Metastatic Prostate Cancer

Metastatic prostate cancer means that the cancer has spread beyond the prostate to distant lymph nodes or organs, often to bones. If you have been diagnosed with metastatic prostate cancer, we are here for you with a community of support, direct assistance, and education.

African American man looking into camera

Metastasis—also referred to as “metastatic cancer”—is the medical term for cancer that has spread to a part of the body outside of where it originated. Metastatic prostate cancer or stage IV (4) prostate cancer generally refer to cancer that has spread beyond the lymph nodes and tissues immediately surrounding the prostate. It is often referred to as advanced prostate cancer. Prostate cancer most frequently spreads to the bones, liver, or lungs

While there is no cure for metastatic prostate cancer, there is hope to manage the disease effectively through new treatments. These new treatment options can help slow the disease progression and give you more time to live your best life.

Learn more about treatments for metastatic prostate cancer.

How and where prostate cancer spreads

Metastasis most commonly occurs when cancer cells break away from the main tumor and circulate through the body via the bloodstream or lymphatic system. These cancer cells can collect and grow in different parts of the body, forming metastases. Several factors influence the likelihood of metastasis in prostate cancer, including the cancer’s aggressiveness, indicated by its Gleason score or Grade Group, and the point at which treatment begins.

Theoretically, any cancer can spread to any part of the body. In reality, certain types of cancer tend to spread to specific places. Prostate cancer most commonly spreads to the bones, followed by the lymph nodes, lungs, liver, and brain. Regardless of where metastases form, the type of cancer remains the same. Prostate cancer that has metastasized to the bones is still prostate cancer, not bone cancer.

Bone metastasis

Many men experience bone related problems as a result of prostate cancer or its treatment. Among other things, the spread of the prostate cancer to the bones (bone metastases) can cause severe pain and fractures (bone breaks). Hormonal therapy for prostate cancer can also cause bone loss, fracture, and joint pain. All men are at risk for fractures as they age, and this risk is compounded when living with a prostate cancer diagnosis.

When prostate cancer spreads beyond the prostate to another organ, most frequently it spreads to the bone. Prostate cancer that spread to the bone is still considered prostate cancer. It is still treated with therapy for prostate cancer.

More than 60% of men with advanced prostate cancer will eventually develop bone metastases. The bones most commonly affected are the spine, hips, and ribs. Once prostate cancer has spread to the bone it can become painful, but treatments like pain medications or radiation therapy to those areas can dramatically reduce pain and improve quality of life.

Making a treatment plan for bone metastasis

When making a treatment plan, it is important to include strategies to maintain good bone health. There are several treatments available to strengthen bones and manage spread and pain. Below is more information on these treatment options: 

Bone loss from prostate cancer treatment

Testosterone, the male sex hormone, fuels the growth of prostate cancer but it also is crucial to bone health. Treatment of prostate cancer with hormone therapy, also called androgen deprivation therapy (ADT), blocks the production of testosterone which stops or slows the growth of the cancer. Without testosterone, bones can become weak and break more easily.

When a man is on ADT, recovery from a bone fracture takes longer than for other men. It is especially important for patients taking ADT to speak with their doctor about how to plan for and manage the bone loss before a problem arises. Bone strength can also be decreased as a result of radiation and chemotherapy used to treat prostate cancer.

Fortunately, there are ways to strengthen and repair your bones including medicines and lifestyle changes. See below on some opportunities to help with bone loss.

  • Bisphosphonates can prevent the thinning of the bone and help make them stronger
    • Oral bisphosphonates include Fosamax (alendronate) and Actonel (risendronate)
    • The intravenous bisphosphonate is Zometa (zolendronic acid)
  • Strive for a healthy diet and make sure to get enough calcium and vitamin D
  • When exercising, include weight bearing and muscle strengthening exercises
  • Avoid tobacco and excessive alcohol