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Stage 4 prostate cancer

Medically reviewed by Last updated on Sep 19, 2023.


Stage 4 prostate cancer happens when cancer spreads beyond the prostate to other parts of the body.

Most prostate cancers are diagnosed when the cancer is only in the prostate. Sometimes prostate cancer doesn't cause symptoms, and the cancer may not be detected until it has spread. When prostate cancer spreads to other parts of the body, it's called metastatic cancer.

Treatments can slow or shrink a stage 4 prostate cancer. But most stage 4 prostate cancers can't be cured. Still, treatments can lengthen life and reduce symptoms of cancer.


Signs and symptoms of stage 4 prostate cancer may include:

When to see a doctor

Make an appointment with a doctor or other health care professional if you have ongoing symptoms that worry you.


The cause of stage 4 prostate cancer is not known. Stage 4 prostate cancer happens when prostate cancer cells break away from where they formed in the prostate. The cancer cells spread to other parts of the body.

Prostate cancer starts when cells in the prostate develop changes in their DNA. A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to replicate much more quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells form a mass called a tumor in the prostate. These tumors can grow to invade and destroy nearby healthy tissue. In time, cancer cells can break away and spread to other parts of the body.

Prostate cancer cells that spread past the prostate most often go to the:

Risk factors

Factors that can increase the risk of stage 4 prostate cancer include:


Tests and procedures to diagnose prostate cancer may include:


Treatments for stage 4 prostate cancer may slow the cancer and extend your life. But stage 4 prostate cancer often can't be cured.

Hormone therapy

Hormone therapy for prostate cancer is a treatment that stops the hormone testosterone either from being made or from reaching prostate cancer cells. Most prostate cancer cells rely on testosterone to grow. Hormone therapy causes prostate cancer cells to shrink or to grow more slowly.

Hormone therapy options include:

Hormone therapy side effects may include not being able to get and keep an erection, called erectile dysfunction. Other side effects include hot flashes, loss of bone mass, lower sex drive, growth of breast tissue on the chest and weight gain.

Radiation therapy

Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from X-rays, protons and other sources. During radiation therapy, you lie on a table while a machine directs radiation to precise points on your body.

Some people with stage 4 prostate cancer have radiation to the prostate or other areas. When the cancer has spread to other areas of the body, radiation therapy can relieve pain or other symptoms.


Surgery isn't often used to treat stage 4 prostate cancer. It might be recommended if the cancer causes symptoms that might be helped by surgery, such as trouble passing urine.

When surgery is an option, the operation may include:

Surgery carries a risk of infection and bleeding. Other risks include not being able to control urinating, erectile dysfunction and damage to the rectum.

Other treatments

Other treatments for stage 4 prostate cancer might include:

Clinical trials

Clinical trials are studies of new treatments. These studies provide a chance to try the latest treatments. The risk of side effects might not be known. Ask your health care team if you might be able to be in a clinical trial.

Palliative care

Palliative care is a special type of health care that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. A team of health care professionals gives palliative care. This team can include doctors, nurses and other specially trained professionals. Their goal is to improve the quality of life for you and your family.

Palliative care specialists work with you, your family and your health care team to help you feel better. They provide an extra layer of support while you have cancer treatment. You can have palliative care at the same time as strong cancer treatments, such as surgery, chemotherapy or radiation therapy.

When palliative care is used with all of the other appropriate treatments, people with cancer may feel better and live longer.

Alternative medicine

No alternative medicine treatments have been proved to cure stage 4 prostate cancer. But complementary and alternative medicine may help you cope with symptoms of your cancer, such as pain.

Complementary and alternative medicine treatments that may reduce cancer pain include:

If your pain isn't controlled enough, talk with a member of your health care team about your options.

Coping and support

People who are diagnosed with a serious illness often say they feel stressed. In time, you'll find ways to help you cope with stress and other feelings that come with a stage 4 prostate cancer diagnosis. Until you find what works for you, some of the following suggestions might help:

Preparing for an appointment

Make an appointment with a doctor or other health care professional if you have ongoing symptoms that worry you. Your health professional might refer you to a doctor who specializes in treating cancer, called an oncologist.

Here's some information to help you get ready for your appointment.

What you can do

When you call to make the appointment, ask if there's anything you need to do before you go to the appointment, such as restrict your diet. Ask a family member or friend to go with you to help you remember the information you get.

Make a list of:

For prostate cancer, questions might include:

Be sure to ask all the questions you have about your condition.

What to expect from your doctor

Be prepared to answer questions about your symptoms and your health, such as:

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