Prostate cancer Managing Bone Metastases and Pain

executive summary by prostate cancer foundation

Prostate cancer cells that spread to the bone are known as prostate cancer bone metastases (not bone cancer). Detecting Metastases

The "gold standard" test for bone metastases is the bone scan. The dye-like material highlights areas where bone tissue is changing rapidly—a hallmark effect of prostate cancer bone metastases.

Bone scans can detect even small amounts of increased bone metabolism, but not all changes are caused by prostate cancer bone metastases. Treating Metastases

An important part of prostate cancer bone metastases management is maintaining adequate calcium and vitamin D levels and exercising regularly. Even though none of these are treatments for bone metastases, they will all help to maintain strong bones and help to minimize bone loss and osteoporosis, which can make treating bone metastases more challenging.

Radiation Therapy Targeting Bone Metastases
Men who experience pain from a bone metastasis will often be treated with radiation targeted directly to the metastasis. (Note that radiation therapy used to treat bone metastases is completely unrelated to radiation therapy that might have been used earlier in prostate cancer treatment.)

Bone-Targeting Agents (Bisphosphonates)
Under normal circumstances, bone cells are destroyed and created at a constant rate. Increasing the activity of osteoblasts, cells that form new bone cells, ultimately results in an overgrowth of bone tissue; increasing the activity of osteoclasts, cells that destroy bone cells, ultimately results in porous, brittle bone tissue. In men with prostate cancer bone metastases, both of these processes occur at faster than normal rates, leading to both an overgrowth of bone tissue and weakened and brittle bones. Bisphosphonates are drugs that are designed to help reset the balance in the bone between bone growth and bone destruction.