Later symptoms in advanced prostate cancer

There is the possibility that over time that the cancer will spread to other places and cause other symptoms in the later stages of advanced prostate cancer. These may occur alongside some of the other earlier symptoms.

However, it is important to remember when reading this that you may not experience any of these symptoms. The palliative care team will be able to help you to manage these and any other symptoms you have and to make you more comfortable. They will also give you emotional support.

Some of the later symptoms of advanced prostate cancer include:

Urinary problems 

Spinal cord compression

Hypercalcaemia

Anaemia

Lymphoedema

Urinary problems

Blood in the urine

Sometimes blood may be noticed in the urine (haematuria); this blood may be coming from the prostate gland. This can usually be controlled with surgery or radiotherapy. Let your doctor or nurse know if you have this symptom so that they can further advise you.
 

Kidneys not working properly

Sometimes the normal working of the kidneys can be affected by advanced prostate cancer. This might happen if the cancer blocks the drainage of the bladder or kidneys or spreads to nearby lymph nodes. 
 
The kidneys are responsible for removing waste products from the blood and making urine. If the kidneys are not working properly it means that waste products are not being cleared well enough from the body and they build up in your blood stream. This is often called kidney failure. 
 
You might notice increased fatigue (tiredness) and sleepiness, poor appetite, swollen ankles or feeling sick. It is important to tell your doctor or nurse if you have any of these symptoms, but remember they could also be present for other reasons.
 
The aim of treatment is to help the urine to flow better from the kidney. This is done either by placing a stent (small tube) into the tube (ureter) that drains the urine from the kidney into the bladder. Or in some situations a tube called a nephrostomy tube is placed into the kidney itself which then drains the urine into a special drainage bag that sits outside of the body. Radiation may also be suggested as a possible treatment to relieve the blockage.

Spinal cord compression

 
Prostate cancer can sometimes spread to your spine. In rare cases, this can lead to a complication called spinal cord compression. This is where the cancer presses on the nerves in your spine. Signs of spinal cord compression include:
 
  • Weakness, tingling (pins/needles) or numbness in your arms or legs
  • A narrow band of pain in your arms, legs or body
  • Unsteadiness on your feet or your foot going from under  you
  • Difficulty using your arms and legs
  • Having no control over emptying your bowels or bladder
  • Pain that moves down your legs or arms

If you develop weakness, numbness or pins and needles in your arms or legs, contact your doctor straight away. Receiving treatment quickly may prevent the nerves in your spine from being permanently damaged.

Hypercalcaemia

Hypercalcaemia means there is an increased amount of calcium present in the blood. This can be the result of the cancer causing calcium to be released from the bone where it is normally stored. Though it is not a common side-effect for men with advanced prostate cancer, it is important that it is treated if it happens.
 
Symptoms of hypercalcaemia may include:
 
  • Fatigue and lack of energy
  • Loss of appetite
  • Confusion
  • Constipation
  • Thirst
  • Passing urine frequently
  • Feeling sick or vomiting
 
Discuss with your doctor if you are having these symptoms, though you could have them for other reasons too. Usually your blood calcium level can be checked by a blood test. If your blood calcium is too high it may mean that you need some treatment to help bring it down.
 
This may mean an admission to hospital to receive fluids through a drip (intravenous) .This helps to flush out the excess calcium from your body. You may also get medicines called bisphosphonates, which help to lower the amount of calcium in your blood.
 
For more information, call the Cancer Nurseline Freephone 1800 200 700. Ask for our Bone Health factsheet (pdf, 408KB).

Anaemia

 
Anaemia occurs as a result of a reduced number of red blood cells in the blood stream. It can happen if there is a low level of iron in the diet or if the bone marrow is not working normally. This may be as a result of the prostate cancer itself or from treatments like chemotherapy or radiotherapy.
 
The red blood cells normally carry oxygen around the body. With symptoms of anaemia you may feel tired (fatigued) and lacking in energy. You might feel that you become breathless while doing simple tasks and you may look pale. A blood test will show if you are anaemic.
 
Talk with your doctor if you feel that you have these symptoms and he or she can investigate what might be causing it. The cause of the anaemia and how low the red blood cells are will influence how best to treat it.
 
Treatment for anaemia may involve taking iron supplements and increasing the amount of iron in your diet, by eating more iron-rich foods like red meat and green leafy vegetables. If the anaemia is more severe you may be given a blood transfusion. This means blood will be given to you through a needle inserted into a vein like a drip. You will usually begin to feel better after you have had a blood transfusion.
 

Lymphoedema 

 
Lymphoedema is a type of swelling that can occur for many reasons, including treatment for prostate cancer. Lymphoedema from prostate cancer treatment usually causes swelling in one or both legs, the tummy or around the genital area.  
 
The lymph nodes (glands) are part of the lymphatic system. This is a transport system that transports fluid called lymph. Normally the lymph nodes act as a filter system and work by helping to remove waste substances that enter our bodies.
 
If lymph nodes are removed or damaged during cancer treatment, or if the cancer has spread to them, the filtering mechanism may not work properly. As a result, a back log of fluid called lymph may build up in the tissues under the skin and cause swelling.
 
Lymphoedema can occur immediately after surgery or it can develop later, sometimes many years after treatment. If you would like further information and advice about lymphoedema you can download our factsheet, Reducing your risk of lymphoedema (pdf, 410KB)
 
You can also call the Cancer Nurseline Freephone 1800 200 700 if you would like to request a copy to be posted or if you would like to discuss your concerns with a cancer nurse specialist in confidence. You can also pay a visit to the local Daffodil Centre if there is one located in the hospital you are attending. 
 

Call our Cancer Nurseline

Freephone 1800 200 700 to talk to a specialist cancer nurse
It's open Monday-Thursday from 9am to 6pm and Friday from 9am to 5pm

Date Last Reviewed: 
Monday, October 19, 2015
Date Last Revised: 
Monday, October 19, 2015