Cancer Prostate Cancer Diagnosis How to Tell If Your Prostate Cancer Has Metastasized Your doctor may use a variety of tests to see if your cancer has spread By Matthew Schmitz, MD Matthew Schmitz, MD LinkedIn Matthew Schmitz, MD, is a professional radiologist who has worked extensively with prostate cancer patients and their families. Learn about our editorial process Updated on February 08, 2020 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Doru Paul, MD Medically reviewed by Doru Paul, MD Doru Paul, MD, is board-certified in internal medicine, medical oncology, and hematology. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents How to Tell If Your Cancer Has Metastasized Types of Imaging Studies When prostate cancer metastasizes, spreads outside of the prostate itself, it typically affects the structures in its immediate vicinity. Structures near the prostate likely to be involved include your seminal vesicles, urinary bladder, and bones of your pelvis. Lymph nodes near the prostate are also often affected. Prostate cancer has a tendency to spread to the bones, specifically the pelvis, upper legs, and lower spine. While those are the most common sites for prostate cancer bone metastasis, any bones in your body could be a potential target. Prostate cancer can involve the liver, intestines, brain, lungs, and other tissues as well, though these are far less common than the bones. Cultura RM/T2 Images/Getty Images How to Tell If Your Cancer Has Metastasized Prostate cancer metastasis may be suspected if you have specific symptoms such as new lower back pain or elevated liver enzymes. These may be signs your cancer has spread to your spine or your liver, respectively. If your prostate-specific antigen (PSA) levels continue to rise despite treatment, especially if they are rising particularly fast, this may be a sign that cancer is metastasizing somewhere in your body. What You Should Know About the PSA Test Types of Imaging Studies If your healthcare provider suspects your cancer might be spreading, they will likely order more imaging tests. A common imaging workup may include a bone scan and a CT scan of the abdomen and pelvis. An MRI might be done as well. Some research centers are also using magnetic MRIs or PET scans to further refine the staging of prostate cancer. Bone scans: Bone scans look at your entire skeleton. Metastases to the bone will usually show up as "hot spots" on the bone scan. There are a number of factors which can cause "false positives" on bone scans, so it's good to understand this before having a study done.CT scans: A CT scan can be used to look for metastases in the abdomen and pelvis. Prostate cancer that has spread to the liver, intestines, or bones of the abdomen and pelvis can usually be found with a CT scan. Cancer which has spread to the lymph nodes can sometimes be detected if the lymph nodes have become enlarged.MRI: MRIs are sometimes used if there is a question as to whether your cancer has spread into tissues near the prostate or to see if there is tissue left behind in the prostate area following surgery.Enhanced MRI: Using an enhanced MRI to look for prostate cancer metastasis is a new area of research that aims to find difficult to detect lymph nodes metastasis. First, you are injected with tiny magnetic particles a day before the scan, then, the next day, you have an MRI. So far this method is the best way to detect lymph node involvement.PET scan: A PET scan is an imaging test that looks at your body's function as well as its anatomy. PET scans are often combined with CT scans. For this procedure, you are injected with a small amount of radioactive sugar. Cells which are actively growing, like cancer cells, take the sugar and light up during the exam. In some cases and with some cancers, PET scans can assist with staging your cancer in ways other tests can not. Prostate Cancer Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Was this page helpful? Thanks for your feedback! Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Prostate Cancer Foundation. Prostate Cancer Staging: What’s My “Stage”? Prostate Cancer Foundation. Prostate Cancer Metastases: What is Metastatic Prostate Cancer? U.S. National Library of Medicine. Prostate cancer. Sarkar S, Das S. A review of imaging methods for prostate cancer detection. Biomed Eng Comput Biol. 2016;7(Suppl 1):1-15. doi:10.4137/BECB.S34255 Additional Reading Leslie SW, Soon-Sutton TL, Sajjad H, et al. Prostate Cancer. StatPearls. Wong SK, Mohamad NV, Giaze TR, Chin KY, Mohamed N, Ima-nirwana S. Prostate cancer and bone metastases: the underlying mechanisms. Int J Mol Sci. 2019;20(10)