IGFBP axis. Growth Hormone & IGF Research 20, 55–62.
  22. Kucuk, O., Sarkar, F.H., Djuric, Z., Sakr, W., Pollak, M.N., Khachik, F., Banerjee, M., Bertram, J.S., Wood Jr, D.P., 2002. Effects of lycopene supplementation in patients with localized prostate cancer. Experimental Biology and Medicine 227, 881–885.
  23. Lansky, E.P., Jiang, W., Mo, H., Bravo, L., Froom, P., Yu, W., Harris, N.M., Neeman, I., Campbell, M.J., 2005. Possible synergistic prostate cancer suppression by anatomically discrete pomegranate fractions. Investigational new drugs 23, 11–20.
  24. Mein, J.R., Lian, F., Wang, X.-D., 2008. Biological activity of lycopene metabolites: implications for cancer prevention. Nutrition reviews 66, 667–683.
  25. Paller, C., Ye, X., Wozniak, P., Gillespie, B., Sieber, P., Greengold, R., Stockton, B., Hertzman, B., Efros, M., Roper, R., 2013. A randomized phase II study of pomegranate extract for men with rising PSA following initial therapy for localized prostate cancer. Prostate cancer and prostatic diseases 16, 50.
  26. Paller, C.J., Pantuck, A., Carducci, M.A., 2017. A review of pomegranate in prostate cancer. Prostate cancer and prostatic diseases 20, 265.
  27. Pantuck, A.J., Leppert, J.T., Zomorodian, N., Seeram, N., Seiler, D., Liker, H., Wang, H., Elashoff, R., Heber, D., Belldegrun, A.S., 2005. 831: Phase II Study of Pomegranate Juice for Men with Rising PSA following Surgery or Radiation for Prostate Cancer. The Journal of Urology.
  28. Posadzki, P., Lee, M.S., Onakpoya, I., Lee, H.W., Ko, B.S., Ernst, E., 2013. Dietary supplements and prostate cancer: a systematic review of double-blind, placebo-controlled randomised clinical trials. Maturitas 75, 125–130.
  29. Rocha, A., Wang, L., Penichet, M., Martins-Green, M., 2012. Pomegranate juice and specific components inhibit cell and molecular processes critical for metastasis of breast cancer. Breast Cancer Research and Treatment 136, 647–658.
  30. Saad, F., Gleason, D.M., Murray, R., Tchekmedyian, S., Venner, P., Lacombe, L., Chin, J.L., Vinholes, J.J., Goas, J.A., Zheng, M., 2004. Long-term efficacy of zoledronic acid for the prevention of skeletal complications in patients with metastatic hormone-refractory prostate cancer. Journal of the National Cancer Institute 96, 879–882.
  31. Schwenke, C., Ubrig, B., Thürmann, P., Eggersmann, C., Roth, S., 2009. Lycopene for advanced hormone refractory prostate cancer: a prospective, open phase II pilot study. The Journal of urology 181, 1098–1103.
  32. Tang, Y., Parmakhtiar, B., Simoneau, A.R., Xie, J., Fruehauf, J., Lilly, M., Zi, X., 2011. Lycopene enhances docetaxel’s effect in castration-resistant prostate cancer associated with insulin-like growth factor I receptor levels. Neoplasia 13, 108–119.
  33. Thomas, R., Williams, M., Sharma, H., Chaudry, A., Bellamy, P., 2014. A double-blind, placebo-controlled randomised trial evaluating the effect of a polyphenol-rich whole food supplement on PSA progression in men with prostate cancer—the UK NCRN Pomi-T study. Prostate cancer and prostatic diseases 17, 180.
  34. Turrini, E., Ferruzzi, L., Fimognari, C., 2015. Potential effects of pomegranate polyphenols in cancer prevention and therapy. Oxidative medicine and cellular longevity 2015.
  35. Yang, C., Yen, Y., Huang, C., Hu, M., 2011. Growth inhibitory efficacy of lycopene and β‐carotene against androgen‐independent prostate tumor cells xenografted in nude mice. Molecular nutrition & food research 55, 606–612.
  36. Yang, C.-M., Lu, Y.-L., Chen, H.-Y., Hu, M.-L., 2012. Lycopene and the LXRα agonist T0901317 synergistically inhibit the proliferation of androgen-independent prostate cancer cells via the PPARγ-LXRα-ABCA1 pathway. The Journal of nutritional biochemistry 23, 1155–1162.
  37. Zhang, X., Yang, Y., Wang, Q., 2014. Lycopene can reduce prostate-specific antigen velocity in a phase II clinical study in Chinese population. Chinese medical journal 127, 2143–2146.

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