Overview of Advanced Prostate Cancer

Prostate cancer, like all cancers, occurs in various stages throughout the duration of the disease. Diagnosis of prostate cancer can occur in any stage. Though this cancer is slow-growing and can remain isolated in the prostate for many years, eventually (or sometimes quickly), it may advance into other areas of the body.

After a prostate cancer diagnosis is given, blood tests, imaging scans, and other examinations are often conducted to evaluate the advancement of a patient’s cancer and determine if and to where the cancer has spread outside of the prostate. This process establishes the “stage” of prostate cancer and describes the exact extent of its spread in the body, and is an important process in determining the best treatment option for the patient.

Many doctors use the TNM System to evaluate the stage and spread of prostate cancer in a patient. “T” stands for “tumor”, and refers to the size of the primary cancer; “N” stands for “nodes”, and refers to whether or not the cancer has spread to lymph nodes nearby; and “M” stands for “metastasis”, and refers to whether or not the cancer has spread beyond the immediate prostate area into surrounding organs and the rest of the body. These three characteristics establish a “stage” for the patient’s prostate cancer. There are four stages that are widely used to describe the advancement of prostate cancer:

Stage 1: The cancer is localized to the prostate and cannot be identified in routine examinations.
Stage 2: The cancer is still localized to the prostate but has enlarged in size.
Stage 3: The cancer has spread beyond the prostate but is confined to nearby tissues only.
Stage 4: The cancer has advanced, or metastasized, beyond the prostate and nearby tissues into lymph nodes and other organs in the body.

Stage 4 cancer is considered advanced, as it has spread beyond the prostate and immediate area to other areas of the body. This stage is currently incurable; however, treatment options exist that can alleviate the often painful symptoms of advanced prostate cancer. These symptoms include weakness and anemia due to a lack of red blood cell production in the bone marrow, bone pain or other widespread pain, or fractures due to weakened bones. Some men also experience pain or difficulty urinating due to the enlargement of the prostate; however, this can also be a symptom of any stage of prostate cancer.

Treatment for Advanced Prostate Cancer

Advanced prostate cancer commonly spreads to the skeletal system. Bone ailments due to this advancement can result in continued pain and discomfort for men with Stage 4 prostate cancer. Radiation therapy is often used to treat and eliminate bone pain in these patients. This therapy can further weaken the bones, so it is often combined with drug treatments that promote bone strength and help reduce the risk of fracture.

Additionally, hormone therapy is usually prescribed to decrease the size and prevent the spread of the tumor or tumors. These treatments may result in undesirable side effects, such as decreased libido, hot flashes, and development of breast tissue, but can greatly improve the quality and extend the life of men in Stage 4 prostate cancer.

Hormone therapy has less and less effect on advanced prostate cancer over time. When a patient stops responding to hormone therapy, chemotherapy is often the next step. This is a more aggressive treatment option that involves chemicals that are usually given through an IV in various cycles. Chemotherapy has many negative side effects but can slow or stop the growth of prostate cancer.