Can a Man Tell if His Prostate Cancer Has Spread Beyond His Prostate Gland?

 

By Dr. David Samadi

  When diagnosed with prostate cancer, one of the most pressing concerns for men is whether the cancer has spread beyond the prostate gland. Prostate cancer that has spread or metastasized can lead to more complex treatments and a potentially less favorable prognosis. However, knowing whether cancer has spread is not always straightforward.   While certain signs and symptoms may suggest that prostate cancer has extended beyond the prostate, definitive diagnosis relies on medical tests. This article will explore how a man might notice potential signs of cancer spread and the medical methods used to confirm metastasis.  

What Happens When Prostate Cancer Spreads?

  Like all cancers, Prostate cancer usually starts as a small tumor localized to the prostate gland. When it spreads, also known as metastasizes, beyond the prostate, it most commonly moves to nearby tissues, lymph nodes, bones, and in more advanced cases, organs like the liver or lungs.    Cancer that spreads outside the prostate can change the approach to treatment. Instead of focusing on local treatments like surgery or radiation, doctors may recommend systemic therapies such as hormone therapy, chemotherapy, or other advanced treatments that target cancer throughout the body.  

Can a Man Feel Symptoms of Cancer Spread?

  In its early stages, prostate cancer often produces no noticeable symptoms. Even as the cancer spreads, a man may not always immediately detect changes in his body. However, certain symptoms can arise if the tumor has metastasized:

• Bone Pain

  A common area prostate cancer tends to spread to is the bones, particularly the spine, hips, and pelvis. Men with advanced prostate cancer may experience persistent bone pain or tenderness in these areas. The pain can be sharp or dull and may worsen over time or with activity.

• Urinary Symptoms

  If prostate cancer spreads locally to nearby structures, it may affect the bladder or urethra, leading to more pronounced urinary symptoms. These can include difficulty starting or stopping urination, a weak urine stream, or even blood in the urine (hematuria). However, it’s important to note that these symptoms can also occur with localized prostate cancer or benign conditions like an enlarged prostate (benign prostatic hyperplasia).

• Swelling in the Legs

  If prostate cancer spreads to the lymph nodes, particularly those in the pelvic region, can cause a blockage in lymphatic fluid drainage. Possible symptoms may include swelling of a leg or foot, also known as lymphedema. A feeling of heaviness or discomfort may accompany the swelling.

• Unexplained Weight Loss and Fatigue

As cancer spreads, it can begin to take a toll on the body’s energy resources. Men with advanced prostate cancer may notice unexplained weight loss or chronic fatigue. While many conditions can cause these symptoms, their presence alongside other symptoms should prompt further medical investigation.

• Numbness or Weakness

  Cancer that spreads to the spine causing pressure on the spinal cord or nerves, can cause symptoms of numbness, weakness, or loss of bladder or bowel control. This is known as spinal cord compression and requires immediate medical attention.  

Medical Testing for Detecting Cancer Spread

  While symptoms may provide clues, the most accurate way to determine if prostate cancer has spread is through medical testing. A combination of exams, imaging studies, and lab tests is necessary to check for signs of metastasis.

• PSA Testing

  Prostate-specific antigen (PSA) is a protein produced by healthy and cancerous prostate cells. After treatment for prostate cancer, rising PSA levels may indicate that the cancer has returned or spread. However, PSA levels alone do not confirm metastasis and additional tests are necessary.

• Bone Scan

  Since prostate cancer often spreads to the bones, a bone scan is one of the primary imaging tests used to detect metastasis. During a bone scan, a small amount of radioactive material is injected into the bloodstream, accumulating in areas where bone is damaged. These areas will appear as “hot spots” on the scan, potentially indicating cancer spread.

• CT Scan or MRI

  A computed tomography (CT) scan or magnetic resonance imaging (MRI) can help detect if the cancer has spread to lymph nodes or other organs. These imaging techniques will show cross-sectional images of are of the body which enable doctors to assess check if cancer has spread beyond the prostate.

• PET Scan

  A positron emission tomography (PET) scan can also detect metastasis. It involves injecting a small amount of radioactive sugar into the body. Since cancer cells consume more sugar than normal cells, the PET scan can highlight areas where cancer may have spread.

• Biopsy of Lymph Nodes

  In some cases, a biopsy of removing small tissue samples may be necessary for lymph nodes near this area that helps detect any signs of the cancer spreading.    

The Importance of Early Detection

  Detecting the spread of prostate cancer early is vital to develop a treatment plan that will include aggressive action. While surgery or radiation may successfully treat many men with localized prostate cancer, the approach to treatment may change significantly if the cancer has spread. Understanding the stage and extent of the cancer is vital for tailoring therapies and improving outcomes.  

Conclusion

  Any man diagnosed with prostate cancer must work as a team with their healthcare providers helping monitor symptoms. Contact your doctor if you experience any new or worsening symptoms, as early detection of metastasis is vital for managing the disease to get better results.    Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board-certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer, Now What? A Practical Guide to Diagnosis, Treatment, and Recovery, and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.