Table of Contents

Chapter 8: Managing Bone Metastases and Pain

As cancer cells begin to spread outward from their original starting place, they can spread locally, to the immediately surrounding areas, or they can spread distantly, to other organs in the body. There’s no way to predict exactly how any type of cancer will spread, but, over the years, researchers have found that different types of cancers tend to spread in distinct patterns, and that different types of cancer cells seem to prefer to settle in some areas more than others. For reasons that remain somewhat unclear, prostate cancer cells seem to prefer bone tissue and tend to migrate there after escaping the pelvic region.

Once the cells settle in, they’re known as prostate cancer bone metastases (singular is metastasis). Unlike bone cancer, which originates in the bone, prostate cancer bone metastases are actually collections of prostate cancer cells that happen to be sitting within the bones. Therefore, the same treatments that are used to kill prostate cancer cells in other areas, such as hormone therapy and chemotherapy, are often used in men with bone metastases as well.

But the prostate cancer cells in the bone don’t just sit there idly. They interact with the bone tissue, often disrupting the normal growth and function of the bone and weakening it. So in addition to any traditional anti-cancer treatments that your doctors might have already given you, treatment strategies for bone metastases also have to focus on making sure that your bones stay as healthy and strong as possible.

Ultimately, there are three treatment goals for men with prostate cancer bone metastases. As with all anti-cancer treatments, the first goal is to slow the growth of the cancer cells as best as possible. The second is to reduce the complications caused by the metastases and the weakened bone tissue. But the third and equally important goal is to relieve or prevent pain. Many men with prostate cancer bone metastases experience pain, and dealing with untreated pain expends a lot of energy—energy that you need to stay healthy and strong.

In this Chapter,we’ll review some of the more common problems caused by bone metastases as well as the ways that doctors and researchers have learned to treat the metastases and improve the lives of men with advanced prostate cancer.