When Prostate Cancer Spreads

Prostate cancer starts when cells in the prostate gland grow out of control. Those cells can spread to other parts of the body and affect healthy tissue.

This can happen for several reasons.

Early Treatment Failure

When prostate cancer is discovered early, treatment usually works. Most men are able to live cancer-free for many years.

But sometimes, treatment doesn't work and prostate cancer can slowly grow.  This usually happens after surgery (called a radical prostatectomy) or radiation therapy.

Sometimes called a chemical recurrence, it's when the cancer survives inside the prostate or reappears and spreads to other tissues and organs. The cancer is usually microscopic and grows very slowly.

You and your doctor will work together to keep an eye on the cancer as it grows. You may come up with a new treatment plan.

Watchful Waiting

Because prostate cancer cells usually grow very slowly, some men might not need treatment right away. Your doctor might suggest something called "watchful waiting" or "active surveillance." Your doctor will still do regular blood tests and exams to keep an eye on your cancer.

This plan is usually for men who don't have symptoms and whose cancer is expected to grow slowly.

The risk with this approach is that the cancer might grow and spread between checkups. This could limit which treatment you could take and if your cancer can be cured.

Treatment Issues

When you're diagnosed with cancer, like any medical issue, it's important that you follow your treatment plan. That can mean scheduling regular checkups or, if radiation therapy is part of your regimen, being sure to go to all scheduled radiation visits.

If you miss several of them, you may have a greater chance that your cancer will spread.

In one study, for example, men who missed two or more sessions during their treatment had a greater chance that their cancer would come back. That was even though they eventually finished their course of radiation.

Late Diagnosis

Experts disagree on whether all men should get tested for prostate cancer. Exams can help find cancer early. But there are questions about if the benefits of screening tests always outweigh the risks.

Some groups suggest all men should have prostate screening tests in their 50s. Some men might want to get tests earlier if they have risk factors that make them more likely to get prostate cancer.

Early prostate cancer usually has no symptoms. You may go to see the doctor when you have trouble urinating or pain in your hips and back. That's when prostate cancer is discovered.

After that, your doctor may find out that your cancer has already spread beyond your prostate. If that's a possibility, you may be asked to take a test like a:

  • Bone scan
  • MRI
  • Ultrasound
  • CT scan
  • PET scan

Knowing if your cancer has spread will help your doctor work with you to choose your best treatment.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on April 22, 2018

Sources

SOURCES:

American Cancer Society: "What Is Prostate Cancer?" "Watchful Waiting or Active Surveillance for Prostate Cancer," "Can Prostate Cancer Be Found Early?" "Signs and Symptoms of Prostate Cancer."

Prostate Cancer Foundation: "Detecting Recurrence."

Harvard Medical School: "How to handle a relapse after treatment for prostate cancer."

National Cancer Institute: "Missed Radiation Therapy Sessions Increase Risk of Cancer Recurrence."

Mayo Clinic: "Prostate Cancer: Diagnosis."

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