According to the TNM and Whitmore-Jewett staging systems, the last stage of prostate cancer is stage IV or D. Cancer is an abnormal condition which occurs once the normal cells start to know an uncontrollable and rapid growth and an even faster death while the cancerous cells tend to multiply at a fast pace and outlive the normal ones. If the tumor is benign, the cancer will not develop but if the organ-confined tumor is malignant, it will soon enter the bloodstream and the lymph vessels and spread to other surrounding areas of the gland, growing other secondary, small tumors. If cancer is diagnosed the staging process is used to find out exactly how far advanced is the tumor and what treatment should be prescribed to stop it from becoming metastatic. If the cancer is metastasized the patient will experience some painful symptoms and if it is left untreated the cancer will eventually lead to death.

The common reported terminal symptoms indicate that the cancerous cells have reached the bone structures and far distanced organs and tissues such as the liver, the lungs, the spinal cord, the pelvis, the ribs or the vertebrae: respiratory problems and chest pains, abdomen pains, pains while urinating, leg pains, muscle weakness and incontinence, the compression of the spine, impotence or other sex problems will soon appear. In stage IV or stage D the cancer is locally advanced or metastatic; this stage is divided into other substages, and as the name of TNM staging system goes, the doctor will determine exactly just how spread is the cancer by analyzing the stage of the tumor, the nodes and the metastatic stage.

In substage D0 the blood tests show that the cancer has spread in the entire body even though the imaging tests and screening examination indicate something different; in substage D1 the cancer is developing in the lymph nodes; in substage D2 the cancer has spread to the surrounding organs, especially the bones since metastatic cancer has a tendency to affect first the bone structures; and in the last substage meaning substage D3, the cancer is somewhat similar as in stage D2, without advancing any further. The treatments available for this end stage give some discouraging and less effective results because in this stage the cancer can not be cured. Surgery or prostatectomy is usually a less effective operation and has little worth in treating the advanced forms of cancer, probably because the cancerous cells had spread outside the prostate capsule and already reached the surrounding areas of the gland.

The other treatment therapy options used in the fighting against cancer, even in its final stages, are: the radiation therapy, damaging the DNA of the cancerous cells with an external beam radiation or implanted radioactive pellets left in the gland until they decay, cryotherapy done freezing the prostate, hormone therapy also known as androgen deprivation therapy or the popular name of chemical castration and chemotherapy. Prevention measures should be taken in consideration by men over forty and the screening tests and prostate biopsy should be routinely done because this is the common method to detect the cancer in its early stages and treat it. Also worth mentioning the fact that cancer can be cured if the patients respond well to the prescribed treatment and if the tumor is not too far advanced.