spread

Last reviewed 01/2018

Prostatic carcinoma spreads in three ways:

• direct local invasion:
• usually involves the seminal vesicles, base of the bladder, and urethra
• rectal involvement is uncommon and late

• lymphatic:
• initially to the obturator nodes, followed by perivesical, hypogastric, ilial, pre-sacral and para-aortic nodes

• haematogenous:
• particularly to bones
• tumour cells have ready access to the rich venous plexus contained within the fibrous sheath of the gland capsule
• common sites for metastasis are, in descending order of frequency, lumbar spine, proximal femur, pelvis, thoracic spine, ribs and skull
• lesions are typically osteosclerotic
• spread may also occur to the liver and the lung