Symptoms of Stage 4 Prostate Cancer

Stage 4 means the cancer has moved beyond the prostate to nearby or distant parts of the body. Difficulty starting or maintaining urine flow, needing to urinate often, or blood in the urine can occur when the prostate or nearby tissues affect the urinary passage. Read more about [Difficulty Passing Urine](/symptoms/difficulty-passing-urine/).

Cancer in bone may cause persistent pain in the back, hips, pelvis or other areas. Weakness, reduced appetite, unintended weight loss and marked tiredness can also occur. Symptoms vary with the location and amount of spread; a symptom alone cannot confirm the cause. The [Prostate Cancer](/conditions/prostate-cancer/) page gives broader disease context.

Arrange an oncology or urology review for new, persistent or worsening symptoms. The assessment may include a history, examination, blood tests and scans, with the results used to plan care. Treatment can be aimed at controlling the cancer, easing symptoms, protecting bones and supporting daily function.

Possible options include hormone-based treatment, chemotherapy, radiotherapy or targeted radioisotope therapy, depending on the cancer and previous treatment. Bone-strengthening therapy may be considered when bones are affected. Procedures such as prostate removal surgery are not suitable for every person with stage 4 disease; the treatment team weighs overall health and where the cancer has spread.

Seek urgent medical help for new leg weakness, numbness, loss of bladder or bowel control, or severe back pain. These symptoms can signal pressure on nerves or the spinal cord and need rapid assessment. Seek emergency care for inability to pass urine, heavy bleeding, sudden confusion, severe breathlessness or pain that cannot be controlled with the prescribed plan.

Which symptoms are most likely related to the cancer or its treatment? Do I need scans to check my bones or other organs? What should I do if urine flow stops or back pain changes? Would radiotherapy, bone-strengthening therapy or targeted radioisotope therapy help my symptoms?