The symptoms of advanced prostate cancer can sometimes cause pain; for instance if cancer is affecting the bones. In this situation it may be possible to undergo the following treatments to relive symptoms. Men who are undergoing this type of treatment should have access to a specialist team known as the palliative care team within their hospital and community. This team will be able to co-ordinate care and provide support for them.
External beam radiotherapy (see localised section) can be used to treat specific areas of the body that may be painful. It may take a few weeks for symptoms to ease following radiotherapy but cancer in the bones can regress as a result. A radioactive substance called strontium 89 can sometimes be injected into the body through a vein. The strontium will naturally accumulate in the bone and give off radiation which may kill cancerous cells. A new type of radioactive isotope called alpharadin is also being evaluated in some specialist centres.
A similar, newer type of treatment in this situation is called Radium 223 (Xofigo).
Biphosphonates are substances that can help prevent and protect the development of bones and prevent bone loss. Prostate cancer which has spread to the bones can affect the balance between healthy new bone tissue being formed and the destruction of old bone. This can cause bone weakness as they become thinner or it can cause bone to grow too fast unevenly and cause pain. The most common Biphosphonates used in prostate cancer is called zoledronic acid (Zometa®) and is given through a drip into a vein. It takes about 15 minutes to administer and can be repeated every 3-4 weeks. It may take up to 3-months to gain the full benefit of the treatment. Some men may get common side effects such as flu like symptoms (including nausea and loss of appetite) and treatment can sometimes compromise the body’s kidney function. For more information on bisphosphonates please see the following information from patient.co.uk
Last reviewed April 2021. Next review 2022.
References available on request.