How does prostate cancer spread to bones and other organs?

Prostate cancer spreads through a process called metastasis, where malignant cells detach from the primary tumor, invade surrounding tissues, and enter the bloodstream or lymphatic system.12

Once in circulation, these cells travel throughout the body and lodge in the capillaries of distant organs. While blood flow patterns influence where cells travel, prostate cancer exhibits a "homing" phenomenon, showing a preferential affinity for the bone. This specific targeting is likely driven by interactions between receptor proteins on the surface of the cancer cells and molecules present in the extracellular matrix of the target tissue, which act as a favorable "soil" for the cancer to establish new secondary tumors.12

To successfully metastasize, cancer cells must also secrete enzymes to digest the extracellular matrix, allowing them to burrow through tissues and penetrate vessel walls. Once they exit the circulation and enter a new organ, they may begin to multiply, often stimulating angiogenesis to secure the nutrient supply necessary for tumor growth.21