Published: Oct 23, 2023

Advanced prostate cancer can be hard to face.

The older title of this topic used scary words.

This guide takes a kinder and safer approach.

Advanced prostate cancer does not always mean a person is dying right now.

Many people live with it for months or years.

Some treatments can slow the cancer.

Some care can ease pain.

Some support can help the patient and family feel less alone.

Still, symptoms can become serious.

It is important to know what to watch for.

This guide explains the symptoms of advanced prostate cancer, red flags, palliative care, end-of-life support, caregiver tips, and when to call a doctor.

For more help, visit our Cancer Awareness & Prevention Hub, Men’s Health Hub, Pain Management & Conditions Hub, Medical Tests & Screenings Hub, Mental Health & Wellness Hub, and Health Hub.

Medical note: This article is for education only. It does not diagnose or treat prostate cancer, metastatic cancer, bone metastases, spinal cord compression, high calcium, kidney failure, infection, blood clots, pain crisis, or end-of-life symptoms. Call the cancer team or emergency services for severe pain, new leg weakness, numbness, trouble walking, loss of bladder or bowel control, confusion, chest pain, severe shortness of breath, fever during treatment, heavy bleeding, or sudden major decline.

Quick Answer: What is advanced prostate cancer?

Advanced Prostate Cancer means prostate cancer has grown beyond the prostate.

It may spread to nearby tissues.

It may spread to lymph nodes.

It may spread to bones.

It may spread to other organs.

When prostate cancer spreads far from the prostate, it is often called metastatic prostate cancer.

Advanced Prostate Cancer may cause:

• Bone pain
• Back pain
• Hip pain
• Fatigue
• Weight loss
• Loss of appetite
• Urinary problems
• Blood in urine
• Leg swelling
• Weakness
• Breathlessness
• Bowel problems
• Low mood or anxiety

Symptoms can often be helped.

Do not suffer in silence.

Does Advanced Prostate Cancer Mean Death Is Near?

Not always.

Advanced Prostate Cancer is serious.

But it does not always mean death is near.

Some people have symptoms for a long time.

Some people respond well to treatment.

Some people need more comfort-focused care.

The outlook depends on many things, such as:

• Where the cancer has spread
• How fast is it growing
• PSA changes
• Scan results
• General health
• Age
• Bone health
• Kidney health
• How well does the treatment work
• Other health problems

Ask the cancer team for a clear and honest update.

It is okay to ask direct questions.

Common Symptoms of Advanced Prostate Cancer

Symptoms depend on where the cancer is.

Some people have many symptoms.

Some have few symptoms.

1. Bone Pain

Prostate cancer often spreads to bones.

Bone pain may feel:

• Deep
• Aching
• Sharp
• Worse at night
• Worse with movement
• In the back, hips, ribs, pelvis, or legs

Bone pain should be reported.

Some treatments may help.

2. Back Pain

Back pain is common in many people.

But in Advanced Prostate Cancer, new or worse back pain needs attention.

It can come from bone spread.

It can also be a warning sign if accompanied by leg symptoms.

3. Fatigue

Fatigue is more than feeling tired.

It can feel like the body has no energy.

It may be caused by:

• Cancer
• Treatment
• Anemia
• Pain
• Poor sleep
• Low appetite
• Low mood
• Infection

Tell the care team.

Some causes can be treated.

4. Urinary Problems

Advanced prostate cancer can affect the ability to pass urine.

Symptoms may include:

• Weak urine flow
• Trouble starting
• Stopping and starting
• Going out often at night
• Feeling that the bladder is not empty
• Pain when passing urine
• Blood in urine
• Not being able to pass urine

Not being able to pass urine is urgent.

5. Weight Loss and Poor Appetite

Some people lose weight.

Food may taste different.

Nausea may happen.

Pain can lower appetite.

Mood can also affect eating.

Ask about nutrition support.

The goal may be comfort and strength, not strict dieting.

6. Swelling

Swelling can happen in the legs, feet, scrotum, or belly.

It may be linked with lymph nodes, low movement, blood clots, low protein, kidney problems, or other causes.

One-sided leg swelling with pain needs urgent care.

7. Bowel Problems

Bowel symptoms may include:

• Constipation
• Diarrhea
• Pain passing stool
• Blood in stool
• New loss of bowel control
• Feeling blocked

Constipation is common with pain medicines.

It can often be treated.

8. Breathlessness

Breathlessness may be caused by anemia, infection, blood clot, lung disease, heart problems, or weakness.

