Stage 4 Prostate Cancer: Understanding Symptoms & Causes

The prostate is a walnut-sized gland located just below the bladder in men. Prostate cancer occurs when the cells in the prostate gland mutate and grow abnormally at an uncontrolled rate. There are four different stages of this cancer, with stage IV being the most advanced stage.

“I had never experienced something... something so terrible. I rushed to the toilet every hour or so. I thought maybe it was just because I was growing old, and how would I tell my family what I was going through?

That's when I saw Friends’ Azadi Mubarak ad on TV. Then it clicked! I wasn’t the only one dealing with urine leakage, so many others were too. And they made adult diapers for this problem. I started using them and went to my doctor to check what was happening in my body. I was diagnosed with stage 1 prostate cancer. I’m happy and well now, the cancer is gone too with the treatment.”

Usually, prostate cancer cells are less aggressive and slow-growing than cells found in other cancers. In 90% of the cases, the cancer is identified while it is still within the prostate, which means, the chances of it developing to stage IV are slim.

Overview of Metastatic Stage 4 Prostate Cancer

If your prostate cancer is diagnosed at stage 4, it has most likely already started growing outside the prostate and has spread to distant parts of the body.

When prostate cancer spreads to other parts of the body, doctors say cancer has ‘metastasized’. Stage 4 prostate cancer is also called ‘metastatic prostate cancer’. By stage 4, prostate cancer is most likely to spread to your:

• bones
• brain
• liver
• lungs
• lymph nodes

Stage 4 Prostate Cancer Symptoms

Since the prostate is very close to the bladder (hollow organ that stores the urine) and urethra (hollow tube that drains the urine from the bladder), the symptoms of prostate cancer are related to the urination process:

• Weak urine flow
• Strong and sudden urge to urinate
• Frequent urination
• Difficulty starting urination
• Pain or burning sensation when urinating
• Blood in urine or semen

Other symptoms of stage 4 prostate cancer depend on how far the cancer has spread and how big the tumors are. These include:

• Fatigue and weakness
• Rapid weight loss
• Bone pain and fractures (if cancer has spread to the bones)
• Abdominal swelling and Jaundice (if cancer has spread to the liver)
• Shortness of breath and chest pain (if cancer has spread to the lungs)
• Headaches, dizziness, and seizures (if cancer has spread to the brain)

Stage 4 Prostate Cancer Causes

Stage 4 prostate cancer causes are mostly unknown. But it happens within your body when the cancer cells have begun to spread. They are not only in your prostate anymore and shift to other body parts, including the liver, bones, and lymph nodes. Several risk factors are associated with prostate cancer which can turn into causes. Although these increase the chances, they are not clear signs of stage 4 prostate cancer. Sometimes, even when there are no risk factors or stage 4 prostate cancer symptoms, the disease can still occur.

Prostate cancer causes or risks are the following –

• Age:

Prostate cancer is more common in older men. The risk increases significantly after the age of 50. The majority of cases are diagnosed in men over 65. So, it is always recommended to get yourself checked from time to time.

• Genes:

In some cases, genes play a significant role. Some of them have been associated with an increased risk of prostate cancer. In this situation, an individual cannot do much. He can only try to manage and lead a healthy lifestyle.

• Family History:

Men with a family history of prostate cancer may have an increased risk. The risk is higher especially if it involves a father or brother. In case multiple relatives were/are affected with prostate cancer, the risk increases.

• Diet:

A diet high in red meat and high-fat dairy products is not good. This combined with low consumption of fruits and vegetables is associated with an increased risk of prostate cancer. But whether diet is one of the leading prostate cancer causesis still up for debate.

• Weight:

Some studies suggest a link between obesity and an increased risk of aggressive prostate cancer. So, on a personal front, it is important to keep your weight in check.

Signs of stage 4 prostate cancer should always be taken care of. If cancer spreads, it means that the cells are behaving aggressively and the body is responding to that.

Stage 4 Prostate Cancer Risk Diagnosis

If you are witnessing any stage 4 prostate cancer symptoms, it is important to get yourself diagnosed. Here are some of the methods –

• Imaging Tests:

Tests including CT, MRI, and bone scans are performed. They help in checking the inside of your body parts to detect prostate cancer and how fast it is spreading. PET scans are also performed if needed.

• Blood Tests:

A blood test is used to measure how much antigen for the prostate is inside the blood. In some cases, the cancer pushes the prostate to prepare extra antigens. This indicates that the person is suffering from cancer.

• Biopsy:

A tissue sample from the prostate is taken for testing in the lab. In some cases, a needle is used to take out the tissue. In others, surgery is required.

Stage 4 Prostate Cancer Risk Factors

According to the Prostate Cancer Foundation (PCF, America), age is the biggest risk factor for prostate cancer. PCF has estimated that almost 60% of all prostate cancer diagnoses are from men older than 65 years of age.

Other additional risk factors of prostate cancer include:

• Family history of prostate cancer.
• A history of smoking.
• Certain groups and races, and men who carry certain inherited mutations such as HOXB13, BRCA1 and BRCA2.

Stage 4 Prostate Cancer Treatments

While stage 4 prostate cancer isn’t curable, it can be treated. Treatment for stage 4 prostate cancer often focuses on slowing or stopping the further growth of cancer cells. Most men would need a combination of treatments over time. These treatments can also ease your symptoms and help you live a long and active life.

