Prostate cancer is the 2nd most frequent malignancy in men around the globe.
The mortality and incidence rates of prostate carcinoma increase with age.
The average age of getting diagnosed with this cancer is 66 years.
At early stages, prostate carcinoma can be asymptomatic. Or it might cause minimal symptoms that may not require treatment.
But, the most frequent complaint is trouble with urination, including nocturia and increased frequency.
Around 50% of men with local prostate cancer can get metastatic cancer. Finding the carcinoma sooner and treating it early on could decrease that rate.
Here, you can find out the signs that prostate cancer has spread, including why and where it spreads.
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What is prostate cancer?
Prostate cancer is a disease in men. Roughly 1.2 million cases were recorded in 2018, making it the 2nd most frequently diagnosed carcinoma in men worldwide. It is also the most prevalent cancer in men older than 55.
This type of carcinoma happens in the prostate. The prostate is a small gland that is the shape of a walnut.
It is responsible for creating seminal fluid to transport and nourish the sperm. In clinical practice, prostate carcinoma is categorized as:
- Localized prostate cancer
- Locally advanced prostate cancer
- Metastatic cancer
Localized prostate cancer
Localized prostate cancer is the one that remains in the prostate and hasn’t spread to other areas of the body. It is also referred to as organ-confined prostate cancer, early prostate cancer, or stage T1 or T2 prostate carcinoma.
Locally advanced prostate cancer
Locally advanced prostate cancer is the one that has begun to escape from the prostate and affects the spot just outside the prostate.
Around 84% of prostate carcinomas are found when the ailment is in only the prostate or nearby organs. This is known as regional prostate cancer or local stage.
Metastatic cancer, on the other hand, spreads to distant parts of the body. This is advanced metastatic prostate cancer that often spreads to the bones, lymph nodes, or other areas. In many cases, the prostate cancer growth rate is very slow.
This means it can take years for experts to detect the presence of cancer. And it can take longer than that for prostate cancer disease to metastasize.
Is prostate cancer aggressive?
Prostate cancer typically does not spread. Almost 80% of prostate carcinoma cases are diagnosed early and cured with proper treatment strategies. But, 1 in 5 patients could have more aggressive prostate cancer symptoms.
What are the signs that prostate cancer has spread?
Prostate carcinoma might cause no symptoms in its early stages. When it is more advanced, it can cause signs such as:
- Blood in the semen
- Blood in the urine
- Reduced urine stream
- Trouble urinating
- Erectile dysfunction
- Bone pain
- Swelling and pain around the affected area
- Weight loss (without trying)
If the metastasized prostate cancer has spread to the liver, it can cause the following signs:
- Itchy skin
- Swollen tummy
- Weight loss
- Poor appetite
- Feeling sick
- Abdominal pain and discomfort
If the lungs are affected, the metastatic prostate cancer symptoms can include:
- Coughing up blood
- Persistent chest infection
- Trouble breathing
- Cough that doesn’t subside
In cases where the area near the bladder is affected, the aggressive cancer symptoms could include:
- Blood in semen or urine
- Trouble passing urine
- Getting up in the middle of the night to urinate
- Frequent urination
In case of a prostate metastasis in the bowel, patients can experience:
- Stomach pain
- Blood in poo
Why does prostate cancer spread?
There is not a fixed reason that accounts for every scenario where prostate cancer starts to spread. Prostate cancer with metastasis can happen for different reasons.
It is important to ensure you understand possible reasons for the spreading of prostate cancer, as this can help you be more aware of your own risks.
Prostate cancer typically does not spread during the earlier stages. In fact, if your prostate cancer is detected early on, the treatments you get will usually produce highly effective results.
When treatment does not work, or you get a diagnosis at some of the more advanced prostate cancer stages, then the risk of spreading becomes much more significant.
One potential cause behind a case where prostate cancer spreads is the failure to provide efficient initial treatment for the cancerous disease.
Early treatment often includes the use of either surgical procedures or radiation therapy. Sometimes, these treatments provide positive results, but a small amount of the cancerous cells still survive.
In this case, a chemical recurrence can occur. This refers to the small number of cancerous cells causing a recurrence of the disease.
In this case, the patient may not notice the recurrence early on, which increases the risk of the cancerous cells spreading to the bones and other parts of the body.
