About Prostate Cancer

Prostate cancer is the most common cancer among men in Canada, representing 21% of all new cancers in men and 1 in 10 new cancer diagnoses (men and women).

In 2017, 21,300 Canadian men were diagnosed with prostate cancer and 4,100 men died of prostate cancer, making it the third most common cause of death from cancer in men after lung/bronchus and colorectal cancer.

About nmCRPC
About Non-Metastatic Castration-Resistant Prostate Cancer (nmCRPC)
Non-metastatic CRPC (nmCRPC) is defined as a rising PSA with no detectable disease in the:
primary site,
lymph nodes beyond the pelvis detected by CT/MRI,
bone detected by radionuclide bone scan or CT, or
in visceral organs
nmCRPC patients with a PSADT of <10 months or elevated PSA levels (>20) are considered to be at a higher risk of developing metastases earlier.

View
the 2025 Canadian Urology Association (CUA) - Canadian Uro Oncology Group (CUOG) guideline for the management of nmCRPC.
View
the recommendations for the early identification of metastatic disease.
About mCSPC
About Metastatic Castration-Sensitive Prostate Cancer (mCSPC)
In Canada, approximately 8% of men with prostate cancer are diagnosed with de novo metastatic disease.
Men with metastatic prostate cancer have a poor prognosis, with an estimated median overall survival (OS) of approximately 3-4 years.
Features of high-risk disease include:
PSA >20 ng/mL
Gleason score >7
Clinical stage T3 or greater

Patients should be classified as high-volume/high-risk or low-volume/low-risk, based on conventional imaging and prostate cancer biopsy for prognostication.

View
the 2025 Canadian Urology Association (CUA) - Canadian Uro Oncology Group (CUOG) guideline for the management of mCSPC.
View
the recommendations for the early identification of metastatic disease.
About mCRPC
About Metastatic Castration-Resistant Prostate Cancer (mCRPC)
Approximately 10-20% of prostate cancer patients will develop castration-resistant prostate cancer (CRPC), within 5 years of follow-up.
Within another 2 years, 1/3 of patients with CRPC will develop metastases significantly increasing their annual risk of mortality from 16% to 56%.
Patients with non-metastatic CRPC may have micro metastatic disease in the bone at levels below the detection limits of standard radiological imaging.
Comprehensive imaging to determine the presence or absence of metastases should be considered when assessing subjects with prostate cancer for enrollment in future clinical trials.

View
the 2025 Canadian Urology Association (CUA) - Canadian Uro Oncology Group (CUOG) guideline for the management of mCRPC.
View
the recommendations for the early identification of metastatic disease.

Bone Metastases & Mortality in Prostate Cancer

Malignant cells are widely disseminated in men with advanced prostate cancer, yet metastases preferentially develop in the bones of the axial skeleton.
Approximately 90% of men with advanced prostate cancer develop bone metastases, and the majority who develop these metastases do so many years following removal of the primary tumour, indicating that the site/location of prostate cancer and the disease itself evolves over time.

For 9 out of 10 men with advanced CRPC / Prostate cancer spreads to the bones.

^{Adapted from Boopathi E,}^{et al}^{. 2022.}

Bone metastases are associated with significant mortality and multiple clinical symptoms, which also negatively impacts quality of life.

Footnotes
CRPC: castration-resistant prostate cancer; CT: Computed Tomography; MRI: Magnetic Resonance Imaging; nmCRPC: non-metastatic CRPC; PSA: prostate-specific antigen; PSADT: PSA Doubling Time.

PP-PF-ONC-CA-0118-1

References
1
Canadian Cancer Society. Canadian Cancer Statistics. A 2018 special report on cancer incidence by stage. Available at: https://cdn.cancer.ca/-/media/files/research/cancer-statistics/2018-statistics/canadian-cancer-statistics-2018-en.pdf. Accessed September 30, 2025.
2
Canadian Cancer Society. Prostate cancer statistics. Available at: https://cancer.ca/en/cancer-information/cancer-types/prostate/statistics. Accessed September 30, 2025.
3
Scher HI, et al. J Clin Oncol. 2016;34:1402-1418.
4
Saad F, So AI, Aprikian A, Finelli A, Fleshner NE, Gleave ME, et al. 2025 Canadian Urological Association-Canadian Uro-oncology Group Guideline: Metastatic castration-resistant prostate cancer (Update). Can Urol Assoc J. 2025;19(8):E276-E89.
5
So AI, et al. CUAJ-CUOG Guideline. CUAJ. 2025;19(5):E142-E152.
6
Kirby M et al. Characterizing the castration-resistant prostate cancer population: a systematic review. Int J Clin Pract. 2011;65(11):1180-92.
7
Crawford ED, Stone NN, Yu EY, et al. Prostate Cancer Radiographic Assessments for Detection of Advanced Recurrence (RADAR) Group. Challenges and recommendations for early identification of metastatic disease in prostate cancer. Urology. 2014;83(3):664-669.
8
Scher H, et al. Prevalence of Prostate Cancer Clinical States and Mortality in the United States: Estimates Using a Dynamic Progression Model. PLoS One. 2015;10(10):e0139440.
9
Yu EY, et al. Detection of previously unidentified metastatic disease as a leading cause of screening failure in a phase III trial of zibotentan versus placebo in patients with nonmetastatic, castration resistant prostate cancer. J Urol. 2012;188(1):103-109.
10
Boopathi E, et al. Bone Health Management in the Continuum of Prostate Cancer Disease. Cancers. 2022;14(17):4305.
11
Shimizu MR, et al. Incidence, Risk Factors, and Survival of Bone Metastases and Skeletal-Related Events in Melanoma Patients: A Systematic Review and Quality Assessment of 29 Studies. Journal of Bone. 2024;46:100603.

About Prostate Cancer

In 2017, 21,300 Canadian men were diagnosed with prostate cancer and 4,100 men died of prostate cancer, making it the third most common cause of death from cancer in men after lung/bronchus and colorectal cancer.

About Non-Metastatic Castration-Resistant Prostate Cancer (nmCRPC)

About Metastatic Castration-Sensitive Prostate Cancer (mCSPC)

About Metastatic Castration-Resistant Prostate Cancer (mCRPC)

Bone Metastases & Mortality in Prostate Cancer

Bone metastases are associated with significant mortality and multiple clinical symptoms, which also negatively impacts quality of life.