Symptoms of advanced prostate cancer

Prostate cancer is often slow-growing and symptoms may not occur for many years.

The symptoms of advanced prostate cancer may include symptoms that are due to an enlarged prostate gland, or the result of secondary cancers.

Symptoms of an enlarged prostate gland can include:

  • difficulty passing urine – for example, a weak flow or having to strain to pass urine
  • passing urine more frequently than usual, or waking up at night to pass urine
  • feeling that the bladder has not fully emptied
  • blood in the urine (this is rare).

The symptoms related to a secondary cancer will depend on which part of the body is affected, although there are a few general symptoms which some men have. These include:

  • being more tired than usual
  • generally feeling unwell
  • having less of an appetite.

Secondary cancer in the bones

The first sign of a secondary cancer in the bones is usually a nagging ache in the affected bone. This can become painful, making it difficult to sleep at night, or move around without taking painkillers. The pain is generally present both day and night, whereas pain from arthritis, for example, is often worse early in the morning and is not there all the time.

A secondary cancer in the bone may gradually make it weaker. Pain and weakness can make getting around difficult, and a bone that is very weak may break (fracture) more easily.

If the bones in the spine are affected, this can sometimes lead to weakness and tingling or numbness in the legs. This is uncommon, but it can happen if the cancer is pressing on the spinal cord. This is called malignant spinal cord compression.

If you have weakness, pain, tingling or numbness in your legs it's important to let your doctors know immediately – even at the weekend or during a holiday period. If you can’t get hold of your cancer doctor, you should go to the nearest A&E department. Explain to them that you have cancer and describe your symptoms.

Sometimes, when bones are affected by cancer cells, extra calcium may be released into the blood. This is called hypercalcaemia. It can cause symptoms such as tiredness, feeling sick, constipation, thirst, poor appetite and confusion.

Secondary cancer in the bone marrow

Sometimes prostate cancer can spread to the bone marrow. This is the spongy material found in the centre of our bones. It produces the different types of blood cells, which include:

  • red blood cells, which carry oxygen around the body
  • white blood cells, which help fight infection
  • platelets, which help the blood to clot and prevent bleeding.

If the bone marrow is unable to produce enough blood cells, you may become anaemic, be more likely to get infections or have bruising or bleeding.

Other symptoms

Prostate cancer can occasionally affect other parts of the body such as the lungs, lymph nodes, brain or liver. If you notice any new symptoms that last for a couple of weeks or more, you should discuss them with your cancer specialist.

It’s important to remember that any of the symptoms can be caused by conditions other than cancer.

The consultant at the local hospital was brilliant, arranging a bone scan and an MRI scan. The options for treatment were discussed and I had hormonal therapy.


Back to Understanding advanced prostate cancer

Cancer and cell types

Cancers are grouped into types. Types of cancer often behave and respond to treatments in different ways.

The prostate

The prostate gland produces semen. It is situated close to the tube, which is called the urethra. Urine and semen leave the body through the urethra.

About advanced prostate cancer

Prostate cancer is the most common cancer in men. Advanced prostate cancer is when the cancer has spread to other parts of the body.

Why do cancers come back?

Sometimes, tiny cancer cells are left behind after cancer treatment. These can divide to form a new tumour.