A diagnosis of prostate cancer is difficult enough, yet about 90% of men with metastatic prostate cancer will face another challenge: bone metastasis. That’s when cells travel from the tumor and settle in the bones. The result can be pain and fractures that prevent you from doing the things you love like gardening, going out with friends or taking a stroll. The good news: There’s plenty you can do to keep bones strong.
Bone metastasis (aka “bone mets”) occurs when cancer cells break away from a primary tumor and enter the blood and lymph vessels. “From there, they are able to travel to distant sites in the body,” explains Swarnali Acharyya, PhD, of the Cancer Biology & Genetics Program at Memorial Sloan-Kettering Cancer Center in New York City. “But it’s not an easy process—only .001% of the cancer cells survive.” Unfortunately, those that do can lodge in other areas—often, in bone tissue—and start to grow new tumors.
How long the process of metastasis takes can vary greatly: In most cases, bone mets occur years after the initial diagnosis of prostate cancer; however, in rare cases they are a man’s first sign of the disease.
It’s important to note that bone mets are different from bone cancer: Bone mets are made of cells from the original cancer. So, for example, when prostate cancer spreads, the tumor is made of prostate cancer cells and it’s known as metastatic prostate cancer.
Bones are constantly renewing and rebuilding themselves, thanks to two different kinds of cells: osteoblasts, which are responsible for creating new bones, and osteoclasts, which break down old bones. However, cancer cells can send both types of cells into overdrive, causing either an abnormal buildup of bones or small holes that weaken bones.
Signs that prostate cancer may have spread to the bones include a dull ache with intermittent sharp pain, fractures, and numbness and weakness in your abdomen and legs. For some people, pain is the first symptom, but others don’t have any symptoms at all.
While bone mets are usually incurable, early intervention and current treatments can help prevent serious complications and painful fractures and help preserve your quality of life. Work with your doctor to find out what tests you’ll need and how often you’ll need them to keep track of the health of your bones, and to make sure you don’t need any adjustments to your treatment schedule.
Cancers of the breast, kidney, lung, prostate and thyroid are more likely to spread to the bones. If you’re at risk, talk to your doctor about the following.
- Any bone pain or injuries. Constant dull bone aches with intermittent sharp pain are often the first symptom of metastasis.
- Bone mineral density testing. Your physician may want to schedule regular DEXA scans to monitor bone loss.
- Signs of bone metastases.
- Report any of these symptoms to your doctor immediately. Bone pain, fractures, high calcium levels, numbness and weakness in the abdomen and legs.