What Are The Signs That Prostate Cancer Has Spread

Consult A Doctor To Learn More About Your Symptoms

What are the Symptoms of Prostate Cancer?

If you are experiencing any of the prostate cancer symptoms mentioned above, make an appointment with one of our expert oncologists today. We offer you access to New Jerseys largest network of cancer specialists and the latest treatments available.

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Symptoms Of Advanced Prostate Cancer

If you are worried about prostate cancer, we have more information about the signs and symptoms.

Symptoms of prostate cancer may not develop for many years. The symptoms of advanced prostate cancer may be caused by an enlarged prostate. Or symptoms may be a sign of secondary cancer, where the cancer has spread to another part of the body.

Certain Factors Affect Prognosis And Treatment Options

The prognosis and treatment options depend on the following:

The stage of the cancer .
The patients age.
Whether the cancer has just been diagnosed or has recurred .

Treatment options also may depend on the following:

Whether the patient has other health problems.
The expected side effects of treatment.
Past treatment for prostate cancer.
The wishes of the patient.

Most men diagnosed with prostate cancer do not die of it.

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What Are The Early Warning Signs And Symptoms Of Prostate Cancer

Most men with prostate cancer have no symptoms.

Erectile dysfunction
Bone pain and/or fractures

One should go to the nearest hospital emergency department without delay if any of the following symptoms occur:

Urinary tract infection : Burning pain on urination, urgency, or frequent urination, especially with fever.
Bladder obstruction: Not urinating or urinating very little despite drinking enough fluid producing little urine despite straining pain due to a full bladder.
Acute kidney failure: Not urinating or urinating little, with little discomfort, despite drinking enough fluid.
Deep bone pain, especially in the back, hips, or thighs, or bone fracture: Possible sign of advanced prostate cancer that has spread to the bone.
Spinal cord compression: This occurs when the cancer has spread to vertebrae of the spine and tailbone region. The weakened vertebrae can collapse on the spinal cord. Typical symptoms that might signal acute spinal cord compression include weakness in the legs and difficulty walking, increased difficulty urinating, difficulty controlling the bladder or bowels, and decreased sensation, numbness, or tingling in the groin or legs. These are often preceded by a persistent new central pain in the back lasting a few days or weeks. This condition is a true emergency and requires immediate evaluation in the nearest hospital emergency department. Failure to be treated immediately can result in permanent spinal cord damage with paralysis.

Who Is More Likely To Have Prostate Cancer Recurrence

Prostate Cancer: Signs, Symptoms, and Complications

In general, the further your cancer has spread and the more aggressive it is, the more likely it is to recur. Specific factors include:

Tumor size: In general, the larger the tumor, the more likely it is to recur.
Gleason score: A higher Gleason score means a more aggressive cancer and a higher rate of recurrence.
Cancer staging: Staging refers to how far the cancer has spread. Higher stage cancers have spread further at initial treatment and have higher rates of recurrence.
Involvement of the lymph nodes: Prostate cancer that has entered the lymph nodes prior to treatment is more likely to recur.

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Here Are Some Red Flags That Men Should Not Ignore:

Swelling in the leg is seen when prostate cancer spreads to the legs due to fluid build-up in the surrounding area and the swelling is known as lymphoedema.
Even pain and numbness are commonly seen in the lower back, hips, or chest, or numbness in your legs or feet.
Discomfort and pain can be encountered in the lower back and pelvic area due to prostate cancer.
Other symptoms that shouldnt be neglected are frequent urination, difficulty in urination, and straining while peeing or a weak flow

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What Questions Should I Ask My Healthcare Provider

If you have prostate cancer, you may want to ask your healthcare provider:

Why did I get prostate cancer?
What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
Has the cancer spread outside of the prostate gland?
What is the best treatment for the stage of prostate cancer I have?
If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
What are the treatment risks and side effects?
Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
Am I at risk for other types of cancer?
What type of follow-up care do I need after treatment?
Should I look out for signs of complications?

A note from Cleveland Clinic

Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.

How Doctors Find Metastatic Prostate Cancer

When you are diagnosed with prostate cancer, your doctor will order tests such as:

These tests may focus on your skeleton and in your belly and pelvic areas. That way doctors can check for signs that the cancer has spread.

If you have symptoms such as bone pain and broken bones for no reason, your doctor may order a bone scan. It can show if you have signs of cancer spread in your bones.

