When cancer cells break away from the prostate gland, they enter blood and lymphatic vessels that carry them to nearby tissues or organs. This spread of cancer is called metastasis. If prostate cancer cells reach the bones, adrenal gland, or lungs, they can cause a more serious form of the disease. In this article, we discuss how metastatic prostate cancer develops and the likely outlook for people with the condition. We also address treatment options.
The most common type of treatment for metastatic prostate cancer involves using medications to destroy cancer cells and prevent them from growing. Doctors use a combination of two or more drugs to deliver these treatments, and they usually administer them intravenously or by injection. They may also give these medications orally, either in the form of pills or liquids. Chemotherapy is generally used after a person’s prostate cancer stops responding to hormone therapy.
Hormone therapy shuts down the production or blocks the action of male sex hormones that promote prostate cancer growth and spread. This is called androgen deprivation therapy or ADT. Doctors may recommend this treatment when they see a rise in the PSA level after surgery or radiation, but before the cancer has metastasized.
Radiation can be effective in reducing tumor size or eliminating it altogether, and is usually combined with chemotherapy. Doctors may give this treatment through a catheter placed in the rectum, or through a needle placed into the perineum (the area between the rectum and scrotum). Radiation can also be given through external beam techniques such as gamma knife or IMRT.
When prostate cancer has spread to the bones, doctors sometimes treat it by placing bone-targeted radiation or brachytherapy implants directly into the affected area. This helps to relieve pain and prevent fractures and other complications. Doctors sometimes prescribe drugs such as bisphosphonates, which prevent the bone cells from breaking down.
People with metastatic prostate cancer often have to make lifestyle adjustments to cope with their condition, including eating well and getting enough physical activity. It’s important to talk with a registered dietitian or nutritionist about the impact of these changes on appetite, eating habits, and weight.
Although the outlook for metastatic prostate cancer is poor, research is moving more quickly than ever before. As a result, some doctors are treating advanced prostate cancer with promising new medicines. The medicines, which are being tested in clinical trials, may one day help improve the survival of people with this disease. It’s always worth talking to your doctor about whether a clinical trial might be right for you.