Severe or sudden breathlessness is urgent.

9. Mood Changes

Advanced cancer affects the mind too.

A person may feel:

• Scared
• Sad
• Angry
• Numb
• Worried
• Alone
• Confused
• Hopeless

This is not a weakness.

Support can help.

Emergency Red Flags

Call emergency services or the cancer team now if there is:

• New leg weakness
• Numbness in legs or around the bottom
• Trouble walking
• New loss of bladder control
• New loss of bowel control
• Severe back pain that is new or worse
• Severe bone pain
• Confusion
• Extreme sleepiness that is new
• Chest pain
• Severe shortness of breath
• Fever during cancer treatment
• Heavy bleeding
• Black stools
• Vomiting blood
• Not passing urine
• One-sided leg swelling with pain
• Sudden collapse

These signs can be serious.

Do not wait for the next appointment.

Spinal Cord Compression: Know the Warning Signs

This is one of the most urgent risks.

It can happen when cancer in the spine presses on the spinal cord.

It needs fast treatment.

Warning signs include:

• New severe back pain
• Back pain that gets worse fast
• Pain that wraps around the chest or belly
• Weak legs
• Numb legs
• Tingling in legs
• Trouble walking
• Falls
• Numbness around the bottom or groin
• New bladder problems
• New bowel problems

If these happen, call emergency services or the cancer team right away.

Fast care can help protect movement and function.

High Calcium From Bone Spread

When cancer affects bones, calcium can sometimes rise in the blood.

This is called hypercalcemia.

It can be serious.

Symptoms may include:

• Thirst
• Peeing a lot
• Constipation
• Nausea
• Vomiting
• Sleepiness
• Confusion
• Weakness
• Bone pain
• Dehydration

Call the cancer team if these symptoms appear.

Confusion or severe weakness needs urgent help.

Advanced Prostate Cancer Treatment Goals

Treatment goals can change over time.

At first, the goal may be to slow the cancer.

Later, the goal may also include comfort.

Both goals matter.

Treatment may aim to:

• Slow cancer growth
• Reduce pain
• Help urine flow
• Protect bones
• Prevent fractures
• Improve energy
• Reduce anxiety
• Support sleep
• Help the family plan
• Improve the quality of life

Care should match the person’s wishes.

Common Treatment Options

Advanced Prostate Cancer treatment can include many options.

The right plan depends on the person.

1. Hormone Therapy

Prostate cancer often uses testosterone to grow.

Hormone therapy lowers or blocks testosterone.

It may help slow cancer growth.

It may also ease symptoms.

2. Chemotherapy

Chemotherapy may be used for some people.

It can help control cancer and symptoms.

It can also cause side effects.

The cancer team will explain the risks and benefits.

3. Radiotherapy

Radiotherapy may help with bone pain.

It may also help with some local symptoms.

It can be used for symptom relief.

4. Bone-Targeted Treatments

Some medicines help protect bones.

They may lower the risk of bone problems in selected people.

Ask the cancer team if bone protection is needed.

5. Pain Medicines

Pain medicine can be simple or strong.

Some people need opioids.

This does not mean they are addicted.

It means pain needs control.

Tell the team if the pain is not controlled.

6. Urinary Symptom Care

Some people need help passing urine.

Care may include medicines, catheter support, or a procedure in selected cases.

Not passing urine is urgent.

7. Clinical Trials

Some people may qualify for a trial.

Ask the oncology team if this is an option.

What Is Palliative Care?

Palliative care is comfort care and support.

It can happen while a person is still getting cancer treatment.

It is not only for the last days of life.

Palliative care can help with:

• Pain
• Fatigue
• Nausea
• Constipation
• Breathlessness
• Sleep problems
• Anxiety
• Low mood
• Family stress
• Care planning
• Spiritual support
• Practical support

Ask for palliative care early.

It can work beside oncology care.

Is Palliative Care the Same as Hospice?

No.

Palliative care can start at any stage of advanced cancer.

Hospice care is usually for people near the end of life.

Hospice focuses on comfort when cure or life-extending treatment is no longer the main goal.

Hospice can help the person and family at home, in hospice, or in another care setting.

Ask the care team what support is available in your area.

Signs That More End-of-Life Support May Be Needed

This section is gentle and honest.

These signs do not always mean death is coming today.

But they can mean the body is getting weaker.

