ABSTRACT
Bone metastases are a very common manifestation of advanced carcinoma of the prostate. In all, 85-100% of patients who die of prostate carcinoma will have bone metastases1. The development of bone pain, pathological fractures, hypercalcemia, and spinal cord and nerve compression syndromes contribute significantly to the morbidity of advanced bone disease2. The primary therapy for bone disease has been androgen deprivation. Although initial response to medical or surgical castration is 85%, the median duration of response is 2 years. For the clinician, the number of potential therapeutic options narrows as hormone resistance develops3. For the patient, irrespective of interventions, the median survival is limited to 10-12 months4. Palliation of these patients is optimized through the subsequent use of opioids, adjunct analgesic and antiinflammatory agents, external beam radiation and chemotherapy. Unfortunately, much of the morbidity of hormone-refractory prostate cancer (HRPC) stems from the complications of the advancing skeletal disease. New strategies to prevent and manage the metastatic disease and its complications are needed.
