THE EFFECTS OF PAMIDRONATE DISODIUM TREATMENT IN METASTATIC PROSTATE-CANCER

Prostate cancer is one of the commonest causes of cancer-related death in men in the Western world and the considerable morbidity associated with the condition is usually a direct consequence of metastatic spre ad to bone. In the skeleton, the disease disrupts controlled and coupl ed bone metabolism, resulting in increased bone formation and destruct ion. Bisphosphonates, including pamidronate, have been shown to dimini sh the characteristic osteolysis in both the tumour-affected and the t umour-free skeleton and can be effective in slowing the accelerated bo ne resorption. They have also been shown to have a beneficial effect o n symptoms, decreasing pain levels and improving performance scores in a proportion of patients with end-stage disease. The mechanisms under lying this effect are poorly understood. The place of pamidronate in t he management of metastatic bone disease from prostate cancer is becom ing established but data from large-scale controlled trials is require d to determine the true clinical efficacy of this and other bisphospho nates.