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Bone Complications in Prostate Cancer

Summary & Participants

When prostate cancer spreads, a common site is bone. This results in weakened bones that cause pain and are prone to fracture. Learn how these bone complications are treated and even prevented making it one less thing a person with prostate cancer has to worry about.

Medically Reviewed On: June 30, 2008

Webcast Transcript

ANNOUNCER: Prostate cancer patients sometimes face a complication with their disease when the malignant cells which have formed in the prostate, spread into the bones.

DEREK RAGHAVAN, MD, PhD: Bone metastases occur relatively commonly. I say relatively because probably 80% of people with prostate cancer don't have problems. But of the people who do, it tends to go to the lymph nodes and or bone in probably 90% of the people who happen to have metastases.

ANNOUNCER: Prostate cancer patients should check with their doctor about the possibility of bone complications.

DEREK RAGHAVAN, MD, PhD: Patients who have prostate cancer who develop metastases in bone, can either get a type called sclerotic metastases. Sclerotic essentially reflects a thickening of the bone. Less commonly there'll be a type of bone metastases called lytic metastases. And that means a hole forms in the bone.

PAUL MATHEW, MD: If there's a metastases present in a weight-bearing bone such as the femur, for example, such a bone might be more prone to fracture than others. Additionally if the cancer is present in the spine a complication know as spinal cord compression can occur and compress or press upon the adjacent spinal cord. This can result in significant disability, such as with paralysis.

ANNOUNCER: The main symptom of bone metastases is pain which can often be confused with arthritis pain in elderly patients.

DEREK RAGHAVAN, MD, PhD: As a general rule, arthritic pain is localized to a joint. So it'll be the knee, the hip, the elbow, something like that. Where mostly metastatic pain is within the actual bony tissue. It ultimately requires a relatively high level of clinical skill to identify the difference between arthritis type pain and metastasis type pain.

PAUL MATHEW, MD: Pain medications will form the centerpiece of managing any patient with malignant pain, whether it's bony or otherwise. And I think the pain can be particularly severe on occasion.

ANNOUNCER: Prostate cancer patients with bone complications do have several treatment options to discuss with their doctor.

DEREK RAGHAVAN, MD, PhD: Prostate cancer is driven by a male hormone or male chemical called testosterone. For the bone complications themselves if you effect a castration, meaning if you use any of the chemical or surgical ways of stopping testosterone production, in about 80% of patients that will cause the bone metastases to shrink and will put them into remission.

PAUL MATHEW, MD: Radiation therapy is generally reserved for patients who have painful metastases to bone that are threatening pathological fracture or a spinal cord compression.

ANNOUNCER: A more common treatment option involves drugs called bisphosphonates.

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