Your doctor will also ask for blood tests, including a check of PSA levels, to look for other signs that the cancer is spreading.

PSA is a protein made by the prostate gland. A rise in PSA is one of the first signs your cancer may be growing. But PSA levels can also be high without there being cancer, such as if you have an enlarged prostate a prostate infection, trauma to the perineum, or sexual activity can also cause PSA level to be high.

If youve been treated, especially if a surgeon removed your prostate, your PSA levels should start to go down. Doctors usually wait seve,ral weeks after surgery before checking PSA levels. A rise in PSA after treatment may suggest the possibility cancer is back or spreading. In that case, your doctor may order the same tests used to diagnose the original cancer, including a CT scan, MRI, or bone scan. The radiotracer Axumin could be used along with a PET scan to help detect and localize any recurrent cancer.

Though very rare, its possible to have metastatic prostate cancer without a higher-than-normal PSA level.

Two Main Models Of Metastasis

Prostate Cancer: Signs & Symptoms

The first model hypothesizes that metastasis-initiating cells need to undergo deep molecular rearrangements to proceed through the various steps of the metastatic cascade, and is often referred to as the phenotypic plasticity model. To leave the primary tumor site, cancer cells must undergo EMT. This process enables them to become more invasive and motile, allowing migration toward gradients of oxygen and nutrients brought by the vasculature associated to the tumor, often leaky, unorganized, and incompletely formed. However, recent literature has pointed out that EMT might be a dispensable process for the occurrence of metastasis but fundamental for the acquisition of chemoresistance .

In the process of initial seeding, cellcell interactions and cell adhesion to the ECM play a critical role. The ECM of the growing cancer undergoes numerous alterations in terms of both biochemical and physical properties . Integrins play a pivotal role in tumor progression, as they can couple ECM-derived mechanical cues with intracellular signaling pathways .

Metastatic PCas show higher levels of active 1 integrin, which confers both an enhanced capacity to colonize distant organs, through the adhesion to ECM molecules like fibronectin and collagen type I, and a survival advantage, through an increase in the resistance to anoikisthe programmed cell death induced by insufficient adhesion to the growth substrate .

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What Are The Signs And Symptoms Of Prostate Cancer

Prostate cancer may not cause any signs and symptoms in the early stages. Hence, it is advisable for men over 50 years of age with or without other risk factors to consult with a doctor to be screened for prostate cancer.

Prostate cancer can cause the following signs and symptoms in the later stages

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Where Prostate Cancer Spreads

Many patients ask, can prostate cancer spread? The answer is, yes. Roughly 80 percent of the time 4 , when prostate cancer cells spread, they spread to bones 5 . Often, the cells spread to the hips, spine, and pelvic bones. This either happens as the cells travel through the blood or lymph nodes or direct invasion. When the cells relocate, they grow and form new tumors .

The good news is that for most men who are diagnosed with prostate cancer, its not terminal. Over 3.1 million men in America who have been diagnosed with prostate cancer are alive today.

Aside from skin cancer, prostate cancer is the most common cancer 6 in American men, with 1 of 9 men diagnosed in their lifetime. If caught early, there are a variety of treatments, including taking the holistic approach to prostate cancer.

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What Should I Do If I Have Prostate Cancer Symptoms

If you are displaying one or more signs of prostate cancer, be sure to promptly consult with a physician. Even benign prostate conditions like prostate enlargement warrant timely medical attention, so dont delay seeking treatment. And, like most other malignancies, prostate cancer is usually more easily treated when it is detected at an early stage.

Medically reviewed by Monica Chatwal, MD.

At Moffitt Cancer Center, we provide a full range of diagnostic testing for prostate cancer. If you have received a prostate cancer diagnosis, we understand that every day counts, and we want to support you every step of the way. Our Urologic Oncology Program includes a multispecialty team that focuses exclusively on evaluating and treating prostate cancer.

Contact Moffitt at or complete a new patient registration form online to speak with one of our specialized oncologists about your symptoms. As Floridas top cancer hospital, were committed to providing all new patients rapid access to a cancer expert within a day of their reaching out.

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Symptoms Of Prostate Cancer Spread To The Lymph Nodes

Lymph nodes are part of a system of tubes and glands in the body that filters body fluid and fights infection.

There are lots of lymph nodes in the groin area, which is close to the prostate gland. Prostate cancer can spread to the lymph nodes in the groin area, or to other parts of the body. The most common symptoms are swelling and pain around the area where the cancer has spread.

