Prostate cancer and spinal cord compression

Prostate cancer metastasis to the spine is an extremely difficult clinical problem to treat. However, it occurs commonly, and all clinicians--not only oncologists--should undertake to understand its pathogenesis, diagnosis, clinical presentation, and current treatment options. This review emphasizes the surgical treatment of prostate cancer metastasis to the spine. The goals of this article are to (1) present an overview of the pathophysiology of this disease, with an emphasis on the mechanisms of metastasis and invasion, (2) provide a general overview of the clinical presentation and diagnosis of metastatic prostate carcinoma, and (3) discuss currently available treatment options. Such options include best medical management, nonsurgical treatments (radiation, chemotherapy), and surgical treatment of newly diagnosed and previously irradiated metastatic prostate carcinoma to the spine. Algorithms for the treatment of this disease are presented.