Prostate cancer is a slowly progressive malignancy, but regardless of whether patients undergo radical prostate cancer surgery or endocrine therapy, they may develop distant metastases as the disease progresses, and the most common distant metastatic lesion from prostate cancer is bone.
The presence of bone metastases in prostate cancer is not always clinically symptomatic; some patients are found only on bone scans, while others have significant clinical manifestations of bone pain and impaired bone metabolism. The newly appeared bone metastasis proves that the prostate cancer is advanced. At this time, PSA should be checked at the same time, and the first thing that should be clarified is whether it has progressed to destructive resistant prostate cancer, and timely application of novel drugs such as abiraterone, or replacement of the original anti-androgen drug. Secondly, if there is clinically significant discomfort such as bone pain, pain relief (e.g. morphine, bupropion, etc.) can be applied, and local osteotomy is feasible when physical conditions allow and the lesion is limited.
Because most bone metastases from prostate cancer cause osteolytic destruction, attention should be paid to changes in bone metabolism, timely application of drugs such as diphosphonates, and prevention of pathological fractures in older patients. The first step in the process is to take care of the patient’s health. The most important point is that prostate cancer bone metastasis is an advanced cancer, so it is important to pay attention to humanistic care and maintain a pleasant and considerable attitude towards life, which also helps in the treatment of the disease.