Over time, metastatic prostate cancer often stops responding to hormonal therapy. Advancing disease may be accompanied by painful symptoms, usually involving the urinary tract or bones, along with weakness, fatigue, and weight loss.

Doctors, including specialists in pain control, can offer a variety of ways to counteract such symptoms and help the patient achieve comfort. Radiation, with either external beam radiation therapy or periodic injections of bone-seeking radioactive chemicals (radionuclides), may ease pain caused by bone metastases, and it may also delay the progress of disease. Surgery can be helpful in opening a blocked urinary tract. Beneficial drugs include steroids and other “second-line” hormonal therapies, as well as painkillers. When pain cannot be entirely eliminated, it can be effectively relieved in the majority of patients.