Advanced prostate cancer includes both locally advanced and distant metastases. Locally advanced means that the tumor grows infiltratively inside the prostate organ and protrudes to the outside of the prostate. Distant metastases of prostate cancer are mostly bone metastases, usually the vertebrae, i.e. the vertebrae on the spine, and then the ribs and iliac bones, which in medical terminology have obvious osteophilic characteristics. The answer is: the mechanism is unknown, however, there are several doctrines that are still more recognized by everyone. The blood circulation theory proposed by Batson suggests that there is a “portal” venous system between the prostate and the low lumbar vertebrae, and has been confirmed as the Batson venous plexus (vertebral venous plexus). The lack of a valve for venous traffic between the prostatic plexus and the Batson’s plexus leads to a much higher chance of metastasis of prostate cancer to the spine. Stephen Paget proposed the “seed and soil” theory, which suggests that distant tumor metastasis is a specific, rather than random, phenomenon. Thus, although prostate cancer cells metastasize throughout the body, this specific biology leads to a tendency for prostate cancer cells to eventually form metastatic foci in the skeleton rather than in other organs; Yonou et al. According to these two theories, bone metastasis is common in prostate cancer, but extraosseous metastasis is rare, even in patients with skeletal metastasis or terminal prostate cancer. It is important to add that extraosseous metastases of prostate cancer are called jumping metastases, such as liver and lung. This type of metastasis is often under-appreciated, delaying the diagnosis and proper treatment.