Advanced Prostate Cancer

What is Advanced Prostate Cancer?

Advanced prostate cancer occurs when prostate cancer spreads beyond the prostate or returns after treatment. Prostate cancer is often grouped into four stages, with stage IV being more advanced prostate cancer.

Early-Stage | Stages I & II: The tumor has not spread beyond the prostate.

Locally Advanced | Stage III: Cancer has spread outside the prostate but only to nearby tissues.

Advanced | Stage IV: Cancer has spread outside the prostate to other parts of the body, such as the lymph nodes, bones, liver or lungs.

When an early-stage prostate cancer is found, it may be treated or watched closely. Advanced prostate cancer cannot be cured, but there are many ways to treat it to slow its progression and manage symptoms.

Symptoms

People with advanced prostate cancer may not have any signs of sickness. Symptoms depend on the size of the new growth and where the cancer has spread in the body. Some men with advanced prostate cancer have problems passing urine or see blood in their urine – mainly if they have not had treatment to the prostate itself. Some may feel tired, weak or lose weight. When prostate cancer spreads to bones, they may have bone pain. 

Diagnosis

Advanced cancer may be found before, at the same time or later than the main tumor. Most diagnosed with advanced prostate cancer have had biopsy and treatment in the past. When a new tumor is found in someone who has been treated for cancer in the past, usually cancer has spread.

Even if you have already been diagnosed with prostate cancer, your health care provider may want to observe changes over time. The following tests are used to diagnose and track prostate cancer.

Blood Tests

The PSA blood test measures a protein in your blood called the prostate-specific antigen (PSA). Only the prostate and prostate cancers make PSA. The test is used to look for changes to the way your prostate produces PSA. It is used to stage cancer, plan treatment and track how well treatment is going.

Digital Rectal Exam

The digital rectal exam is a physical exam to feel for changes in your prostate. This test may also be used to screen for and stage cancer or track how well treatment is going. During this test, a health care team member feels for abnormalities in the prostate gland.

Imaging and Scans

Imaging helps your health care team learn more about your cancer.

Treatment

The goal of advanced prostate cancer treatment is to shrink or control tumor growth and control  symptoms. There are many treatment choices for advanced prostate cancer. Which treatment to use, and when, will depend on discussions with your health care team. It is important to talk to your health care team about your treatment options, including potential side effects before you choose a plan.

Other Considerations

Incontinence

Incontinence is the inability to control the release of urine and can sometimes happen with prostate cancer treatment. There are different types of incontinence:

Stress Urinary Incontinence, when urine leaks with coughing, laughing, sneezing or exercising or with any additional pressure on the pelvic floor muscles. This is the most common type.

Urge Incontinence, or the sudden urge to pass urine, even when the bladder is not full, because the bladder is overly sensitive. This might be called overactive bladder.

Mixed Incontinence, a combination of stress and urge incontinence with symptoms from both types.

Erectile Dysfunction

Patients may have sexual health problems following their cancer diagnosis or treatments. Cancer in the prostate, colon, rectum and bladder are the most common cancers that can affect a man’s sexual health. Treatments for cancer, along with emotional stress, can lead to Erectile Dysfunction.

Source: Urology Care Foundation