Signs That Prostate Cancer Has Spread

Prostate cancer ranks as one of the most frequently diagnosed malignancies in men worldwide.

The incidence and mortality rates of prostate cancer are known to increase significantly with advancing age.

The average age for a diagnosis of this cancer is typically around 66 years, but it can be diagnosed in men of various age groups.

In the early stages, prostate cancer can be asymptomatic for some individuals or may cause minimal symptoms that, in some cases, may not necessitate immediate treatment.

However, one of the most common symptoms is urinary issues, such as nocturia and increased frequency, though it’s not the only potential sign.

Approximately 50% of men with localized prostate cancer have the potential to develop metastatic cancer. Detecting and treating it early can significantly reduce this risk.

Here, you can find out the metastatic prostate cancer symptoms, signs that prostate cancer has spread, including why and where it spreads.

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Types of 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

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 prostate cancer

Metastatic cancer, in contrast, spreads to distant parts of the body, including the bones and lymph nodes. While prostate cancer often has a slow growth rate, metastatic cases can sometimes be more aggressive.

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. Therefore, prostate cancer in lymph nodes might take years to be

Is prostate cancer aggressive? 

Prostate cancer is often manageable when diagnosed and treated early, leading to successful outcomes in nearly 80% of cases. 1 in 5 patients could have a more aggressive form of prostate cancer.

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What are the signs that prostate cancer has spread?

When it comes to advanced prostate cancer, it can cause signs such as:

  • Blood in the semen
  • Blood in the urine
  • Reduced urine stream
  • Trouble urinating
  • Erectile dysfunction
  • Bone pain
  • Back pain
  • Swelling and pain around the affected area
  • Weight loss (without trying)

Symptoms of prostate cancer spread to the lymph nodes

  • Enlarged Lymph Nodes (Lymphadenopathy): typically in the pelvic area. These swollen nodes can often be felt during a physical examination.
  • Pain around pelvic area
  • Leg Swelling (Edema): Lymphatic blockage can lead to fluid accumulation in the legs, resulting in swelling and discomfort. This is known as lymphedema.

Symptoms of metastasized prostate cancer spread to the liver

  • Itchy skin
  • Jaundice
  • Swollen tummy
  • Weight loss
  • Poor appetite
  • Feeling sick
  • Abdominal pain and discomfort

Symptoms of advanced prostate cancer spread to the lungs:

  • Coughing up blood
  • Persistent chest infection
  • Trouble breathing
  • Cough that doesn’t subside

Symptoms of prostate cancer spread to the bladder:

  • Blood in semen or urine
  • Trouble passing urine
  • Getting up in the middle of the night to urinate
  • Frequent urination

Symptoms of prostate cancer spread to the bowel:

  • Stomach pain
  • Constipation
  • Blood in poo

Why does prostate cancer spread?

The factors leading to the spread of prostate cancer can vary, and there is no single, universal cause. Prostate cancer can metastasize for various reasons. 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.

Late diagnosis or Inadequate Initial Treatment

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.

Increased Risk in Advanced Stages

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.

In some cases, the spread of prostate cancer can be linked to the failure of initial treatment. However, it’s essential to acknowledge that disease progression can occur despite efficient initial treatment.

Recurrence and Rapid Progression

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.

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.

Unexpected Growth

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.

Spreading of prostate cancer can happen suddenly and unexpectedly. In most cases, cancer that affects the prostate gland grows very slowly.

Timely Diagnosis and Treatment

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.

Other Risk Factors

In addition to the factors mentioned, other potential risk factors associated with prostate cancer spreading may 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

The behavior of metastatic prostate cancer can vary from one patient to another. Although prostate cancer typically grows slowly, metastatic cases may exhibit different characteristics. 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 essential to understand that when prostate cancer spreads, cancerous cells may either form tumors in different areas of the body or exist as isolated cells. 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. 

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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 prognosis for prostate cancer that has metastasized depends on factors such as the location of the metastasis, the rate of progression, and the patient’s overall health. Survival rates can vary widely.

General risk assessment tools provide the following guidelines for the mean survival period for prostate cancer metastasis:

  • Spread to lymph nodes: For example, when prostate cancer spreads to lymph nodes, the mean survival period is estimated to be around 32 months, but individual outcomes may differ.
  • Spread to the bones: 21 months
  • Cancer spread to the liver: 14 months
  • Spread to the lungs: 19 months

Prevention 

The primary risk lies in leaving prostate cancer untreated, which increases the likelihood of disease progression and metastasis. 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. 

Modifying your diet and incorporating a suitable exercise routine may contribute to better prostate cancer management. However, these lifestyle changes should complement medical treatment rather than replace it.

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. 

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Conclusion

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.

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Sources

  1. Rawla P. Epidemiology of Prostate Cancer. World J Oncol. 2019.
  2. Rosario E, Rosario DJ. Localized Prostate Cancer. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. 
  3. Ornish D, Weidner G, Fair WR, Marlin R, Pettengill EB, Raisin CJ, Dunn-Emke S, Crutchfield L, Jacobs FN, Barnard RJ, Aronson WJ, McCormac P, McKnight DJ, Fein JD, Dnistrian AM, Weinstein J, Ngo TH, Mendell NR, Carroll PR. Intensive lifestyle changes may affect the progression of prostate cancer. J Urol. 2005. 

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