Prostate cancer preferentially metastasizes to bone and the mortality from prostate cancer is 70% once bone metastases are present. In addition, prostate cancer-induced bone metastases are associated with significant complications including severe pain, skeletal fractures, spinal cord compression and bone marrow suppression.
Most doctors structure their treatment protocols against bone metastases by treating the cancer systemically (other than targeted radiation to treat pain). Systemic therapies spread throughout the body, through the blood stream, either by intravenous delivery or by ingesting a pill. Systemic treatment differs from is local therapies, which are directed at a single area. Systemic therapies for prostate cancer include chemotherapy or hormone therapy. Local therapies include surgery, targeted radiation or intensive microwaves and
Hormonal therapy is the usual the first line of treatment and it has been the mainstay of treatment for bone metastatic disease for many years. However, the results are often short-lived. There are presently no chemopreventive or curative therapies for prostate cancer bone metastases.
There are also drugs called bisphosphonates that can help make diseased bones stronger and help prevent fractures. These drugs are used to supplement the chemotherapy and hormonal therapy to retard the growth of bone metastasis and to prevent fractures resulting from the loss of bone density.
Local treatments such as radiation therapy can relieve the pain in a bone by destroying the cancer and reducing the size of the tumor. Sometimes, a doctor will look at an x-ray and determine that a bone is close to breaking. Depending upon what bone has been affected sometimes your doctor will recommend a surgery that involves placing a thin steel rod in the bone to add strength. It is much easier to prevent a damaged bone from breaking than to repair it after it has broken.
Bone metastases are significant and need to be aggressively dealt with. Let your doctor know if you feel any bone pain as soon as possible.
Joel T Nowak MA, MSW
I am a 57 year old with advanced prostate cancer that thas spread to my back. I have been on Lupron for 10 months. I have pain in back and legs. Should I report this to my doctor?
Should I be on any other treatment besides Lupron at this time for my back and leg pain?
Yes, Always let your doctor know if you are in any pain. The pain you are experiencing could be a result of a bone metastasis. Your doctor should arrange for you to have a scan to confirm the presence of a bone metastasis and then plan to treat the situation. This pain can often be reduced or even eliminated by irradiating he tumor to shrink its size. If this doesn’t work, you might be able to find relief by taking some pain killers.
There is no reason, in todays world, for you to have suffer. Talk to your doctor. Call your doctor on the phone or make an appointment to be seen right away.
Have your doctor treat your pain aggressively.
As far as your question about alternative treatments to just Lupron, I can not answer it. There are other treatments available and the appropriate treatment is very dependent upon your numbers. Is the cancer responding to the Lupron, have you reach castrate levels of testosterone are just a few of the items you need to know.
Is your doctor a medical oncologist who specializes in the treatment of prostate cancer? If not, you need to find one now and immediate see them. The is vital. Also, always consider a second opinion.
I should have also suggested that you join my yahoo internet support group for advanced prostate cancer survovors and their family. Join by going to: http://healthunlocked.com
You should also find a support group to participate in.
Go to the malecare web site (www.malecare.org) and se if there is a support group near you. If there isn’t I will help you fing one, let me kow where you live.
The malecare web sight also has a lot of information about prostate cancer.