Prostate Cancer Metastasis (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 carries sperm 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 primary 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 health care 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 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:

• Orchiectomy: A surgeon removes one or both testicles. Removal of the testicles, which make most of the male hormone testosterone, can reduce the amount of the hormone in the body. The cancer needs testosterone to grow and spread.
• Hormone treatments: Estrogen, a female hormone, may be prescribed to help treat prostate cancer.
• Pituitary suppressor: An injectable medicine may be prescribed that prevents the testicles from making testosterone.
• Chemotherapy: Anticancer drugs may be used to try 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 decreases pain associated with spread of the cancer to the bone.

How can I take care of myself?

• Follow your health care provider's advice.
• 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.

How can I help prevent prostate cancer metastasis?

Because the cause of prostate cancer and its metastases is not known, health care 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 health care provider do an exam for prostate cancer every year.