When prostate cancer cells break away from the original tumor and travel to other parts of the body, the cancer becomes what’s known as metastatic prostate cancer. This advanced stage is more serious and harder to treat than cancer that stays in the prostate. It often affects the bones, lymph nodes, liver, or lungs.
The most common metastatic prostate cancer treatment is hormone therapy, which lowers or blocks the testosterone that helps the cancer grow. Other treatments may include chemotherapy, bone-targeting drugs, or newer medications like androgen receptor blockers. In some cases, targeted radiation or surgery may also be used.
There isn’t just one answer for treatment of prostate cancer that has spread?. The approach depends on several things, like where the cancer has spread, how fast it’s growing, and how the body responds to earlier treatments. The main options include:
- Hormone therapy to starve cancer cells of testosterone
- Chemotherapy for aggressive or resistant cancer types
- Drugs for castration resistant prostate cancer, when hormone therapy no longer works
- Treatments that help manage bone metastases and reduce pain
- Clinical trials that offer access to new types of therapy for prostate cancer.
Learn more about the condition itself, what it means when prostate cancer has spread, and the treatments now available to help slow its progress and improve survival rates for metastatic prostate cancer.
About metastatic prostate cancer
Metastatic prostate cancer is what happens when cancer cells leave the prostate gland and grow in other parts of the body. This usually means the cancer is in an advanced stage. While it’s not considered curable, it can often be treated and controlled for years.
The spread of the cancer, often called bone metastases, can cause new symptoms like bone pain, fatigue, and weakness. Understanding this stage of cancer can help a person prepare for the treatments and decisions ahead. 
Doctors can diagnose this condition using a combination of scans, blood tests, and biopsies. When a metastatic prostate cancer diagnosis is made, the treatment goal usually shifts from cure to control, with the focus on slowing the cancer’s spread and easing symptoms.
What is metastatic prostate cancer?
Metastatic prostate cancer happens when cancer from the prostate travels through the blood or lymph system to other parts of the body. Most often, the cancer ends up in the bones, but it can also spread to the lungs, liver, or brain.
- The cancer may still look like prostate cancer under a microscope, even in other parts of the body
- This type of cancer is often managed long-term like a chronic condition
- Treatments may aim to shrink the cancer, delay its growth, or reduce symptoms.
What are the signs and symptoms of spreading prostate cancer?
When prostate cancer spreads, it often causes new and sometimes painful symptoms. These may be very different from those caused by early-stage prostate cancer.
Common signs and symptoms include:
- Bone pain, often in the hips, back, or ribs
- Fatigue or weakness that doesn’t go away
- Unexplained weight loss
- Swelling in the legs or pelvic area
- Trouble urinating or blood in the urine (less common).
These symptoms can affect a person’s daily life and may increase over time if not treated.
About treating prostate cancer
What FDA-approved treatments are available for advanced prostate cancer?
The U.S. FDA has approved several treatment options to manage metastatic prostate cancer. These include:
- Hormone therapy (also called androgen deprivation therapy or ADT), which lowers testosterone
- Androgen receptor inhibitors like Xtandi or Erleada
- Chemotherapy drugs such as docetaxel or cabazitaxel
- Bone-targeting agents like Reclast or Xgeva, that don’t directly act on the cancer, but help to control the outcomes
- Radiopharmaceuticals such as radium-223 for prostate cancer that has spread to the bones.
These treatments are used based on the stage and behavior of the cancer.
How do current treatments help metastatic prostate cancer?
FDA-approved treatments help manage the disease by:
- Slowing the growth of prostate cancer cells
- Reducing symptoms like bone metastases and pain
- Delaying the time before the cancer becomes castration resistant
- Improving quality of life and increasing survival rates for metastatic prostate cancer.
Some treatments like hormone therapy can work for several years. Others are added later if the cancer becomes more aggressive or stops responding.
Are there off-label treatments for prostate cancer?
Are there off-label treatments for prostate cancer?Some treatments are used “off-label,” which means they’re not officially approved for prostate cancer but may still help. These might include:
- Immunotherapies that boost the immune system’s ability to fight cancer
- Targeted therapies that block certain genetic mutations found in the cancer
- Drugs approved for other cancers that show promise in metastatic prostate cancer treatment, such as Keytruda.
Participation in clinical trials may offer access to these and other experimental options.
What are the most common side effects of treatments for advanced prostate cancer?
Most treatments come with side effects, which can vary depending on the type used.
Common side effects include:
- Fatigue and weakness
- Hot flashes or mood changes from hormone therapy
- Nausea, vomiting, and lowered blood counts from chemotherapy
- Bone thinning or joint pain with bone-targeting drugs
- Sexual side effects like reduced libido or erectile dysfunction
- Digestive upset, especially with newer hormone blockers.
Doctors will usually monitor these effects and may adjust treatment plans to help manage them.
Conclusion
Metastatic prostate cancer is a serious condition, but it is treatable in many cases. When prostate cancer has spread, it often affects the bones and other parts of the body, changing both the treatment goals and the daily experience of living with cancer.
The most commonly used treatments include hormone therapy, chemotherapy, and bone-targeting drugs. These therapies aim to slow down the cancer’s spread, relieve symptoms, and increase how long a person can live with the disease. In recent years, newer treatments like androgen receptor blockers and radiopharmaceuticals have improved outcomes, especially for people with castration resistant prostate cancer.
Some people may be offered treatments that aren’t officially approved for this condition but may still help. These off-label options and clinical trials may provide hope for those whose cancer has stopped responding to traditional treatment.
While metastatic prostate cancer is not curable, it is often manageable. With the right combination of care, a person can live for several years after diagnosis, and the range of available therapies continues to grow. Having clear information about all the available options helps individuals and families make informed decisions during a difficult time.
Frequently asked questions about metastatic prostate cancer
At what stage is prostate cancer not curable?
Prostate cancer is generally not considered curable once it has reached the metastatic stage. This means the cancer has spread beyond the prostate to other parts of the body, like the bones or lymph nodes. Treatment can still help, though. Many people live for years with proper care. The main goal becomes controlling the cancer and improving quality of life rather than getting rid of it completely.
How quickly does metastatic prostate cancer spread?
The speed of spread depends on many factors, including the cancer type, genetics, and overall health. In some people, metastatic prostate cancer grows slowly and responds well to hormone therapy. In others, it can spread more quickly, especially if it becomes castration resistant. Doctors use scans and blood tests to keep track of how fast the cancer is progressing.
Can you beat prostate cancer?
Although metastatic prostate cancer isn’t usually curable, it can often be controlled for a long time. Many people live several years with the disease, especially if it responds to hormone therapy or other treatments. Newer drugs and clinical trials are also helping some people live longer with fewer symptoms. Staying informed and working closely with a care team can make a big difference.
What is the life expectancy of someone with spreading prostate cancer?
Life expectancy varies widely. Some people live just a few years, while others live 10 years or more with treatment. Factors that affect life expectancy include:
- How far the prostate cancer has spread
- How well the cancer responds to treatment
- The person’s overall health
- Whether the cancer is castration resistant or still responds to hormone therapy.
Doctors may provide estimates based on individual circumstances.
What happens if you don’t treat metastatic prostate cancer?
Without treatment, metastatic prostate cancer can spread quickly and cause serious problems. Bone metastases can lead to pain, fractures, and other issues. Other organs may be affected, causing breathing problems, weight loss, or severe fatigue. Most people benefit from starting treatment to slow the disease, even if the goal isn’t a cure.
