You might think you’d know it if your cancer has spread, but that's not always true. Most men with advanced prostate cancer don't have any symptoms.
This is why your follow-up doctor visits are so important. You’re most likely to find out the cancer has spread if your doctor tests your blood and finds high levels of prostate-specific antigen, or PSA. He might also find it with a digital rectal exam or on an X-ray or other test. If you do have symptoms, they often include trouble peeing or blood in your urine. You might also feel very tired, short of breath, or lose weight without trying.
You’re more likely to feel pain if the cancer has gone into your bones. Where it hurts will depend on which bones it affects. For instance, you might feel hip or back pain if cancer has spread into your pelvic bones.