There are several tests that can be used to find out if prostate cancer has spread to the bone. A bone scan is the most common test used. It is a very good test because it can diagnose cancer before symptoms start and before the cancer can be seen on regular X-rays. Other tests that can be used are: ProstaScint scan, CT scan, MRI and a bone biopsy.

Bone Targeted Therapy

Treatments are used to reduce pain and slow down the spread and growth of cancer in the bones. Options include: radiation therapy, radiopharmaceuticals and bisphosphonates.

Most men find that external beam irradiation relieves pain but it has not been shown to extend life. Depending on how much the cancer has spread, there are two possible approaches. “Local field" irradiation focuses on a few small areas of bone. "Wide field" irradiation gives radiation throughout the body. The radiation used in these treatments is lower intensity than radiation used to treat cancer in the prostate.

Radiopharmaceuticals are radioactive drugs given by intravenous injection. Cancer cells take up radiation at a much faster rate than regular cells so this treatment is good at targeting cancer. These drugs provide pain relief, and because they are taken up by cancer cells throughout the skeleton, they are most helpful for men whose bone metastases has spread to more than one location.

Bisphosphonates are a class of drugs that keep bones strong. They reduce the risk of pain and fractures and some studies suggest they may even slow the growth of bone metastases.

Bone Pain

Bone metastases often cause significant pain that affects quality of life. Pain medications are an important part of care for most men with metastatic prostate cancer. Long acting opioids are used to prevent pain. Shorter-acting medications, like acetaminophen with codeine, treats breakthrough pain. Since strong pain killers can cause constipation, laxatives and stool softeners are often needed as well.