If the disease has reached clinical
T3 or T4, it is classified as advanced
prostate cancer. Advanced prostate
cancer with bone
metastasis or lymph
node metastasis is more likely to cause Prostate
Cancer Symptoms than is an early stage of the disease.
Doctors usually check for bone metastasis and lymph
node metastasis which are denoted respectively by M
and N in clinical
In clinical stage T3, the tumor has extended beyond the prostatic capsule, possibly into the seminal vesicles, and is specifically called extraprostatic extension. Extraprostatic means ‘independent of the prostate gland.’ In clinical stage T4, the disease invades surrounding organs (other than the seminal vesicles) such as the bladder neck, external sphincter, or rectum.
is more likely to occur during advanced prostate cancer.
Metastatic disease refers to prostate cancer that has
left the prostate
gland and its neighboring organs. Advanced prostate
cancer bone metastasis and lymph node metastasis, which
can be local or distant, and bone metastasis are both
associated with advanced prostate cancer. Metastases
may involve symptoms that are not in the Prostate
Cancer Treatment Guide.
What causes Prostate Cancer Metastasis?
Metastasis occurs through a process called angiogenesis. Angiogenesis is the process by which new blood vessels are formed; malignant cells are capable of ‘hitching a ride’ into another part of the body. The malignant cells can commonly become lodged in the bones or lymph nodes. From there, the cells “take root” and start dividing uncontrollably.
Prostate Cancer Lymph Node Metastasis
The body produces a fluid called lymph which contains white blood cells and circulates through the lymphatic system. Lymph nodes are small oval or circular organs that filter this fluid. Cancerous cells that circulate through the body can become trapped in the lymph nodes. Once trapped, cancerous cells can begin their cycle of unhealthy division and result in lymph node metastasis.
There are two types of lymph node
metastasis: local and distant. Local lymph node metastasis
is designated by clinical
stage N1. Two lymph nodes lie on either
side of the bladder. Because these nodes are close to
the prostate gland, metastasis is considered local.
If cancerous cells begin to grow in any other lymph
node, the metastasis is considered distant. Distant
lymph node metastasis is denoted by clinical stage M1a.
Prostate Cancer Bone Metastasis
Primary cases of bone cancer are relatively
rare. Patients who develop bone cancer are more likely
to develop the disease as a result of advanced prostate
cancer metastasis. In prostate cancer, extension leading
to bone disease is designated by a clinical stage M1b.
If a person develops bone disease as a result of prostate
cancer, he does not now have bone cancer. Because the
cancer is classified according to where it originated,
he has prostate cancer with bone metastasis.
Symptoms of advanced prostate cancer
bone metastasis may cause stiffness or frequent soreness
in areas such as the lower back, hips, and thighs. Some
patients will experience more severe pain than others.
As the disease progresses, some prostate cancer patients
radiation therapy to alleviate the pain associated
with bone cancer.
The Growth of Prostate Cancer to Advanced Stages
Most cases of prostate cancer, however, usually grow
very slowly. Many men die with prostate cancer
rather than from prostate cancer and never
reach the stages of advanced prostate cancer. The slow
growth of the disease is one of the reasons why treatments
such as watchful
waiting are viable options, and why treatments such
are not. Watchful waiting monitors the disease for sudden
progression instead of starting an invasive treatment.
Chemotherapy on the other hand indiscriminately kills
quickly dividing cells. If the malignant cells in the
gland are not dividing quickly, treatment will not be
The Prostate Cancer Treatment Guide uses the Clinical and Pathological staging created by the American Joint Committee on Cancer (AJCC). To read more about prostate cancer clinical staging and pathological staging, please go to Prostate Cancer Staging.
iThe Prostate Cancer Treatment Guide uses the Clinical and Pathological staging created by the American Joint Committee on Cancer (AJCC). To read more about prostate cancer clinical staging and pathological staging, please go to Prostate Cancer Staging.