Call the cancer team, palliative care team, or hospice team if you notice:

• Sleeping most of the day
• Eating very little
• Drinking very little
• More confusion
• More weakness
• Needing help with most tasks
• More pain
• More breathlessness
• More restlessness
• Less urine
• Cool hands or feet
• Changes in breathing
• Trouble swallowing pills
• Repeated falls
• Family struggling to cope at home

These are reasons to ask for more support.

No one should handle this alone.

What Comfort Care Can Include

Comfort care is active care.

It is not doing anything.

It may include:

• Pain medicine changes
• Nausea medicine
• Constipation care
• Breathlessness care
• Anxiety medicine if needed
• Help with sleep
• Mouth care
• Skin care
• Pressure sore prevention
• Home nursing
• Family teaching
• Spiritual care
• Emergency plan

The goal is comfort, dignity, and support.

How to Manage Pain

Pain can often be eased.

Tell the care team:

• Where the pain is
• How strong is it
• What it feels like
• When it happens
• What makes it worse?
• What helps?
• How long does medicine last
• If side effects happen

Do not wait until pain is unbearable.

Ask for help early.

Constipation Care

Constipation is common in Advanced Prostate Cancer.

It can be caused by pain medicine, low movement, low fluid, low food intake, high calcium, or the cancer itself.

Tell the team if there is:

• No stool for several days
• Belly pain
• Vomiting
• Swollen belly
• Hard stool
• Pain passing stool

People taking opioid pain medicine often need a bowel plan.

Ask before constipation becomes severe.

Fatigue Care

Fatigue may not go away with rest.

Still, small steps may help.

• Save energy for important tasks.
• Use a chair in the shower.
• Accept help with meals.
• Use short walks if safe.
• Rest between tasks.
• Ask about anemia tests.
• Ask about sleep support.

Energy is precious.

Use it with care.

Food and Drink Support

Food may become hard.

Do not force large meals.

Try small comfort foods.

Ask the care team about:

• Small meals
• Soft foods
• High-protein snacks
• Nausea control
• Mouth care
• Swallowing problems
• Fluid goals
• When eating less is part of the natural process

Near the end of life, a person may not feel hunger in the same way.

The care team can guide the family.

Breathlessness Care

Breathlessness can be scary.

Call urgent care for sudden or severe breathlessness.

For ongoing breathlessness, the care team may suggest:

• Position changes
• Cool air from a fan
• Breathing techniques
• Medicine
• Oxygen in selected cases
• Treating anemia or infection if present

Do not try to manage severe breathing trouble alone.

Emotional Support

Advanced Prostate Cancer can bring grief before death.

The patient may grieve the loss of strength.

The family may grieve changes, too.

Support may include:

• Counseling
• Support groups
• Faith or spiritual care
• Palliative care team support
• Social worker support
• Family meetings
• Medication for anxiety or depression if needed

Fear is normal.

Help is available.

Caregiver Tips

Caregivers need care too.

Simple steps can help.

• Keep a symptom notebook.
• Keep medicine lists updated.
• Ask for a 24-hour contact number.
• Learn red flags.
• Accept help from family or friends.
• Use home nursing if available.
• Ask about equipment like a hospital bed or commode.
• Rest when you can.
• Eat and drink.
• Ask for respite care if needed.

Caregiving can be loving and exhausting.

You do not need to do it alone.

Planning Ahead

Planning can feel hard.

But it can reduce fear later.

Ask about:

• Goals of care
• Treatment choices
• Emergency plan
• Home care support
• Hospice timing
• Advance directives
• Power of attorney
• Preferred place of care
• Preferred place of death
• Spiritual wishes
• Funeral wishes, if the person wants to talk about them

These talks can be emotional.

They can also be a gift to the family.

What Not to Do

• Do not ignore new severe back pain.
• Do not ignore leg weakness or numbness.
• Do not wait with loss of bladder or bowel control.
• Do not stop cancer medicine without the oncology team.
• Do not hide pain to “be strong.”
• Do not skip constipation care with opioid pain medicine.
• Do not force food near the end of life without guidance.
• Do not assume palliative care means giving up.
• Do not leave caregivers without support.
• Do not wait until a crisis to ask about hospice.

Simple 7-Day Support Plan

This plan does not replace cancer care.

It helps you get organized.

Day 1: Write Symptoms

List pain, urine problems, appetite, sleep, mood, bowels, and energy.

Day 2: Check Red Flags

Learn the warning signs for spinal cord compression, infection, and urgent symptoms.

Day 3: Call the Cancer Team

Ask which symptoms need same-day help.

Day 4: Ask About Palliative Care

Ask for symptom support, even if treatment is still active.