Sometimes, the spreading of prostate cancer happens suddenly and unexpectedly. In most cases, cancer that affects the prostate gland grows very slowly.
At a very early stage, the doctor may not think it is necessary to implement treatment right away. This means the use of radiation or surgery is avoided, and the progress of the cancer is closely monitored.
You need to visit the doctor regularly in these cases to ensure they can watch for developments in cancer.
Sometimes, cancer may start to grow rapidly between two appointments, which is generally unexpected due to the findings of the previous appointment with the doctor. In this case, there is also a risk of cancer spreading to other parts of your body.
Apart from these, other potential factors that increase the risk of prostate cancer spreading include:
- A late diagnosis may already include the spreading of cancer to bone tissue in the surrounding area, as well as other parts of the body.
- When the patient does not fully comply with their treatment plan, it also raises the risk of prostate cancer spreading. For example, even missing just a single appointment for radiation therapy can increase this risk.
Where does prostate cancer spread?
The advanced prostate cancer symptoms will vary based on where the carcinoma has spread. It can spread to the lungs, liver, bones, and lymph nodes. A big tumor in the prostate gland could press on areas close to the prostate, such as the urethra or back passage.
When the patient has prostate cancer, it begins with errors in the DNA of normal cells within this gland. According to research institutes, this leads to the development of different prostate gland tumors.
These tumors can be different in terms of genetics, and some of them can have the ability to spread. Cells can then break away from the tumor and spread toward other parts of the body.
Locally advanced prostate cancer generally occurs when cancerous cells spread toward surrounding tissue. This happens when prostate cancer advances to the stage where cells start to break off the tumor that formed.
Patients can consider a prostate cancer progression timeline to see the risks of prostate cancer growth and spreading to certain areas in their bodies.
What to expect if prostate cancer spreads
Metastatic cancer from the prostate can be different for every patient. In most cases, prostate cancer is slowly growing. The patient may not expect the prostate cancer severity to increase when test results show a slow growth rate and stability.
It is, however, important to understand what to expect in a case where prostate cancer progression results in metastasis.
It is important to note that when prostate cancer spreads, the cancerous cells may start to develop tumors in various areas of the body. This means what you should expect largely depends on where the cancerous cells start to form new tumors.
If cancer spreads to nearby tissue, you may experience problems with bladder function. Problems with the bladder can lead to stress urinary incontinence and similar issues. Some men also complain about erection problems when the tumor affects surrounding tissues. In cases where cancer spreads toward the lungs, the patient may experience trouble breathing and pain in the chest. Prostate cancer weight loss is also relatively common among patients with metastasis. The weight loss can have a sudden onset, and the patient may lose excessive weight in just a short period.
What is the prognosis of prostate cancer that has spread?
The prognosis largely depends on where the cancer spreads and the severity. Doctors will use certain screening guidelines and may also conduct a digital rectal exam. This can help to determine the disease progression.
Individuals with aggressive prostate cancer may experience a faster spreading and progression of the disease. Prostate cancer in late stages also may have a poor prognosis compared to early detection and treatment procedures.
The mean survival rate for prostate metastasis depends on where the cancerous cells spread toward, as well as the progression rate and how long it takes the patient to reach end-stage prostate cancer.
General risk assessment tools provide the following guidelines for the mean survival period for prostate cancer metastasis:
- Spread to lymph nodes: 32 months
- Spread to the bones: 21 months
- Cancer spread to the liver: 14 months
- Spread to the lungs: 19 months
The major risk comes into play with untreated prostate cancer. The patient needs to ensure they adhere to their doctor visits once prostate cancer is diagnosed.
It is also important to get regular checkups at a doctor, especially since prostate cancer often does not produce early symptoms. This can help to ensure the disease is diagnosed before the cancer advances.
Research studies have also shown positive effects from certain lifestyle changes in patients who are diagnosed with prostate cancer.
This could potentially reduce the risk of prostate cancer advancing to the point where it starts to spread. In addition to these, patients should also ensure they opt for the appropriate type of treatment in a timely manner.
Prostate cancer is usually successfully treated when diagnosed at an early stage, but there are cases where some of the cells still survive. In these situations, and with a late diagnosis, the patient has a risk of prostate cancer metastasis. This is when the cancerous cells start spreading toward other body parts.
It is important to realize the signs that signal prostate cancer is spreading or has spread, as an early diagnosis and treatment can yield more successful results.