Stage four prostate cancer: what to know

Stage four disease can involve nearby structures, lymph nodes, or distant sites such as bones. The location and extent of spread, tumour features, previous treatment, symptoms, and general health all influence the plan. Prostate cancer can affect urinary flow and the bones, but symptoms differ between people.

Difficulty passing urine may reflect blockage or another urinary problem and needs assessment rather than assumption. Your team may use examination, blood tests, imaging, and biopsy information to clarify what is happening and establish a baseline for follow-up.

Treatment may include medicines that reduce the signals prostate cancer uses to grow, chemotherapy, radiotherapy, or targeted radioisotope therapy. Radiotherapy can treat a selected area, while brachytherapy places a radiation source within or close to the prostate and is suitable only in particular situations. Surgery is not appropriate for everyone with stage four disease, but prostate removal surgery or robotic cancer surgery may be discussed in selected plans.

Bone-strengthening therapy may help protect bones when cancer affects them or treatment creates bone-health concerns. Tell the team about pain, weakness, falls, constipation, or urinary changes; early support can preserve movement and comfort.

Get urgent medical help for new leg weakness or numbness, loss of bladder or bowel control, severe back pain, inability to pass urine, chest pain, severe breathlessness, or confusion. These can signal complications requiring prompt assessment. Contact your oncology team quickly for fever, uncontrolled pain, repeated vomiting, or a sudden decline in function.

Ask where the cancer has spread, what each treatment is intended to achieve, and how response will be monitored. Ask whether bone-strengthening therapy or radiotherapy could help a painful area, how urinary symptoms should be handled, and which number to call overnight. Discuss exercise, falls prevention, sexual health, and emotional support as part of the plan.