When we hear about prostate cancer, we often imagine it confined within the gland, but in advanced cases, prostate cancer can spread or metastasize to other parts of the body. Prostate cancer begins with abnormal cell growth in the prostate gland.

Metastatic prostate cancer, according to the website onlymyhealth, occurs when cancer cells spread outside the prostate to other parts of the body, classifying the disease as stage four or advanced.

While most prostate cancers are diagnosed early, metastatic disease usually develops in those with a history of prostate cancer treatment. Although curing metastatic prostate cancer is difficult, various treatments can help slow its progression and control symptoms.

The exact cause of metastatic prostate cancer remains unclear. It may occur when cancer cells break away from the original tumor in the prostate and spread to other parts of the body, usually traveling through the bloodstream or lymphatic system to form new tumors elsewhere.

Common metastatic sites associated with prostate cancer include:

• Bones: This is the most common site, especially the spine, hips, and ribs.
• Lymph nodes: These small glands, part of the immune system, are involved in about 10.6% of metastatic cases.
• Liver: About 10.2% of cases involve the liver.
• Lungs: Around 9.1% of men with advanced prostate cancer have lung metastases.
• Adrenal glands
• Brain
• Pancreas

Bones are the most common sites; new back or hip pain should never be ignored in anyone with a history of prostate cancer.

In early stages, metastatic prostate cancer may show no noticeable symptoms, but as the disease progresses, some signs may appear, including:

• Persistent fatigue or unusual tiredness
• Frequent urination or discomfort during urination
• Unexplained weight loss
• Nausea or vomiting episodes
• Developing pain in the back, hips, pelvis, or bones, which tends to worsen over time

These symptoms often depend on where the cancer has spread in the body.

Risk factors that increase the chance of prostate cancer spreading (metastasis) are the same as those that increase the risk of developing it initially. Key risk factors include:

• Age: Prostate cancer becomes more common with age, especially after 50 years.
• Race and ethnicity: In the United States, Black men face a higher risk of prostate cancer and are more likely to develop aggressive or advanced forms. The reasons are not fully understood.
• Family history: Having a blood relative such as a father, brother, or even grandfather with prostate cancer can increase risk.
• Inherited genetic mutations: Some inherited DNA changes, such as those in BRCA1 and BRCA2 genes (known for breast and ovarian cancer links), also increase prostate cancer risk.
• Obesity: According to cancer research in the United Kingdom, excess weight is linked to a higher risk of aggressive prostate cancer and faster growth and recurrence after treatment.
• Tobacco smoking: Studies indicate smokers are more likely to develop prostate cancer that spreads beyond the gland and may face higher recurrence risk, although research results are mixed.

Treatments for metastatic prostate cancer can weaken bones, making them more fragile and prone to fractures. To help protect bone health, doctors may recommend:

• Exercise: Aim for 30 minutes of weight-bearing activity most days (walking, light strength training).
• Nutrition: Eat calcium-rich foods (dairy products, leafy greens) and discuss vitamin D or calcium supplements with your doctor.
• Lifestyle: Quitting smoking to support overall bone and vascular health.

If you have had prostate cancer before or experience any of the symptoms mentioned, especially bone pain, fatigue, or urinary problems, it is important to consult your doctor. Early evaluation makes a significant difference. Even if previously treated, new symptoms deserve attention. Timely treatment slows disease progression and maintains quality of life.