This fact sheet is for men with advanced prostate cancer who are having problems with pain. We describe ways to treat and control pain, and list further sources of support.
Updated: May 2017 | Due for Review: May 2020
Attar S, Steffner RJ, Avedian R, Hussain WM. Surgical intervention of nonvertebral osseous metastasis. Cancer Control. 2012;19(2):113–121.
Bennett MI. Effectiveness of antiepileptic or antidepressant drugs when added to opioids for cancer pain: systematic review. Palliat Med. 2011 Jul 1;25(5):553–9.
British Pain Society. Cancer pain management: a perspective from the British Pain Society, supported by the Association for Palliative Medicine and the Royal College of General Practitioners. London: British Pain Soc.; 2010.
British Uro-oncology Group (BUG), British Association of Urological Surgeons (BAUS). Multi-disciplinary Team (MDT) Guidance for Managing Prostate Cancer. 2013.
Bubendorf L, Schöpfer A, Wagner U, Sauter G, Moch H, Willi N, et al. Metastatic patterns of prostate cancer: An autopsy study of 1,589 patients. Hum Pathol. 2000 May;31(5):578–83.
Carlin BI, Andriole GL. The natural history, skeletal complications, and management of bone metastases in patients with prostate carcinoma. Cancer. 2000;88(S12):2989–2994.
Cosgriff N, Gordon S. Cancer related lymphoedema in males: a literature review. J Lymphoedema [Internet]. 2010 [cited 2017 May 8];5(2). Available from: http://www.journaloflymphoedema.com/media/journals/_/1078/files/49-61-cosgriff.pdf
Davies A, Buchanan A, Zeppetella G, Porta-Sales J, Likar R, Weismayr W, et al. Breakthrough Cancer Pain: An Observational Study of 1000 European Oncology Patients. J Pain Symptom Manage. 2013 Nov;46(5):619–28.
Denosumab: updated recommendations - GOV.UK [Internet]. [cited 2017 May 22]. Available from: https://www.gov.uk/drug-safety-update/denosumab-updated-recommendations
Hadley G, Derry S, Moore RA, Wiffen PJ. Transdermal fentanyl for cancer pain (review). Cochrane Database Syst Rev [Internet]. 2013 [cited 2017 Feb 1];(10). Available from: http://doi.wiley.com/10.1002/14651858.CD010270.pub2
Hurlow A, Bennett MI, Robb KA, Johnson MI, Simpson KH, Oxberry SG. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults. Cochrane Database Syst Rev. 2012;3.
James ND, Bloomfield D, Luscombe C. The changing pattern of management for hormone-refractory, metastatic prostate cancer. Prostate Cancer Prostatic Dis. 2006;9(3):221–229.
Kane C, Hoskin P, Bennett M. Cancer induced bone pain (clinical review). BMJ. 2015;350(h315).
Loblaw DA, Mitera G, Ford M, Laperriere NJ. A 2011 updated systematic review and clinical practice guideline for the management of malignant extradural spinal cord compression. Int J Radiat Oncol. 2012;84(2):312–7.
Loblaw DA, Perry J, Chambers A, Laperriere NJ. Systematic review of the diagnosis and management of malignant extradural spinal cord compression: The Cancer Care Ontario Practice Guidelines Initiative’s Neuro-Oncology Disease Site Group. J Clin Oncol. 2005;23(9):2028–37.
Loh J, Gulati A. The Use of Transcutaneous Electrical Nerve Stimulation (TENS) in a Major Cancer Center for the Treatment of Severe Cancer-Related Pain and Associated Disability. Pain Med. 2015;16(6):1204–1210.
Lutz S, Berk L, Chang E, Chow E, Hahn C, Hoskin P, et al. Palliative Radiotherapy for Bone Metastases: An ASTRO Evidence-Based Guideline. Int J Radiat Oncol. 2011 Mar;79(4):965–76.
Lymphoedema Framework. Best practice for the management of lymphoedema. International Consensus. Lond MEP Ltd. 2006;
Mottet N, Bellmunt J, Briers E, Bolla M, Cornford P, De Santis M, et al. Guidelines on prostate cancer. European Association of Urology; 2016.
