Metastatic Prostate Cancer

Treatment of Metastases

Treatment of Bone Metastases

Prostate cancer cells can spread to the bones, generally to the spine. The treatment of bone metastases can have severe side effects. Your doctor will help to prevent and treat possible complications and side effects. This may allow you to live longer and with fewer symptoms.

Bone metastases can cause back pain. Your doctor will prescribe painkillers to manage the pain. In some cases your doctor may recommend a very strong painkiller, like morphine.

When tumours in the spine grow, they may cause spinal cord compression. This is a rare complication, but it is an emergency situation because it can lead to paralysis of the legs. The main signs of spinal cord compression are:

  • Pain in a specific spot in your spine that is different from your usual pain
  • New pain in the spine which gets worse and does not respond to painkillers
  • A tingling sensation down your spine, into your legs or arms
  • Pain in your spine which changes when you change position
  • Numbness in your legs
  • Stiffness or heaviness in your legs that make you lose your balance
  • Pain down your legs or arms
  • Weakness in your legs or arms

If you think your spinal cord may be compressed you should contact your medical team immediately.

Bones that are affected by tumours fracture more easily. If you are at risk of bone fractures, your doctor may recommend drugs to stabilize your bones. The most common are bisphosponates and denosumab. Your doctor may recommend a procedure to strengthen your bones by injecting material that helps harden your bone. This is known as cementoplasty. In rare cases, surgery is needed to stabilize your bones.

Bisphosphonates are administered with an IV every 4 weeks. They increase your bone mass, and can reduce pain and prevent fractures. Because bisphosphonates can damage your jaws, your doctor will advise you to see a dentist before you start treatment.

Denosumab is administered under the skin every 4 weeks. It also increases bone mass and generally causes fewer side effects than bisphosphonates.
If the bone metastases cause symptoms while you receive drug treatment, radiation therapy may help to relieve them and prevent fractures.

To keep your bones healthy you could exercise regularly, keep a healthy weight, stop smoking, and drink alcohol in moderation.

The risk of bone complications increases with age. To prevent complications from bone metastases, you may need to take nutritional supplements like calcium or vitamin D3.

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