Once metastasis has occurred, the cancer is diagnosed as stage IV, and if lymph nodes or bones have been affected by the spread of the disease, symptoms may slowly begin to appear. Treatment for metastatic prostate cancer often requires multiple therapy options used in conjunction with one another to achieve the best possible outcome for the patient.
When Prostate Cancer Spreads to the Lymph Nodes
A fluid known as lymph, which contains white blood cells, is created within the body. The lymphatic system is a process by which lymph is circulated throughout the body, and the lymph nodes are tiny organs that are meant to filter the circulating fluids. If prostate cancer begins to spread throughout the body, some cancerous cells may enter the lymphatic system and become lodged in the lymph nodes. Once entrenched, the cells begin multiplying and metastasis to the lymph nodes can be diagnosed.
Metastasis to the lymph nodes can occur in both local and distant lymph nodes. If prostate cancer spreads to local lymph nodes, it is designated a clinical stage of N1. The lymph nodes closest to the bladder are usually the ones affected in localized lymph node metastasis. However, if distant lymph nodes are affected by the spread of prostate cancer, a clinical stage of M1a is said to have been reached.
When Prostate Cancer Spreads to the Bones
It is fairly uncommon for cancers to begin in the bones. More often than not, cancers of the bones occur as the result of the metastasis of another cancer. Spreading to the bones is one of the most common occurrences in metastatic prostate cancer. If this occurs, a clinical stage of M1b has been reached. The original disease combined with the secondary cancer would now be referred to as prostate cancer with bone metastasis.
If metastasis to the bones occurs, it is usually the spine or femurs that are affected. According to the American Joint Committee on Cancer, some of the signs that prostate cancer has spread to the bones are stiffness and soreness in the lower back, thighs and pelvic region. A secondary cancer in the bones can be discovered through various diagnostic tests, including highly sensitive bone scans -- the most commonly utilized method of detection for bone metastases.
Other techniques your doctor may recommend for detecting bone metastases from prostate cancer are computed tomography (CT) scans, magnetic resonance imaging (MRI) tests and biopsies of the bones themselves.