Treatment for prostate cancer spread to bones

When prostate cancer spreads to bone, cancer cells are present in places such as the spine, pelvis or ribs. Bone involvement can cause pain, stiffness or weakness, but some people have few symptoms. Tests help show where the cancer is and whether a bone is vulnerable.

Treatment that travels through the body can slow cancer activity. Radiotherapy can target a painful area, while targeted radioisotope therapy may be considered for selected disease patterns. Bone-strengthening therapy supports skeletal health. Treatment decisions also consider urinary symptoms, other illnesses and what matters most to you.

Ask which medicines will lower or block hormone signals, how response will be checked and whether bone-strengthening treatment is suitable. Tell the team about pain, falls, dental problems, numbness, leg weakness or [Difficulty Passing Urine](/symptoms/difficulty-passing-urine/).

Radiotherapy or targeted radioisotope therapy may help selected bone symptoms or disease patterns. Surgery is not automatically needed for spread to bone, but an orthopaedic or spinal review may be useful when a bone is unstable or the spinal cord is threatened. Keep a record of symptoms and treatment effects.

Get urgent help for new leg weakness, numbness, difficulty walking, or loss of bladder or bowel control. These can indicate pressure around the spinal cord. Sudden severe pain after a small movement or fall may indicate a fracture and also needs prompt assessment.

Seek immediate care if you cannot pass urine, develop severe confusion, or become unusually drowsy or dehydrated. Contact the oncology team about new or rapidly worsening pain rather than waiting for a scheduled review.

Where has the cancer spread? What is the aim of each treatment? How will bone strength and hormone response be monitored? Should I see a dentist before bone-strengthening therapy? Which symptoms require the emergency department?