Advanced or metastatic prostate cancer means the cancer has spread beyond the prostate gland to other parts of the body. It’s still prostate cancer because the cancer cells started in the prostate — they just moved elsewhere.

Here’s a simple breakdown

Definition

• Advanced prostate cancer: The cancer has grown outside the prostate into nearby tissues (like the seminal vesicles, bladder, or rectum).

• Metastatic prostate cancer: The cancer has spread to distant sites through the bloodstream or lymphatic system — most commonly to:

  • Bones (hips, spine, ribs)

  • Lymph nodes

  • Less often: lungs, liver, or other organs

How It Happens

Prostate cancer cells can break away from the primary tumor, travel through blood or lymph, and form new tumors (metastases) elsewhere in the body.

Even though it spreads, the cancer cells still look and act like prostate cancer cells — not like bone or liver cancer.

Common Symptoms

• Bone pain (especially in back, hips, or ribs)

• Fatigue or weakness

• Unexplained weight loss

• Swelling in legs (if lymph nodes are blocked)

• Urinary symptoms (if the prostate or bladder area is affected)

Treatment Goals

At this stage, treatment usually focuses on:

• Slowing or stopping cancer growth

• Managing symptoms

• Improving quality of life

Main Treatment Options

1. Hormone Therapy (Androgen Deprivation Therapy, ADT)
   → Lowers or blocks testosterone, which fuels cancer growth.

2. Chemotherapy (e.g., docetaxel, cabazitaxel)
   → Kills rapidly dividing cancer cells.

3. Next-Generation Hormone Blockers
   → e.g., enzalutamide, abiraterone — used when cancer resists standard hormone therapy.

4. Targeted Therapy
   → For genetic mutations (e.g., PARP inhibitors for BRCA1/2).

5. Immunotherapy
   → Helps the immune system recognize and attack cancer (e.g., sipuleucel-T).

6. Radiation Therapy
   → To relieve pain or treat bone metastases.

7. Bone-Strengthening Drugs
   → e.g., zoledronic acid or denosumab — reduce fracture risk and bone pain.

Prognosis

• Metastatic prostate cancer isn’t usually curable, but it can often be controlled for years.

• Modern treatments can slow progression, reduce symptoms, and extend life expectancy significantly.