Prostate cancer metastasis: Where does prostate cancer spread?

Question: I’m concerned about prostate cancer metastasis. Where can prostate cancer spread?

Answer: In theory, prostate cancer cells can spread anywhere in the body. In practice, though, most cases of prostate cancer metastasis occur in the lymph nodes and the bones.

Prostate cancer metastasis

Metastasis occurs when cells break away from the tumor in the prostate. The cancer cells can travel through the lymphatic system or the bloodstream to other areas of the body.

More commonly prostate cancer metastasis can occur in the:

  • Bones
  • Lymph nodes
  • Lungs
  • Liver
  • Brain

Rare locations of prostate cancer metastasis include:

  • Adrenal glands
  • Breasts
  • Eyes
  • Kidneys
  • Muscles
  • Pancreas
  • Salivary glands
  • Spleen

If you’ve been diagnosed with prostate cancer and you’re concerned about prostate cancer metastasis, talk with your doctor about your risk of prostate cancer metastasis and your treatment options.

Metastatic and Advanced Prostate Cancer

Continuous advances have provided a new understanding of the diagnosis, staging, and treatment of metastatic and advanced prostate cancer. The earlier definition of advanced disease (bone metastasis and soft-tissue involvement) has also been improved.

Prostate cancer is the second leading cause of cancer-related deaths in the United States among men and the most commonly diagnosed cancer in American males. Most prostate cancer–related deaths are due to advanced disease, which results from any combination of lymphatic, blood, or contiguous local spread.

This article provides an overview of the current modalities available in the treatment of advanced prostate cancer, highlighting the following points:

  • Identification of the population at risk of developing advanced prostate cancer
  • Evolution of clinical staging and therapeutic options currently available to these patients
  • Controversies surrounding early versus delayed treatment and combined androgen blockade (CAB)
  • Definition and management of biochemical failure
  • Hormone-refractory prostate cancer

The most important and established prognosticators for prostate carcinoma include the Gleason grade, the extent of tumor volume, and the presence of capsular penetration or margin positivity at the time of prostatectomy.

High-grade prostate cancer, particularly the percentage presence of Gleason grades 4 and 5, is associated with adverse pathologic findings and disease progression. Conversely, low-grade prostate tumors can also be biologically aggressive.

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