Cancer cells can stop lymph fluid from draining away. This might lead to swelling in the legs due to fluid build up in that area. The swelling is called lymphoedema.

A Genetic Biomarker Test For Newly Diagnosed Prostate Cancer

Results from a study of a different genetic biomarker test suggest that it could one day help inform treatment decisions for men newly diagnosed with localized prostate cancer.

According to findings published February 24 in JCO Precision Oncology, a biomarker test called the Oncotype DX Genomic Prostate Score accurately predicted the long-term risk of metastasis and death from prostate cancer in men with localized disease. The test needs to be validated in larger forward-looking studies before it can be used to guide treatment, the study researchers noted.

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When To See Dr Steven Gange

Note your symptoms and take action. If you are between the ages of 59 and 69, are African American, and/or have a family history of prostate cancer, see your doctor as soon as possible.

Typically, a screening test for prostate cancer will be performed, which includes digital rectal exam and a PSA test.

If you have one or more of the five warning signs of prostate cancer, contact Dr. Steven Gange at , or request an appointment online, for an evaluation.

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Experimental Treatments For Advanced Prostate Cancer

Researchers are currently testing many new approaches and treatments for prostate cancer, including new medications. These include the following:

Immune checkpoint inhibitors

The immune system uses âcheckpointsâ to stop it from attacking the bodyâs healthy cells. These checkpoints are proteins on immune cells.

Cancer cells often use these checkpoints to keep the immune system from attacking them.

Immune checkpoint inhibitors are drugs that can these checkpoints on cancer cells. Inhibiting these checkpoints can allow a personâs immune system to attack the cancer cells.

Chimeric antigen receptor T cell therapy

This treatment involves taking immune cells from the personâs blood. A scientist then alters these cells in a lab to have receptors called chimeric antigen receptors on their surface.

These receptors help the cells attach to proteins on the surface of prostate cells. A scientist then multiplies these altered T cells in a lab before putting them back into the personâs blood.

Scientists hope these T cells can then find prostate cancer cells and launch a targeted immune attack.

However, this treatment is complicated and may have some serious side effects. This means it is currently only available as part of clinical trials.

Targeted drug therapies

Targeted drug therapies can act on specific parts of cancer cells and the environments surrounding them.

These drugs

Two possible targeted therapy treatments are:

Treating prostate cancer that has spread to the bones

Surgery For Prostate Cancer

10 Warning Signs of Prostate Cancer

There are many types of surgery for prostate cancer. Some are done to try to cure the cancer others are done to control the cancer or make symptoms better. Talk to the doctor about the kind of surgery planned and what you can expect.

Side effects of surgery

Any type of surgery can have risks and side effects. Be sure to ask the doctor what you can expect. If you have problems, let your doctors know so they can help you.

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Cancer May Spread From Where It Began To Other Parts Of The Body

When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began and travel through the lymph system or blood.

Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor in another part of the body.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if prostate cancer spreads to the bone, the cancer cells in the bone are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer.

Denosumab, a monoclonal antibody, may be used to prevent bone metastases.

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Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.

An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.

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How Does The Doctor Know I Have Prostate Cancer

Prostate cancer tends to grow slowly over many years. Most men with early prostate cancer dont have changes that they notice. Signs of prostate cancer most often show up later, as the cancer grows.

Some signs of prostate cancer are trouble peeing, blood in the pee , trouble getting an erection, and pain in the back, hips, ribs, or other bones.

If signs are pointing to prostate cancer, tests will be done. Most men will not need all of them, but here are some of the tests you may need:

PSA blood test: PSA is a protein thats made by the prostate gland and can be found in the blood. Prostate cancer can make PSA levels go up. Blood tests will be done to see what your PSA level is and how it changes over time.

Transrectal ultrasound : For this test, a small wand is put into your rectum. It gives off sound waves and picks up the echoes as they bounce off the prostate gland. The echoes are made into a picture on a computer screen.

MRI: This test uses radio waves and strong magnets to make detailed pictures of the body. MRI scans can be used to look at the prostate and can show if the cancer has spread outside the prostate to nearby organs.

Prostate biopsy: For a prostate biopsy, the doctor uses a long, hollow needle to take out small pieces of the prostate where the cancer might be. This is often done while using TRUS or MRI to look at the prostate. The prostate pieces are then checked for cancer cells. Ask the doctor what kind of biopsy you need and how its done.