Day 5: Review Medicines

Check pain medicine, bowel medicine, nausea medicine, and side effects.

Day 6: Plan Home Support

Ask what equipment, nursing, or caregiver help is available.

Day 7: Talk About Wishes

Ask what matters most to the patient now.

Daily Checklist

• Is pain controlled?
• Can the person pass urine?
• Has there been a bowel movement?
• Is there new back pain?
• Is there leg weakness or numbness?
• Is breathing okay?
• Is the person confused?
• Is there a fever?
• Is food or drink very low?
• Are medicines being taken safely?
• Does the caregiver need help?
• Do we need to call the care team?

Questions to Ask the Cancer Team

• What stage is the cancer now?
• Where has it spread?
• What symptoms should we expect?
• What symptoms are emergencies?
• Is treatment still helping?
• What are the goals of treatment now?
• Can palliative care help now?
• How can we control pain better?
• Do we need bone protection treatment?
• What should we do for constipation?
• When should we consider hospice?
• Who do we call at night or on weekends?
• What support is available for caregivers?

FAQ

What is Advanced Prostate Cancer?

Advanced Prostate Cancer means prostate cancer has grown beyond the prostate. It may spread to nearby tissue, lymph nodes, bones, or other organs.

Does Advanced Prostate Cancer mean death is near?

Not always. Advanced Prostate Cancer is serious, but some people live with it for a long time. The outlook depends on where it has spread, treatment response, symptoms, and overall health.

What are common symptoms of Advanced Prostate Cancer?

Common symptoms may include bone pain, back pain, fatigue, urinary problems, weight loss, appetite loss, leg swelling, bowel problems, breathlessness, and mood changes.

What are urgent warning signs?

Urgent signs include new leg weakness, numbness, trouble walking, loss of bladder or bowel control, severe back pain, confusion, chest pain, severe shortness of breath, fever during treatment, or not passing urine.

Can Advanced Prostate Cancer cause bone pain?

Yes. Prostate cancer can spread to bones and cause pain. Bone pain may be deep, aching, sharp, worse at night, or worse with movement. Tell the cancer team because treatment can help.

What is palliative care for Advanced Prostate Cancer?

Palliative care helps ease symptoms and improve quality of life. It can help with pain, fatigue, nausea, constipation, breathlessness, mood, family stress, and care planning.

Is palliative care the same as hospice?

No. Palliative care can happen at any stage of advanced cancer. Hospice care is usually for people near the end of life when comfort is the main goal.

What signs may mean more end-of-life support is needed?

More support may be needed if the person sleeps most of the day, eats or drinks very little, has more confusion, has more pain, becomes very weak, has breathing changes, or the family cannot manage care at home.

Can pain from Advanced Prostate Cancer be treated?

Often, yes. Pain may be helped with pain medicines, radiotherapy, bone treatments, palliative care, and other support. Tell the team if the pain is not controlled.

When should caregivers call for help?

Caregivers should call for help with severe pain, confusion, breathing trouble, fever, falls, new weakness, bladder or bowel changes, not passing urine, or if care at home feels unsafe.

Related Reading

• Cancer Awareness & Prevention Hub
• Men’s Health Hub
• Pain Management & Conditions Hub
• Medical Tests & Screenings Hub
• Mental Health & Wellness Hub
• Cancer Prevention: Daily Habits That May Lower Risk
• Hot Flashes and Cancer: Possible Links and When to Check
• Secondary Liver Cancer: Symptoms and Care
• Lung Cancer Symptoms NHS: Early Signs and Care
• Mental Health Self-Care Tips
• Health Hub

Key Takeaway

Advanced prostate cancer is serious.

But it does not always mean death is near right now.

Symptoms may include bone pain, back pain, fatigue, urinary problems, weight loss, swelling, bowel changes, breathlessness, and mood changes.

Many symptoms can be helped.

Palliative care can support comfort and quality of life.

Call for urgent help with new leg weakness, numbness, trouble walking, bladder or bowel control changes, severe back pain, confusion, chest pain, severe breathlessness, fever during treatment, or not passing urine.

The goal is care, comfort, dignity, and support for the patient and family.

 

References and Sources

• National Cancer Institute — Palliative Care in Cancer
• American Cancer Society — Treatments for Prostate Cancer Spread to Bones
• Cancer Research UK — Symptoms of Metastatic Prostate Cancer
• Prostate Cancer UK — Managing Symptoms in Advanced Prostate Cancer
• Macmillan Cancer Support — Advanced Prostate Cancer