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Advanced Prostate Cancer: Bone MetastasisThe spread of cancer to the bone is the primary cause of death due to prostate cancer. Treatment is available, both to try and slow the spread of cancer to the bone, and to alleviate pain and suffering.
Cancer that has metastasized to the bone causes bone pain and osteoporosis, a weakness in bone from reduced bone density and increased porousness. Bone weakness puts patients at greater risk of fractures, which can be dangerous, particularly for older patients. Ongoing spread of cancer in the bone can cause severe pain and spinal damage, requiring further treatment or surgery, and eventually death. Cancer that has metastasized can wear small holes, called osteolytic lesions, in bone. This is called resorption and it can cause bones to become weak and fragile. Bone metastases can also cause abnormal bone formation. Abnormal areas of new bone, called osteosclerotic lesions, can form. They are weak and unstable and can break easily or collapse. Hormone therapy can also cause osteoporosis. In many cases, this bone weakening can be overlooked, so it is important to be checked for bone weakness when being treated with hormone therapy. Medications, such as bisphosphonates, are available to help strengthen bones and reduce the impact of cancer on the bone. Bisphosphonates are also being researched for their potential to block cancer from taking root in the bones. Radiation can be used to treat cancer in the bone in a specific area. Surgery is sometimes needed to remove tumors from the bone and support bone structure. Systemic therapies that treat the cancer wherever it is in the body include hormone therapy, chemotherapy, and radiopharmaceuticals, which are radioactive drugs that seek out and treat bone. Hormone therapy and chemotherapy are used to treat recurrent prostate cancer before it has spread to bone and to slow the spread of cancer once it has spread. To learn about research into new ways to treat bone metastasis, please visit the following pages in our new Research Section:
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