What is stage 4 prostate cancer?

Stage 4 prostate cancer is serious. As with all cancers, the higher the stage number, the worse the expected outcome. The way to think about cancer staging is like golf—you always want the lowest number.

Stage 4 cancers are the most advanced and mean that the cancer has spread from the prostate to other parts of the body. Most commonly, stage 4 prostate cancer will demonstrate cancer in the bones. We do not completely understand why this is, but about 90 percent of men with stage 4 prostate cancer have cancer that has spread to the bones. Unfortunately, this can cause pain in the bones, and rarely may lead to fractures or compression of the spinal cord. Other places in the body where prostate cancer may spread includes lymph nodes in the abdomen in about a third of patients, and less commonly the lung and liver.

Symptoms besides pain may include fatigue, change in appetite, weakness and urinary issues.

Fortunately hormone treatment can control stage 4 prostate cancer, often for years. It is not curative, but is effective in the vast majority of patients, at least initially.

Stage 4 prostate cancer has progressed to tissues near the prostate such as the rectum, bladder, and lymph nodes, or else it has spread into distant organs or the bones. The prostate is a small organ normally the size of a walnut that functions as part of the male reproductive system, producing and transporting semen. Prostate cancer is a common cancer among men and can be difficult to detect in its early stages.

Stage 4 prostate cancer is part of the second most common cancer type after skin cancer. Prostate cancer is also the second-highest cause of death among men suffering from cancer. Of the 2,276,112 men with a history of prostate cancer in the United States in 2007, 4 percent were at a stage (such as stage 4) in which the cancer had metastasized, or spread to other parts of the body.

Effects of stage 4 prostate cancer can primarily be found in the male urinary and reproductive systems. Urinary problems can include difficulty starting and stopping urination or a weakened urine stream, feeling the need to urinate more than usual, blood in the urine, or a burning sensation during urination. Reproductive symptoms include difficulty achieving an erection or blood in the semen. Stage 4 prostate cancer can also cause pain in the bones and muscles of the pelvic area such as the hips, thighs, and lower back, as well as swollen legs.

Stage 4 prostate cancer is generally detected and diagnosed through routine screening. Prostate cancer can be detected even before symptoms begin to appear. There are two common tests for the disease: digital examination, in which the doctor physically feels the prostate using a lubricated finger inserted through the rectum; and the prostate-specific antigen (PSA) test, which is a blood test. If either of these tests indicates the potential for prostate cancer, further tests will be ordered, possibly including an ultrasound and a biopsy, or sample, of prostate tissue. Although it is possible to detect and diagnose stage 4 prostate cancer before symptoms appear, the practice remains controversial, as early detection of prostate cancer is not necessarily linked to higher survival rates.

Stage 4 prostate cancer is the most serious and deadliest of the four stages. In contrast to the other stages' five-year relative survival rates of 100 percent, stage 4 prostate cancer's survival percentage over the same period is a mere 30 percent. If the cancer has become metastatic, or spread to other organs, then no cure is possible and death cannot be prevented and usually comes within three years of diagnosis.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.