Patients may think they can detect if their tumor has spread, but this is not the case. Most people with advanced prostate cancer do not have obvious symptoms.
This is why regular follow-up is important, because a progressive increase in prostate specific antigen (PSA) on follow-up exams is likely to indicate that the tumor has spread. The doctor can also determine whether the tumor has spread through rectal exams or imaging, and the earlier it is detected, the better the treatment.
Some patients will have symptoms, such as difficulty urinating or hematuria, that suggest the possibility of tumor spread. Other patients may present with extreme weakness, shortness of breath, or unexplained weight loss.
If the cancer has spread to the bone (bone metastases), the patient may be in a lot of pain. The location of the pain depends on the bones involved; for example, if the cancer has spread to the pelvis, you may feel pain in the hip or back.
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