Advanced Prostate Cancer: Caring for Your Bones

Medically Reviewed by Kumar Shital, DO on April 26, 2021

If you have advanced prostate cancer, it means the cancer has moved to a part of your body outside your prostate gland. The bones are a common place for it to spread.

The cancer may show up in your spine, pelvis, ribs, or the upper part of your thigh bone, called the femur.


When the cancer moves to your bones, you can have problems like:

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, weak, dizzy, and short of breath.

Bone loss and fractures. The cancer can weaken your bones. Plus, medicines that lower your levels of testosterone and other male sex hormones (which are called androgens) can lead to bone loss and broken bones.

Pressure on your spinal cord. This can happen when the cancer spreads to your spine. It can cause bladder and bowel problems, trouble walking, and weakness or numbness in your legs. It's an emergency and needs treatment right away.

How to Prevent and Treat Bone Problems

Radiation therapy. This treatment shrinks your bone tumors. It can ease your bone pain if your hormone therapy stops working. Your doctor may focus a beam of radiation on a certain spot, or they 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 tumor in your bones and then repair the bone with bone cement, pins, screws, plates, rods, or other devices. You may also need surgery to strengthen a broken bone.

Bisphosphonates. These drugs slow the breakdown of bones, making them stronger. Zoledronic acid (Zometa) can ease pain and delay or prevent breaks in some men with prostate cancer, and can help protect their bones when they are taking hormone therapy.

Denosumab (Prolia, Xgeva). This drug can slow the loss of bone. It may also protect your bones when you 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 severe pain.

Lifestyle changes. While you are taking hormone therapy for advanced prostate cancer, you can boost your bone health with these 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 take calcium and vitamin D supplements.

Show Sources


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Paller, C. Clinical Interventions in Aging, Sept. 14, 2012.

Nieder, C. BMC Cancer, June 13, 2010.

National Institutes of Health: "What is anemia?"

Rabow, M. Urologic Clinics of North America, November 2012.

American Academy of Orthopaedic Surgeons: "Cauda equina syndrome."

Bishr, M. Current Opinion in Supportive and Palliative Care, September 2012.

American Academy of Orthopaedic Surgeons: "Metastatic bone disease."

American Cancer Society web site.

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