What should you know about advanced metastatic prostate cancer?

Care is tailored to where the cancer has spread, previous treatment, general health and personal priorities. A plan may combine medicines that reduce or block male hormones with other cancer treatments and supportive care.

Metastatic disease means prostate cancer cells have travelled to another part of the body. Bones and lymph nodes can be involved, and other organs may also be affected. The cancer is still called prostate cancer because treatment is based on where the cells began.

Symptoms vary with the areas involved. Advanced prostate cancer can present with persistent bone pain, tiredness, weakness, weight or appetite changes, or difficulty passing urine. Some people have few symptoms when spread is first found on imaging.

Your oncology team reviews scans, blood tests, symptoms and earlier treatment before recommending a plan. Systemic medicines reach cancer cells throughout the body. Radiotherapy may treat painful or threatening areas, while targeted radioisotope therapy may suit selected cancers. Bone-strengthening treatment can be considered when bone health needs support.

Keep a record of pain, mobility, bladder symptoms, appetite and treatment effects. Take prescribed medicines as directed, and tell the team about supplements or other medicines because interactions can alter treatment. Supportive and palliative care can be added alongside cancer treatment to help with pain, sleep, mood and daily function.

Seek urgent medical assessment for new leg weakness or numbness, loss of bladder or bowel control, severe back pain, inability to pass urine, sudden confusion, chest pain or marked difficulty breathing. These problems can signal pressure on nerves, urinary blockage or another complication that needs rapid treatment.

Contact the oncology team promptly for fever during treatment, pain that is new or worsening, repeated vomiting, reduced drinking, or side effects that prevent normal activity. Use the emergency service recommended by your care team if symptoms are severe or rapidly worsening.

Ask where the cancer has spread, what the treatment is intended to achieve, how response will be checked and which side effects warrant an immediate call. It can also help to discuss bone protection, exercise, sexual health, urinary symptoms and who to contact outside clinic hours.