Can back pain in men possibly be prostate cancer?

Nov 01, 2023
Can back pain in men possibly be prostate cancer?

Back pain – whether it’s a pain in the upper or lower back, is a common reason men schedule a doctor’s seeking a solution. If the pain is particularly persistent and unpleasant whenever a man moves, sits, twists bends over, or is causing him to miss work, men want relief as quickly as possible.

Back pain and its cause can be due to multiple factors – lifting something too heavy, exercising too hard, tight hips, or even stress, can be reasons why men suffer from this disorder. But if back pain does not respond to home remedies or even the doctor’s treatment, it could be a symptom of metastatic prostate cancer.

What is metastatic prostate cancer?

All types of cancers can metastasize or spread to other body parts. Cancer cells can migrate from the original tumor, whether it is prostate or another cancer. Once free, the cancer cells can travel through the lymphatic system or the bloodstream to other body areas. The cells can break through the wall of a blood vessel, attaching themselves to whatever tissue they find. At this point, they can multiply and grow new blood vessels to bring nutrients to the new tumor.  

Not all cancer cells that break away from the original tumor will form new tumors. They will often not survive in the bloodstream, or some will die once they get to a new site. Other breakaway cancer cells can remain inactive for many years or never become active.

Cancer cells originating from prostate cancer tend to spread to specific areas such as lymph nodes, the ribs, pelvic bones, or the spine.

The number of men diagnosed with advanced prostate cancer who will have a subsequent diagnosis of metastatic cancer is around 50%. In some men, they may not even discover they have prostate cancer until it has metastasized. It is important to know that men diagnosed with early-stage or localized prostate cancers are highly unlikely to have prostate cancer that has spread to the bones. 

Diagnosing back pain and prostate cancer

When first diagnosed with prostate cancer, an oncologist will most likely order tests to see if it has spread beyond the prostate. These tests could include x-rays, CT scans, or an MRI. However, because of the location of the prostate, the tests will primarily focus on the pelvic region and spine for any signs that cancer has metastasized.

If a man has been experiencing low back or bone pain in general or has experienced recent broken bones for no reason, then a doctor may order a bone scan too.

Another test the doctor will order is blood tests, including a PSA or prostate-specific antigen test to check the PSA levels, a protein made by the prostate gland. If the PSA level has risen, it is one of the first signs cancer could be growing; however, a high PSA can also be due to an enlarged prostate or prostatitis.

When a man has completed initial treatment for his prostate cancer, such as radiation or hormone treatment, a rise in PSA could also indicate the possibility that cancer has spread. 

Managing metastasized prostate cancer

The goal of any prostate cancer treatment regimen is to manage symptoms, slow cancer growth rate, and shrink the tumor.   Even though there are currently no treatments that can cure prostate cancer that has spread, there is a way to help control it and any related symptoms.  

A thorough discussion with your doctor looking into all options is necessary. Some treatments can slow the spread of advanced prostate cancer and relieve symptoms but often cause side effects. Older patients may decide that the risk of side effects outweigh the benefits of treatment and instead choose not to treat their advanced prostate cancer.  

Treatment options for back/bone pain

Treatment for bone metastasis in prostate cancer is to help relieve pain and prevent complications. A doctor will work with the patient to develop a suitable treatment plan. One drug sometimes recommended is bisphosphonates, which work by reducing bone loss, helping lower the risk of fractures, and slowing down cancer growth in bones. Zoledronic acid (Zometa) is the bisphosphonate doctors commonly prescribe for people with prostate cancer. It’s usually administered by intravenous injection every 3 to 4 weeks. 

Another drug used to reduce bone loss is Denosumab. Every four weeks, this medication is injected under the skin helping lower the risk of fractures, especially if zoledronic acid is not working. It can also help slow down the spread of cancer that has not yet reached the bones.  

Radiation therapy is another solution to consider by aiming an external beam at the cancer cells. It can help by reducing bone pain, shrinking tumors on the spine to relieve pressure, and may shrink tumors in other areas of the body to alleviate symptoms. 

Radiopharmaceuticals are a type of medication used to treat people with bone metastases. Once inside the body, these drugs move to the bones and release radiation that can kill cancer cells. 

Takeaway message

Whatever a man decides, he should remember that researchers are always looking for new and better treatments that will cause fewer side effects, better disease control, and longer survival rates. 


Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.