What Stage is Prostate Cancer in Bones?

The prostate is a small gland that sits right below the bladder, in front of the rectum. Its principal function is to make fluid that forms the semen that carries sperms. Prostate cancer occurs due to abnormal and uncontrolled growth of prostate gland cells. It is the second most commonly occurring cancer among men worldwide.

According to the American Cancer Society, when this cancer spreads or is metastasized beyond the prostate gland, it is termed “Advanced.” Let’s find out a little about prostate cancer and the stage at which it spreads to the bones.

What is prostate cancer?

Prostate cancer is defined by the abnormal growth of cells in the prostate gland. Most prostate cancers are confined to the prostate gland and grow slowly and are confined to the prostate gland, where they may not cause serious harm.

However, while some types of prostate cancer grow slowly, other types are aggressive and spread quickly.

Stages of prostate cancer

Prostate cancer is further divided into specific stages based on cancer’s size, extent, and aggressiveness. The staging of prostate cancer ranges from 1 to 4, and it is helpful in the treatment and progression of cancer.

  • Stage 1 prostate cancer: It is present on only one side of the prostate and usually grows slowly.
  • Stage 2 prostate cancer remains confined to the prostate gland.
  • Stage 3 prostate cancer is locally advanced, where the tumor has progressed and is more likely to grow and spread.
  • Stage 4 prostate cancer – The stage where cancer spreads to bones. In this stage, cancer has spread to lymph nodes and distinct parts of the body and is further divided into two substages:
    1. Stage 4A: Cancer has spread to surrounding lymph nodes.
    2. Stage 4B: Cancer has spread to another body area, such as the bones or distant lymph nodes.

Stage 4 is also termed metastatic bone cancer, as it first spreads to the bones. The survival rate of stage 4 prostate cancer is the lowest, close to 30%.


If you have advanced prostate cancer (4th stage), it has moved to a part of your body outside your prostate gland. Cancer may appear in your bones, especially your spine, pelvis, ribs, or the femur’s upper part of your thigh bone. When cancer moves to your bones, you may experience symptoms like:

  • Pain. It can be a mild ache or sharp stabbing, and it may worsen at night.
  • Anemia. Cancer generally affects your bone marrow, which produces red blood cells. Anemia, or a low red blood cell count, can cause tiredness, weakness, dizziness, and shortness of breath.
  • Bone loss and fractures. Cancer tends to weaken your bones. In addition, medicines that lower your testosterone levels and other male sex hormones can cause bone loss and broken bones.
  • Pressure on the spine. Cancer spreads to your spine and puts pressure on the spinal cord and spinal nerves. This leads to bladder and bowel problems (constipation and trouble urinating), trouble walking, and weakness in your legs.

Survival rates of advanced prostate cancer with bone metastases

It is impossible to predict exact life expectancy after a diagnosis of metastatic bone cancer. It can be influenced by factors such as age and extent of spread. People with multiple sites of cancer spread have a lower life expectancy.

A recent survey estimated that people with prostate cancer that spreads to the bones show :

  • 1-year survival rate seen in 35% of the population.
  • 3-year survival rate seen in 12% of the population.
  • 5-year survival rate seen in 6% of the population.

Early detection of bone metastases may help the prognosis of the malignant disease.

How fast does prostate cancer spread to the bones?

Prostate cancer is graded based on factors like the size of the tumor, prostate-specific antigen (PSA) level, and other clinical symptoms.

If cancer has spread to the bones, it’s considered the most advanced, or stage 4.

The cells are observed during the biopsy (observing cancer tissue under a microscope) to diagnose prostate cancer. When more abnormal cells are seen, the cancer is more likely to spread faster.


The prognosis for prostate cancer with bone metastases usually depends on various factors. Although there’s no cure for stage 4 prostate cancer, treatment can help strengthen the weakness in bones and ease symptoms such as bone pain.


As cancer spreads outside the prostate gland, the primary goal of treatment is to slow down or prevent further spread to the bones.

Treatment options differ from person to person. Some commonly used options include:

1. Chemotherapy

Chemotherapy drugs destroy cancer cells and can slow the progression and spread of cancer to the bones. It is also used to shrink tumors to reduce their effects of the tumor.

2. Pain medications

Bone pain from advanced prostate cancer can be relieved by taking pain medications such as anti-inflammatories or opioids. You may also take pain medications for pain in the spine.

3. Corticosteroids

These medications are often used to treat the spreading of prostate cancer, and they also relieve bone pain for some and help lower prostate-specific antigen (PSA) levels.

4. External radiation

Radiation may be used to destroy cancer cells and reduce pain in case of a few bone tumors.

5. Radiopharmaceuticals

If cancer has spread to multiple bone sites, these radioactive medications are injected inside the bone to destroy cancer cells, which also helps reduce tumor size and pain.

6. Bisphosphonates

These are oral or injectable drugs that strengthen bones and prevent them from thinning. This reduces pain and the risk of fractures. Zoledronate (Zometa) is the most commonly used drug for prostate cancer spread to bones.

7. Denosumab (Xgeva)

Similar to bisphosphonates, this medication can help strengthen bones and prevent bone fractures. It is commonly used for people who already have cancer spread to the bones or are undergoing hormone therapy.

8. Surgery

If prostate cancer spreads to and weakens the spine, a minor surgery known as kyphoplasty is performed by surgeons to stabilize the affected spinal bones.


It can be very challenging to deal with a diagnosis of the advanced stage of prostate cancer. It’s natural to wonder if and how you can fight cancer. The cure is not guaranteed in stage 4 cancer, but with the latest advances in management, the spread of cancer to the bones can be slowed down and prevented.

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