How to treat bone metastasis in advanced prostate cancer?

Written by Yan Chun
Oncology
Updated on March 21, 2025
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For cases of advanced prostate cancer with bone metastasis, the following clinical treatment measures can be taken:

Firstly, for the pain caused by bone metastatic lesions, symptomatic pain relief treatment should be administered with medication. The pain from bone metastatic lesions generally presents as moderate to severe, and medications usually involve weak or strong opioids for pain relief. For some patients with advanced bone metastases, pathological fractures may occur, necessitating treatments such as bone stabilization and bone cement.

For some patients with advanced bone metastasis from prostate cancer, monthly injections of zoledronic acid can also be administered to treat the bone metastases. When prostate cancer has metastasized to the bone, it indicates that the disease is at an advanced stage, and the opportunity for curative surgery is lost. In most cases, treatments such as targeted therapy and endocrine therapy are adopted as conservative medical approaches.

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Commonly used drugs for endocrine treatment of prostate cancer

The purpose of endocrine therapy for prostate cancer is to reduce the concentration of androgens in the body, inhibit the synthesis of androgens originating from the adrenal glands, inhibit the conversion of testosterone to dihydrotestosterone, or block the binding of androgens to their receptors, thereby inhibiting or controlling the growth of prostate cancer cells. The medications include a luteinizing hormone-releasing hormone analogue, with representative drugs being leuprorelin, goserelin, and triptorelin. There is also an androgen-blocking drug, including steroidal drugs with representative drugs like cyproterone acetate, and non-steroidal drugs with representative drugs like bicalutamide and flutamide. Additionally, there are estrogens, with the most common being diethylstilbestrol.

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Is chemotherapy for prostate cancer painful?

For patients with advanced prostate cancer, endocrine therapy is primarily used. Chemotherapy is generally chosen when endocrine therapy is resistant and ineffective. The side effects of chemotherapy are similar to those of other chemotherapy treatments. The first is the gastrointestinal side effects, such as nausea, vomiting, decreased appetite, or bloating and abdominal pain. The second is bone marrow suppression, which leads to a decrease in white blood cells and platelets. The side effects of chemotherapy vary with each patient's constitution and other factors. In most cases, with the support of medications for stomach protection, anti-nausea, and increasing white blood cells, the majority of patients can generally tolerate the treatment.

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Late-stage prostate cancer with bone metastases: how long can one survive?

Bone metastasis is the most common site of metastasis for prostate cancer. If prostate cancer has metastasized to the bones, it means it is not in its early stages but has entered the advanced stages. However, this type of tumor is not like others with a higher degree of malignancy. If it has a good sensitivity to hormone therapy, after our standardized treatment, the survival time can still be quite long.

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Best treatment methods for prostate cancer

Treatment methods for prostate cancer include surgery, radiotherapy, chemotherapy, and endocrine therapy, among others. The choice of specific treatment methods is comprehensively considered based on the stage of the disease and the patient's physical condition. Early-stage prostate cancer patients can choose prostatectomy or radical radiotherapy. For patients with locally advanced T3 or T4 stage prostate cancer, since the efficacy of prostatectomy alone is relatively poor, radiotherapy combined with endocrine therapy can be chosen. For patients with metastatic prostate cancer, those who are found to have bone metastasis or distant metastasis from the onset, endocrine therapy is primarily used. If endocrine therapy is ineffective or fails, chemotherapy can also be adopted for these late-stage metastatic prostate cancer patients. If the bone metastasis causes pain, local radiotherapy can also be used to alleviate the pain symptoms.

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Can people with prostate cancer eat mutton?

Patients with prostate cancer can eat mutton. There is a folk belief about certain foods being "heaty", which refers to foods like mutton, beef, roosters, and bamboo shoots, often labeled as such and believed to be unsuitable for consumption. However, this belief is unscientific. From a medical perspective, patients with prostate cancer should primarily avoid junk food, such as barbecued items, pickled and smoked products, and especially oily and high-fat foods. Reducing the intake of these foods is recommended. Other than that, all other foods can be eaten, as long as there is a balanced nutrition and a good mix of meat, eggs, vegetables, and fruits. The idea of the so-called "heaty" foods is not scientifically based.