We can’t speak only of advanced prostate cancer and rib pain without first knowing what prostate cancer is and what we are dealing with. Prostate cancer is the second most common type of cancer in men aged more than 45, and represents the second cause of fatality, by neoplasia, after lung cancer.



At the moment, this type of cancer seems to be gaining ground in the world, due mostly to greater longevity in the population, and also due to the progress seen in the technology meant to discover this type of cancer. From a hystiological standpoint, most of the cases involve an adenocarcinoma (or glandular epitelioma). This cancer is most often developed starting from the peripheral caudal portion of the gland, far from the urethra, which determines a sort of latency, as the signs of compression on the urinary tract occur late in the evolution.



The local, regional and lymphatic extension of the disease: after the intra-capsular stage, manifested through urethral compression, the cancer progresses in a centrifugal manner, towards the bladder, the rectum, the pelvis, lymph ducts and lymph nodes. Metastatic extensions dominated by bone metastasis (20-70%), where there can be a connection between advanced prostate cancer and rib pain, usually located in the bone marrow, but also near the liver, pleura, lungs, etc. These latter locations, however, are less frequent.

The symptoms include urinating disorders. These are present in 80% of cases. For local and regional expansion, symptoms include: revelatory anuria, flebitis, lymphedema. Diagnosis is issued based on: the presence of revelatory clinical urinary and bone signs (pain in the bones), a rectal digital examination, the clinical examination for the detection of mechanical complications, metastatic localizations in the liver and lymph nodes, additional examinations; SPA – specific prostatic antigen, alkaline phosphatase, endorectal ultrasonic scan, prostatic biopsy.

These primary diagnosis criteria are associated with: standard radiology (to outline metastatic extensions to the pelvis, eachis, urinary tract), bone scintigraphy, tomodensitometry; standard biological analysis: hematologic, metabolic, hepatic, renal.

The treatment of prostate cancer, regardless of the stage, is established based on: the existence of a hystiologically confirmed diagnosis, the stage of the tumor, life expectancy. Localized prostate cancer imposes two types of therapeutic attitude, depending on the life expectancy, evolution and aggressiveness of the disease, appreciated through the evolution of the prostate specific antigens and through bioptic examination: monitoring the patient, radical treatment through radical prostatectomy and external radiotherapy. Non localized prostate cancer includes: advanced cancer, without metastasis, and advanced cancer with metastasis.



The treatment of metastasized cancer is mostly palliative and involves the improvement of life quality for the patient. Prostate cancers are, most of them, androgen dependents, which is why the goal is an androgenic suppression by: chemical castration (orhiectomy or bilateral pulpectomy), medical castration using LHRH analogues (triptorelin), the association of one of the above methods with the administration of an anti-androgenic, to extend action to the supra-renal androgens, not only the testicular androgen. The choice of treatment will be made in accordance with official prostate cancer treatment guides, depending on the clinical conditions, the undesirable effects of the treatment and, last but not at all least, the choice made by the patient.