Prostate Cancer Metastases (Spread)

What is prostate cancer?

Prostate cancer is the abnormal growth of cells in a man's prostate gland. The prostate gland is part of the reproductive system of men. It is the size and shape of a walnut. It is located below the bladder and in front of the rectum. The prostate surrounds the upper part of the urethra. (The urethra is the tube that carries urine from the bladder and through the penis.) The prostate makes the fluid that nourishes sperm and passes out of the penis during orgasm.

How does prostate cancer metastasis occur?

In metastatic prostate cancer, the tumor has spread (metastasized) from the prostate gland to other parts of the body. This means that the tumor in the prostate sheds cancer cells that travel through the bloodstream and lymph system and lodge in other parts of the body (usually the bones). There they begin to grow new tumors.

The cause of prostate cancer is not known.

What are the symptoms?

Metastatic prostate cancer may have no symptoms. The most common symptom of spread of prostate cancer is bone pain, especially in the lower back and pelvis.

How is it diagnosed?

Your healthcare provider will review your symptoms and examine you. You will have X-rays of the area where you have pain. For painful areas, bone scans or magnetic resonance imaging (MRI) may also be done to look for the spread of cancer.

How is it treated?

The treatment for metastatic prostate cancer depends on:

• how large the tumor is
• how much it has spread to other parts of the body
• which treatments you have already had
• your overall physical condition.

Some of the treatment options, which may be used alone or in combinations, are:

• Hormones:
  • Estrogen, a female hormone pill, may be prescribed to help treat prostate cancer.
  • Surgery may be done to remove both testicles (orchiectomy). The testicles make the male hormone, testosterone. Removal of the testicles can reduce the amount of this hormone in the body. The cancer needs testosterone to grow and spread.
  • Injections of a type of medicine called a pituitary suppressor may be given to keep the pituitary gland from stimulating the testicles to make testosterone.
• Chemotherapy: Anticancer drugs, usually docetaxel, may be used to kill the cancer cells.
• Radiation therapy: If the cancer has spread to the bones and is causing pain, an option is to expose the cancerous area to radiation. This will shrink the tumor or destroy some of the cancer cells. It usually relieves pain associated with spread of the cancer to the bone.

How long will the effects last?

How long you will live after being diagnosed with metastatic prostate cancer depends on:

• how much the cancer has spread
• how dependent the cancer is on male hormones
• where the new tumors are.

Some men have lived for years, even after the cancer has spread to the bones.

As long as male hormones are reduced in the body, there will be little to no sexual desire or function.

How can I take care of myself?

• Follow the full course of treatment prescribed by your healthcare provider.
• Eat a healthy diet and get plenty of rest.
• Take more time to relax.
• Ask your provider any questions you may have about the course of the disease, treatments, side effects of the treatments, sexuality, support groups, and anything else that concerns you.
• Ask your provider about alternative methods for pain control, such as relaxation techniques, guided imagery, and hypnosis.
• For more information, contact:

  American Cancer Society, Inc.
  Phone: 800-ACS-2345 (800-227-2345)
  Web site: http://www.cancer.org

  National Cancer Institute
  Phone: 800-4-CANCER (800-422-6237)
  Web site: http://www.cancer.gov

How can I help prevent the spread of prostate cancer?

Because the cause of prostate cancer and its spread is not known, healthcare providers do not know how to prevent it. In the hope of early diagnosis leading to longer life and fewer complications, men over 50 may have a healthcare provider do a rectal exam for prostate cancer every year and also measure a substance in the blood, prostate-specific antigen (PSA). The prostate usually makes more PSA if you have prostate cancer. However, there is no clear evidence that early detection (screening) and treatment increase the chance for cure. Many older men have prostate cancer that never spreads and they never know that they have prostate cancer. The current recommendations are that men age 75 and older should not be screened for prostate cancer. Men younger than 75 should discuss the benefits and harms of the PSA test with their healthcare provider before being tested.