How to treat bone metastasis in advanced prostate cancer?

Written by Yan Chun
Oncology
Updated on March 21, 2025
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For cases of advanced prostate cancer with bone metastasis, the following clinical treatment measures can be taken:

Firstly, for the pain caused by bone metastatic lesions, symptomatic pain relief treatment should be administered with medication. The pain from bone metastatic lesions generally presents as moderate to severe, and medications usually involve weak or strong opioids for pain relief. For some patients with advanced bone metastases, pathological fractures may occur, necessitating treatments such as bone stabilization and bone cement.

For some patients with advanced bone metastasis from prostate cancer, monthly injections of zoledronic acid can also be administered to treat the bone metastases. When prostate cancer has metastasized to the bone, it indicates that the disease is at an advanced stage, and the opportunity for curative surgery is lost. In most cases, treatments such as targeted therapy and endocrine therapy are adopted as conservative medical approaches.

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Endocrine therapy after radical prostatectomy for prostate cancer

Endocrine therapy after radical prostatectomy for prostate cancer is equivalent to adjuvant endocrine therapy for prostate cancer. Its purpose is to treat residual lesions, positive residual lymph nodes, and microscopic metastatic foci, thereby improving long-term survival rates. Currently, the indications for adjuvant endocrine therapy are based on postoperative pathology-positive results, positive lymph nodes post-surgery, and postoperative pathology confirmation of stage T3 or T4, but with high-risk factors. According to major guidelines, the duration of adjuvant endocrine therapy should be at least eighteen months.

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What causes prostate cancer?

The current causes of prostate cancer are not completely understood, but a large amount of research indicates that genetic and environmental factors play a significant role. Dietary factors, such as the intake of a large amount of unsaturated fatty acids, vasectomy, smoking, obesity, and alcohol consumption, also increase the risk of developing prostate cancer. Overall, the occurrence and development of prostate cancer are related to various factors, including both internal causes in the patient and the influence of external factors.

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What are the symptoms of prostate cancer?

Early-stage prostate cancer generally has no symptoms, but if the patient also has prostate enlargement, or in cases of mid to late-stage prostate cancer where the tumor invades the urethra or bladder, various degrees of urinary obstruction or irritative urinary symptoms may occur. This is characterized by frequent urination and urgency. If there are local infiltrative symptoms, perineal pain and sciatica might occur. If the vas deferens is compressed, it can cause back pain and pain in the testicles on the affected side. Invasion of the rectum can cause difficulty in defecation or obstruction of the colon, and if the membranous part of the urethra is involved, urinary incontinence may occur. The most common site of metastasis for prostate cancer is the bones. If it spreads to the bones, it can cause bone pain, pathological fractures, anemia, and spinal cord compression leading to paralysis of the lower limbs.

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Will prostate cancer embryonic antigen rise?

Prostate cancer is a common malignant tumor in the male urinary system. In some patients with prostate issues, there may be an increase in the carcinoembryonic antigen index in blood tests, but not all patients will exhibit this marker increase. Most prostate cancer patients will show an increase in the prostate-specific antigen (PSA) in blood tests, or there may be abnormal ratios of free PSA to bound PSA. Carcinoembryonic antigen and prostate-specific antigen are tumor markers for prostate cancer, but they only provide auxiliary value for diagnosis and do have some evaluative value regarding the effectiveness of anti-tumor treatment. Additionally, they can serve as a monitor for the condition of prostate cancer. Clinically, to confirm a diagnosis of prostate cancer, it is necessary to rely on the results of pathological tissue obtained through biopsy.

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Best treatment methods for prostate cancer

Treatment methods for prostate cancer include surgery, radiotherapy, chemotherapy, and endocrine therapy, among others. The choice of specific treatment methods is comprehensively considered based on the stage of the disease and the patient's physical condition. Early-stage prostate cancer patients can choose prostatectomy or radical radiotherapy. For patients with locally advanced T3 or T4 stage prostate cancer, since the efficacy of prostatectomy alone is relatively poor, radiotherapy combined with endocrine therapy can be chosen. For patients with metastatic prostate cancer, those who are found to have bone metastasis or distant metastasis from the onset, endocrine therapy is primarily used. If endocrine therapy is ineffective or fails, chemotherapy can also be adopted for these late-stage metastatic prostate cancer patients. If the bone metastasis causes pain, local radiotherapy can also be used to alleviate the pain symptoms.