The best treatments for stage 4 prostate cancer are:

1. Hormone Therapy

Hormone therapy suppresses the production of male sex hormones such as testosterone that help prostate cancer cells grow. Some drugs stop the production of testosterone, while others work to prevent testosterone from stimulating cancer cell growth. There is even a surgical procedure to remove the testicles, which is where testosterone is produced. Potential side effects of hormone therapy include injection site reactions, anemia, and low sex drive.

2. Radiation

Radiation uses high-energy X-rays to kill cancer cells. Doctors can give you radiation therapy externally as well as internally.

In external radiation, beams of radiation focus on your prostate from a machine outside your body. The treatment just takes a few minutes and can ease symptoms when prostate cancer has spread to the bones. Even though it doesn’t hurt, fatigue is a common side effect.

In internal radiation, your doctor will insert small radioactive pallets, about the size of a rice grain, into your prostate. The pallets will emit a permanent low dose of radiation or a temporary high dose of radiation. Side effects of internal radiation include low sex drive, urinary-related problems, and bowel problems.

3. Chemotherapy

In chemotherapy, anti-cancer drugs kill cancer cells throughout your body. You might get chemo if hormone therapy isn’t working for you. Side effects of chemo include nausea, loss of appetite, hair loss, and weight loss.

4. Surgery

While surgery might seem like a good option for removing tumors, your doctor is less likely to recommend it to you if you have stage 4 prostate cancer and the cancer has spread to multiple parts.

But if your cancer hasn’t spread much beyond the prostate gland, your doctor might surgically remove the entire organ, and some tissue around it. You might also get radiation therapy after surgery to kill any cancer cells that were left behind.

Be sure to tell your doctor if you are facing any side effects from the treatments. In addition to treating cancer, your doctor can also give you treatments for the symptoms of prostate cancer like pain, incontinence, and fatigue.

And as we mentioned before, with treatment you can live for many years even with stage 4 prostate cancer. Learning about your cancer is extremely important. Be aware of some common prostate cancer emergencies so you can always be prepared. Also, educate your loved ones about these emergencies so they can always step in. See you in another blog!

5. Palliative care

In case of a serious illness like prostate cancer, palliative care is provided. This helps make the patient feel better and manage the illness better. In the case of prostate cancer, a doctor provides this type of care and it helps in relieving the symptoms. Apart from your doctor, specially-trained professionals and nurses are also present. The main aim is to improve your life and mental health. It shows that you have the complete support of your doctor during a tough situation. Palliative care is often accompanied by radiation therapy, surgery, and chemotherapy.

6. Clinical trials

Clinical trials play an important role in the medical field. They give a ray of hope that a cure can be found for life-threatening diseases. The same is the case with prostate cancer. Currently, several trials are running for the same. The medicines that will be approved for prostate cancer 4th stage treatment will enter the market. Medicines that have proved to be successful during clinical trials have helped patients treat or manage the disease.

Frequently Asked Questions about Stage 4 Prostate Cancer

1. What are the final symptoms of stage 4 prostate cancer?

Some symptoms of stage 4 prostate cancer depending on how far the cancer has spread are:

Fatigue and weakness, Rapid weight loss, Bone pain, fractures (if the cancer has spread to the bones), Abdominal swelling, and Jaundice (if the cancer has spread to the liver), Shortness of breath and chest pain (if cancer has spread to the lungs), Headaches, dizziness, and seizures (if cancer has spread to the brain).

2. What are the signs that prostate cancer has spread?

Some of the signs that prostate cancer has spread outside the prostate gland are:

• Fatigue and weakness
• Rapid weight loss
• Bone pain and fractures (if cancer has spread to the bones)
• Abdominal swelling and Jaundice (if cancer has spread to the liver)
• Shortness of breath and chest pain (if cancer has spread to the lungs)
• Headaches, dizziness, and seizures (if cancer has spread to the brain)

3. Is end-stage prostate cancer painful?

End-stage prostate cancer can cause pain in the areas the cancer has spread to. However, treatments can effectively ease the symptoms and reduce or relieve the pain.

4. What is the survival rate of stage 4 prostate?

Five-year stage 4 prostate cancer survival rate is 28%.

5. Is Stage 4 prostate curable?

Stage 4 prostate cancer is not curable but is treatable. Stage 4 prostate cancer treatment can not only prevent further growth of cancer but also ease the symptoms and help you live a long and active life.

6. How long can you live with 4-stage prostate cancer?

When stage 4 prostate cancer symptoms are detected, there are survival chances of approximately 28% for an average of 5 years. The rest depends on how your body is responding to the treatment.

7. How do you deal with Stage 4 cancer diagnosis?

Prostate cancer 4th stage treatment is a tough journey but there are a few options through which you can control the disease and pain. There are some systematic drugs like chemotherapy and targeted therapy which are common for the 4th stage.

8. How common is prostate cancer?

Every 1 out of 8 men is diagnosed with prostate cancer. It affects older men. As the age increases, the chances also increase. That’s why, men aged 50 or more should get themselves tested timely.

9. What can I do to help prevent prostate cancer?

Prostate cancer in most cases cannot be prevented. This is because the risks are associated with family history and genes. What you can do is follow a healthy diet, maintain weight, exercise every day, and stay sexually active.

10. Are some men more likely to be diagnosed with prostate cancer?

Men who have a medical history of prostate cancer are more likely to be diagnosed with it. It is also more common in older men above 65 years of age.