Prostate cancer metastasizes in three main ways: direct spread, lymphatic tract, and blood.
Specifically:
- Direct spread is that prostate cancer can break through the prostate envelope and spread locally, directly invading and infiltrating adjacent tissues and organs, including seminal vesicles, bladder, vas deferens, pelvic wall tissues, etc.
- Lymphatic metastasis refers to the metastasis of prostate cancer along the lymphatic vessels, most commonly to the pelvic lymph nodes, and rarely to the retroperitoneal, mediastinal and supraclavicular lymph nodes, and occasionally to the inguinal lymph nodes;
- Bloodstream metastasis is also more common, that is, cancer cells invade blood vessels and metastasize with blood flow, most commonly bone metastasis, and a few can be seen in the lung, liver, brain, pleura, adrenal gland and other visceral metastases.
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Bone metastases are the most common of these metastatic pathways, occurring in more than 70% of all patients with distant metastases, and the most common sites of bone metastases are the weight-bearing bones such as the vertebrae, pelvis, and upper femur.