Clinical Approaches to Osseous Metastases in Prostate Cancer

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Recognize the biology underlying metastatic prostate cancer to bone. Identify the clinical risks that osseous metastases pose to prostate cancer patients. Explain the clinical management of osseous disease in prostate cancer patients. Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com Background. Prostate cancer is unique among solid tumors in its proclivity to metastasize primarily to bone. Osseous metastases pose a formidable health threat to patients with metastatic disease, putting them at risk for pain, marrow crowding, fracture, and other sequelae. Treatments directed against bone disease have the potential both to palliate pain and to increase survival. Conclusions. A number of agents exist that have the potential to palliate the effects of osseous metastases and should be routinely applied in the clinical care of the patient with advanced prostate cancer. These include hormones, bone-seeking radiopharmaceuticals, chemotherapy, and bisphosphonates. Strategies under investigation aim to eradicate bone disease, and not merely palliate symptoms. These approaches combine those listed above with tumor-directed targeting of osseous disease and manipulation of the biology that underlies the cancer's relationship to bone.