Treatment of prostate cancer bone metastasis

The main treatments for prostate cancer bone metastasis include endocrine therapy, targeted therapy, radiotherapy, bisphosphonate drug injection therapy, surgery, etc. Bone metastasis of prostate cancer may be related to factors such as tumor spread and osteoclast activation, and usually manifests as bone pain, pathological fractures and other symptoms.

1. Endocrine therapy

Endocrine therapy is the basic treatment for prostate cancer bone metastasis, which delays tumor progression by suppressing androgen levels. Commonly used drugs include goserelin acetate sustained-release implants, leuprolide acetate microsphere injection, etc., which can reduce testosterone concentration in the body. Some patients may experience adverse reactions such as hot flashes and fatigue.

2. Targeted therapy

Targeted drugs such as abiraterone tablets and enzalutamide soft capsules can block tumor cell signaling pathways and are suitable for patients who have failed traditional endocrine therapy. This type of drug may cause side effects such as high blood pressure and abnormal liver function, and relevant indicators need to be monitored regularly during medication.

3. Radiotherapy

For metastases with obvious local pain, external radiation therapy can be used to relieve symptoms. The common plan is 30 Gray divided into 10 fractions. Patients with multiple bone metastases can be treated with the radionuclide strontium-89, but this may temporarily inhibit bone marrow hematopoiesis.

4. Bisphosphonates

Injectable zoledronic acid, pamidronate disodium and other drugs reduce bone destruction by inhibiting osteoclast activity and are administered intravenously every 3-4 weeks. It is necessary to monitor renal function and prevent hypocalcemia during use, and to be fully hydrated before use.

5. Surgical treatment

Internal fixation surgery can be performed on load-bearing bones that are about to undergo or have pathological fractures. Spinal canal decompression is required when spinal transfer compresses nerves. The patient's general condition and expected survival time need to be assessed before surgery, and other comprehensive treatments must be coordinated after surgery.

Patients with prostate cancer bone metastasis should maintain an appropriate calcium intake but avoid excessive calcium supplementation. They should engage in low-intensity exercise such as walking based on their physical fitness to prevent further bone loss. Pay attention to prevent falls during daily activities, and review bone scans promptly when new or worsening bone pain occurs. Regular detection of prostate-specific antigen levels and imaging evaluation can help determine the effectiveness of treatment. All treatments require individualized plans under the guidance of an oncologist.