When advanced prostate cancer spreads to bones

This is called bone metastasis. It is not the same as a cancer that started in bone, and treatment is selected according to the prostate cancer and the difficulties it is causing.

Prostate cancer cells in bone can disrupt normal bone renewal. Possible effects include persistent or localised pain, reduced mobility, weakening of a bone, and altered calcium levels. Some people have bone metastases detected on imaging before they cause noticeable symptoms.

Cancer in a vertebra can sometimes press on the spinal cord or nearby nerves. The location of a lesion therefore matters as much as the amount of pain, particularly when symptoms involve leg strength, sensation, or bladder and bowel control.

Management may combine treatment for cancer throughout the body with radiotherapy to a painful or vulnerable area, pain medicines, and bone-strengthening treatment when appropriate. Physiotherapy, mobility aids, and advice about safe activity can help maintain independence.

Describe exactly where pain occurs, whether it wakes you, what movements trigger it, and whether medicines relieve it. Do not start high-impact exercise or stop moving altogether without guidance; the team may first need imaging to judge whether a bone is stable.

Treat new leg weakness, difficulty walking, numbness around the inner thighs or genitals, loss of bladder or bowel control, and severe new back or neck pain as an emergency. Seek immediate medical assessment because spinal cord compression can progress quickly.

Urgent help is also needed after a minor injury if a limb becomes suddenly painful, deformed, or impossible to use. Contact the oncology team promptly for steadily worsening bone pain, unusual thirst with confusion, constipation with marked drowsiness, or repeated vomiting.

Ask which bones are affected, whether any area is at risk of fracture or nerve pressure, what activities are safe, and how pain relief will be reviewed. Also ask whether dental assessment is needed before a bone-strengthening medicine and which jaw or mouth symptoms should be reported.