It’s common for advanced prostate cancer to spread to your bones. It often spreads to your:
- Upper part of your thigh bone (femur)
This can cause problems, such as:
Pain. It can be a dull ache or sharp and stabbing. And it may feel worse at night.
Anemia.Cancer can affect your bone marrow, which makes red blood cells. Anemia, or a low red blood cell count, can make you feel tired and weak, dizzy, or short of breath.
Bone loss and fractures. The cancer itself can weaken your bones. Plus, medicines that lower your levels of testosterone and other male sex hormones (also called androgens) can lead to bone loss and fractures.
Pressure on your spinal cord. This happens when the cancer spreads to your spine. The pressure can cause bladder and bowel problems, trouble walking, and weakness or numbness in the legs. It’s an emergency and needs treatment right away.
How to Prevent and Treat Bone Problems
There are many ways to treat and even prevent bone problems that come from prostate cancer. These include:
Radiation. External radiation therapy can relieve bone pain in men for whom hormone therapy stops working. It shrinks bone tumors. Your doctor may focus a beam of radiation on a certain spot. Or he may inject a radioactive substance into your vein, which kills the prostate cancer cells that absorb it.
If your prostate cancer hasn’t spread beyond your bones, your doctor may consider using the drug radium-223 (Xofigo). It delivers radiation directly to the bone tumors. You get it by injection once a month.
Surgery. A surgeon can remove a prostatecancer tumor in your bones, and then repair it with bone cement, pins, screws, plates, rods, or other devices. You may also need surgery to strengthen a fractured bone.
Bisphosphonates. These drugs slow the breakdown of bones, making them stronger. Research shows that drugs such as alendronate (Fosamax) and zoledronic acid (Zometa) can ease pain and delay or prevent fractures in some men with prostate cancer, and can help protect their bones when they are taking hormone therapy.
Denosumab (Prolia, Xgeva). This drug can curb bone loss. It may also protect men's bones when they take hormone therapy.
Painkillers. Several drugs can help manage your pain, including:
- Prednisone. This steroid can curb swelling around the cancer in bones.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, which can ease mild pain.
- Opioids, such as long-acting morphine or fentanyl patches, which you may need if you have more severe pain.
Lifestyle changes. While you are on hormone therapy for advanced prostate cancer you can boost your bone health with these healthy habits:
- Exercise regularly. Weight-bearing exercise, like using handheld weights, weight machines, yoga, or other activities that use your body weight for resistance, is especially important.
- Limit alcohol and caffeine.
- If you smoke, stop.
Ask your doctor if you should also take calcium and vitamin Dsupplements.