Some patients will have metastatic disease on initial presentation. Others may present with symptoms of recurrent disease after a previous cancer diagnosis. Access to the best available therapies, including clinical trials, as well as treatment overseen by a multidisciplinary team, are crucial to achieving the best outcomes for anyone with locally recurrent or metastatic disease.

Signs and symptoms will depend on the type of cancer initially diagnosed and the location of metastatic disease. They may be discovered by the patient or by surveillance in the post-treatment period. Patients with locally recurrent disease can present asymptomatically with a rising PSA, or with symptoms such as urinary symptoms. Symptoms such as pain, loss of energy or weight loss can occur in men with metastatic disease.

Imaging (pelvic MRI and PSMA PET/CT) may help to differentiate local recurrence, which may be curable with salvage therapy, from metastatic disease.