Treatment of Metastatic Bone Disease in Prostate Cancer

More than 90% of patients with metastatic prostate cancer (PCa) are diagnosed with bone metastases. The presence of metastatic bone disease contributes to decreased quality of life resulting from pain and pathologic fractures, as well as increased treatment cost and overall mortality. A multimodal approach with analgesics, radiation, bone-modifying therapy, surgery, and chemotherapy are used to manage bone metastases from PCa. These treatments can be used independently or concurrently based on patient symptoms, complications of disease, plan for other systemic chemotherapy, and goals of care. Pharmacists are key components of the healthcare team that guide patients' management by providing counseling on side effects, treatment monitoring, and cost of therapy for the agents used for metastatic PCa.