ABSTRACT
The most commonly encountered complications of prostate cancer result from either obstructive uropathy or the effects of metastatic spread. Since the favored site of secondary spread is the skeleton, the majority of problems stem from that source. Pathologic fractures may affect the long bones, spine, or pelvis. If the spinal cord is compressed urgent action may be required to prevent permanent paralysis. The first step in management is to accurately establish the diagnosis, treatment selection will depend on whether the cancer is hormone naive or whether one is dealing with a hormone-resistant prostate cancer (HRPC). In the latter situation the prognosis is significantly worse. Recent data suggests that some skeletal-related events may be prevented or delayed by the judicious use of the bisphosphonate zoledronic acid (See Chapter 102).
