What Is Advanced Metastatic Prostate Cancer?

What is advanced metastatic prostate cancer? is something you may wonder if you have prostate cancer. Metastatic prostate cancer is when cancer has spread from the prostate to another place in the body. You may be diagnosed with advanced prostate cancer initially as is the case in 5 to 10% of patients with new diagnoses. Or you may develop advanced prostate cancer after initial treatment.

Your doctor may also refer to this as stage IV prostate cancer. The prostate cancer spreads outside of the prostate to areas such as the bladder or rectum as well as lymph nodes or other sites, such as bone.

What is advanced metastatic prostate cancer–symptoms

Advanced metastatic prostate cancer does not have specific symptoms. Rather, symptoms are often a result of where the prostate cancer has metastasized to and the size of the metastatic growth.

For example, metastatic disease to the spine may lead to back pain, while spread to the brain may cause headache or behavior changes, and spread to the lungs might lead to cough.

What is advanced metastatic prostate cancer–treatment

The treatment of advanced metastatic prostate cancer is complex. You need to make sure you discuss and understand all your treatment options with your doctor.

In general, first-line therapy for metastatic prostate cancer is androgen deprivation therapy. Prostate cancers grow as a result of male hormones such as testosterone, and treatments that lower testosterone levels decrease the size of prostate cancer. Patients who have an elevated PSA and worsening metastatic disease are generally considered to have failed androgen deprivation therapy.

It is not well known which treatments to pursue after failing androgen deprivation therapy for advanced metastatic prostate cancer. There have not been head-to-head clinical trials to evaluate second line treatments. Additionally, clinical trials of these agents have been done with different patient populations, making it difficult to apply results to all patients with prostate cancer.

A newer treatment for advanced metastatic prostate disease is a cancer vaccine called Provenge (sipuleucel-T). Provenge is an immunotherapy that utilizes your body’s own immune system to help fight your advanced metastatic prostate cancer.

With Provenge, your own immune cells are taken out of your body and treated to develop your personalized Provenge infusion. When your immune cells are given back to you as an infusion, your immune cells have been trained to find and attack the advanced prostate cancer cells in your body.

Am I a good candidate for Provenge?

The following characteristics have been found to indicate patients that might be a good candidate for Provenge:

  • Rising PSA level despite hormone therapy
  • Cancer that has spread to other parts of the body
  • Spread is not significant enough to need narcotics for pain control

Read more in our Prostate Cancer Health Center.


Hall SJ et al. Integrated safety data from 4 randomized, double-blind, controlled trials of autologous cellular immunotherapy with sipuleucel-T in patients with prostate cancer. J Urol 2011; 186(3):877.

Kantoff PW et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 2010; 363:411-422.