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Symptoms of advanced prostate cancer

The symptoms of advanced prostate cancer depend on where the cancer has spread to. Find out about the possible symptoms and when to see your doctor. 

Advanced prostate cancer means that a cancer that began in the prostate gland has spread to another part of the body. If your cancer has spread you might:

  • feel very tired (fatigue)
  • feel generally unwell
  • have weight loss for no known reason

Where does prostate cancer spread?

The most common place for prostate cancer to spread to is the bones. It can also spread to the lymph nodes, liver and lungs and other organs.

A large tumour in the prostate gland can spread into or press on areas around the prostate, such as the back passage or urethra. The urethra is the tube which carries urine from the bladder to the outside of the body.

Diagram showing metastasis of prostate cancer

Symptoms

You might have specific symptoms depending on where the cancer has spread to. These symptoms can also be caused by other medical conditions so might not be a sign that the cancer has spread.

Symptoms of cancer that has spread to the: 

The most common place for prostate cancer to spread to is the bones. This can include the:

  • skull
  • spine
  • pelvis
  • ribs
Prostate cancer that has spread to the bone

The most common symptom if cancer has spread to the bone is bone pain. It is usually there most of the time and can wake you up at night. The pain can be a dull ache or stabbing pain.

Your bones might also become weaker and more likely to break (fracture).

Spinal cord compression happens when cancer that has spread to the spine puts pressure on the spinal cord. This stops the nerves being able to work properly. Back pain is usually the first symptom.

Spinal cord compression is an emergency. Your treatment team should give you a number to contact if you are worried you have spinal cord compression.

Lymph nodes are part of a system of tubes and glands in the body that filters body fluid and fights infection.

The most common symptom if cancer has spread to the lymph nodes is that they feel hard or swollen. There are lots of lymph nodes in the groin area, which is close to the prostate gland.

Diagram of prostate cancer that has spread to the lymph nodes

Cancer cells can also stop lymph fluid from draining away. This might lead to swelling in the legs due to fluid build up in that area. The swelling is called lymphoedema.

You might have any of the following symptoms if your cancer has spread to the liver:

  • discomfort or pain on the right side of your tummy (abdomen)
  • feeling sick
  • poor appetite and weight loss
  • a swollen tummy (called ascites)
  • yellowing of the skin and whites of the eyes (jaundice)
  • itchy skin

You may have any of these symptoms if cancer has spread to your lungs:

  • a cough that doesn’t go away
  • breathlessness
  • ongoing chest infections
  • coughing up blood
  • a build up of fluid between the chest wall and the lung (a pleural effusion)

Large tumours in the prostate can press on the urethra. The urethra is the tube that carries urine from the bladder. Prostate cancer can also spread to the urethra and bladder. You might find that that you:

  • pass urine more often
  • get up in the night to pass urine
  • have difficulty passing urine
  • have a strong urge to empty your bladder
  • have blood in your urine or semen
Diagram showing prostate cancer pressing on urine system

The rectum is part of the bowel that is close to the prostate. Prostate cancer can spread to the bowel, but it is rare. You might have:

  • constipation
  • abdominal (tummy) pain
  • blood in your poo or from your back passage

You should contact your doctor if you're concerned about any symptoms

Symptom control team

There are symptom control teams in most cancer units. They can help you to stay as well as possible for as long as possible. They are also in hospices and many general hospitals.

Most symptom control teams have home care services so they can visit you at home.

Coping

Finding out that your cancer can’t be cured is distressing and can be a shock. It’s common to feel uncertain and anxious. It's normal to not be able to think about anything else.

Lots of information and support is available to you, your family and friends. It can help to find out more about your cancer and the treatments you might have. Many people find that knowing more about their situation can make it easier to cope.

Talk to your doctor or nurse to understand:

  • what your diagnosis means
  • what is likely to happen
  • what treatment is available
  • how treatment can help you
Last reviewed: 
26 Jun 2019
  • Is Prostate Cancer Changing? Evolving Patterns of Metastatic Castration-Resistant Prostate Cancer.
    SM Doctor and others. Cancer, 2014. Vol 120. Issue 6.

  • Prostate Cancer: Diagnosis and treatment.
    National Collaborating Centre for Cancer, 2014

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