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Staying Silent About Signs
and Symptoms of Prostate Cancer?


Advanced prostate cancer can affect you in obvious and, sometimes, not so obvious ways. Nobody knows your body better than you do.

Talk to your doctor about any of these symptoms you may be experiencing:

  • Tiredness/fatigue
  • Aches, pain, or discomfort
  • Weakness/numbness
  • Trouble falling or staying asleep
  • Anxiety or distress as a result of pain
  • Difficulty doing normal activities

You should also talk to your doctor about:

  • Any treatment side effects you are experiencing
  • Potential setbacks on current therapy
  • If you have had a rise in your latest PSA test

If you are experiencing anything abnormal or different, talk to your doctor to find out what is causing the problem.



If your prostate cancer is advancing, here are treatment options that provide a variety of benefits for this stage of your disease.


Because male hormones, such as testosterone (a type of androgen), help prostate cancer grow, this type of therapy works to lower those hormone levels. ADT is used to treat prostate cancer that has returned after surgery and radiation therapy or cancer that has spread to other parts of the body. However, ADT does not cure prostate cancer and eventually stops controlling the cancer. Non-surgical ADT therapies are either injected or taken by mouth.


Surgery called an orchiectomy is used to remove both testicles to stop the production of testosterone. When the testicles are removed, the cancer tends to stop growing or shrinks for a period of time. It’s a permanent procedure, as the testicles cannot be re-inserted, but also tends to be one of the less expensive androgen-reducing treatment options.

Prostatectomy is a surgical procedure performed at any stage of the disease, that removes all or part of the prostate and seminal vesicles. Sometimes cancer begins in, or spreads to, the lymph nodes. Lymph nodes exist in many places in the body and may need to be removed from the pelvic area during a prostatectomy. This procedure can happen at any stage of the disease. The goal is to reduce the risk of the cancer from spreading to other parts of the body. This procedure may cause sexual problems, because nerves can be damaged during the process. Efforts can be taken to resume normal function. You may have difficulty controlling your urine.

Hormonal Therapy

Hormonal therapy works to reduce the effects of androgen when your regular antiandrogen therapies have stopped working. This type of therapy can block an enzyme that stops the testicles and other parts of the body from making testosterone. Hormonal therapy can be taken by mouth.


There are two different types of radiopharmaceuticals—alpha-emitting and beta-emitting. These treatments are designed to treat cancer that has spread to the bone. After being injected into a vein (intravenously or IV), the medicine travels throughout the body, and settles predominantly in areas of bone that have been affected by cancer. The radiation kills cancer cells. Unlike external beam radiation therapy (EBRT), a type of radiation that focuses on one area at a time, this treatment can treat many bones affected by cancer at the same time.


Chemotherapy may be used when prostate cancer has spread outside of the prostate gland and hormone therapy isn’t working. Its goal is to destroy cancer cells by stopping them from growing or dividing into more cancer cells. Because chemotherapy targets cells that divide quickly, it can affect fast-growing cells in the:

  • Bone marrow
  • Lining of the mouth and intestines
  • Hair follicles

Chemotherapy is injected into a vein intravenously or taken by mouth. It’s delivered through the bloodstream to reach cancer cells all over the body. This type of treatment can lead to side effects.


Immunotherapy uses a person’s own immune system to fight cancer. The immune system is made up of cells like the ones in your blood. The immune system cells travel through your body to protect it from germs that cause infections. These cells can be used to fight and kill cancer cells.


Radiation uses x-ray beams or small radioactive pellets also known as “seeds” placed (implanted) inside the prostate. These kill cancer cells by destroying the part responsible for controlling how cells grow and divide.

Radiation therapy can be used to:

  • Treat low-grade cancer only in the prostate
  • Treat cancer that has grown outside of the prostate gland and into nearby tissues
  • Treat cancer that is not completely removed or returns to the area of the prostate after surgery
  • Reduce the size of the tumor if the cancer is advanced

External beam radiation therapy (EBRT), a type of radiation, provides relief from the most painful symptoms of bone metastases.

Supportive Care

Cancer can break down the bone. Bisphosphonates are used to protect the bone from these damaging effects. Bisphosphonates may also increase bone mass density. This lowers the chance of a serious bone incident such as a fracture. Bisphosphonates are given through the vein intravenously (IV) or by injection.

There is another type of supportive care called beta-emitting radiopharmaceuticals. They are focused only on relieving bone pain.


Do you ever ask your doctor for a medicine by name? Select one.


A PSA test is performed along with other tests when prostate cancer is suspected, but only a biopsy can confirm the presence of the disease. Many doctors and organizations recommend PSA screening for men as young as 40 years old who are at a higher risk. If you have already been treated for prostate cancer, the PSA test may be used to determine if the prostate cancer has returned.

In advanced prostate cancer, studies have shown that the PSA test should not be used alone to determine long-term outcomes, like living longer. The PSA level also does not predict whether or not a man will have symptoms. Other factors should be considered before your doctor recommends a treatment approach.


There are a number of different ways to monitor and find prostate cancer. Some of these include an MRI, a CT scan, a PET/CT scan, and a bone scan.

An MRI is useful in determining the severity of the disease and the appropriate treatment approach. It is typically used in patients that are at a higher risk for disease progression who may be candidates for surgery. Imaging can also be a useful tool in locating the tumor within the prostate. Many MRIs may be taken throughout the course of the disease.

Doctors may also perform a CT scan and/or a PET/CT scan. A CT scan is commonly done on the abdomen, pelvic, and chest areas, and can see if the cancer has spread from the prostate to other parts of the body, such as the bone. A PET/CT scan uses "tracers" to give doctors a more detailed look at areas where cancer cells may be in the body.

In addition, your doctor may perform a bone scan. During a bone scan, material is sent into your bloodstream and is absorbed by areas of damaged or compromised bone. If the test confirms “hot spots,” it is possible that prostate cancer has spread to your bones. If this occurs, it is important to talk to your doctor to see if a different treatment approach may be in your best interest.