National Institute for Health and Care Excellence (NICE). Palliative cancer care - pain (Clinical Knowledge Summary) [Internet]. 2015. Available from: https://cks.nice.org.uk/palliative-cancer-care-pain
National Institute for Health and Care Excellence. Metastatic spinal cord compression: Diagnosis and management of adults at risk of and with metastatic spinal cord compression. NICE clinical guideline 75 [Internet]. 2008. Available from: https://www.nice.org.uk/guidance/cg75
National Institute for Health and Care Excellence. Neuropathic pain – pharmacological management: The pharmacological management of neuropathic pain in adults in non-specialist settings [Internet]. 2013 [cited 2014 Jul 17]. Available from: http://www.nice.org.uk/guidance/CG173/chapter/introduction
National Institute for Health and Care Excellence. NSAIDs - prescribing issues- Clinical Knowledge Summary (CKS) [Internet]. 2015. Available from: https://cks.nice.org.uk/nsaids-prescribing-issues
National Institute for Health and Care Excellence. Palliative care for adults: strong opioids for pain relief. Clinical guideline 140. (modified August 2016); 2012.
National Institute for Health and Care Excellence. Percutaneous cementoplasty for palliative treatment of bony malignancies. IPG179. 2006;
National Institute for Health and Care Excellence. Percutaneous vertebroplasty. IPG12. 2003.
National Institute for Health and Care Excellence. Prostate Cancer: diagnosis and treatment. Full guideline 175. 2014.
Paice JA, Ferrell B. The management of cancer pain. CA Cancer J Clin. 2011 May;61(3):157–82.
Parker C, Nilsson S, Heinrich D, Helle SI, O’Sullivan JM, Fosså SD, et al. Alpha Emitter Radium-223 and Survival in Metastatic Prostate Cancer. N Engl J Med. 2013;369(3):213–23.
Posternak V, Dunn LB, Dhruva A, Paul SM, Luce J, Mastick J, et al. Differences in demographic, clinical, and symptom characteristics and quality of life outcomes among oncology patients with different types of pain: PAIN. 2016 Apr;157(4):892–900.
Ripamonti CI, Santini D, Maranzano E, Berti M, Roila F, on behalf of the ESMO Guidelines Working Group. Management of cancer pain: ESMO Clinical Practice Guidelines. Ann Oncol. 2012 Oct 1;23(suppl 7):vii139-vii154.
Samphao S, Eremin JM, Eremin O. Oncological emergencies: clinical importance and principles of management. Eur J Cancer Care (Engl). 2010;19(6):707–13.
Todd M. Understanding lymphoedema in advanced disease in a palliative care setting. Int J Palliat Nurs. 2009;15(10):474.
Westhoff PG, de Graeff A, Monninkhof EM, Pomp J, van Vulpen M, Leer JWH, et al. Quality of Life in Relation to Pain Response to Radiation Therapy for Painful Bone Metastases. Int J Radiat Oncol. 2015 Nov;93(3):694–701.
World Health Organisation. WHO’s cancer pain ladder for adults [Internet]. [cited 2016 Dec 20]. Available from: http://www.who.int/cancer/palliative/painladder/en/
XGEVA - Summary of Product Characteristics (SPC) - (eMC) [Internet]. [cited 2017 May 24]. Available from: https://www.medicines.org.uk/emc/medicine/24755
Yuen KK, Shelley M, Sze WM, Wilt TJ, Mason M. Bisphosphonates for advanced prostate cancer (Review). Cochrane Database Syst Rev. 2006;(4).
This fact sheet is for men who have been diagnosed with advanced (metastatic) prostate cancer - cancer that has spread from the prostate to other parts of the body. It explains what advanced prostate cancer is, what your test results mean, and the treatments available.
This booklet is for men who have prostate cancer that has spread to other parts of the body (advanced prostate cancer) and who have symptoms such as fatigue or bone pain. We describe the symptoms you might get and the treatments available to help manage them.