Bone Metastasis and Prostate Cancer
Nuada Medical Specialist Imaging
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| Prof. Anwar Padhani | Dr. Dow-Mu Koh |
Prostate cancer often spreads to the bones, but unlike breast cancer patients with bone metastasis, most prostate cancer patients have few problems relating to the bones. The reason for this is because Prostate cancer metastases tend to be blastic;* that is, they make the bones around them thicker and more dense.
Therefore even though the prostate cancer may have spread to the spine for example, it does not necessarily mean that there will be spine complications, such as pain, fractures or muscle weakness.
In many other types of cancer such as breast mentioned earlier, the cancer metastasis to the bones tends to be lytic*, which means the bone around the cancer lesion is destroyed.
The metastatic deposits of prostate cancer in the spine can cause pain but there are many effective treatments available which eliminate the pain. Prostate cancer is a relatively slow-growing type of cancer. Many men have it in their later years, but few of them actually die of it. Since it tends to effect elderly men, many men with prostate cancer will die of "natural causes" unrelated to the cancer. Many patients whose prostate cancer has spread to their bones enjoy a long survival, often several years, and occasionally a lot longer.
*Blastic and Lytic lesions
Bone is tissue. And like all living tissues, it is constantly turning over (old tissue dies/new tissue grows.) This is called "bone remodeling." In bone, there are cells called OSTEOCLASTS that are responsible for breaking down old bone to make room for the new tissue. When osteoclastic activity is high, LYTIC lesions result, areas of low bone density.
The converse are OSTEOBLASTS which are responsible for laying down new bone. When osteoblast activity out-paces the breakdown work of osteoclasts, areas of increased bone density result. These are BLASTIC lesions.