• Bone metastases are cancer cells that have travelled from the prostate to the bones. In prostate cancer, the most common areas of bone metastases are the:
  • Ribs 
  • Pelvis 
  • Spine.

Does this mean I have bone cancer?

• No. Small ‘seeds’ of your prostate cancer (the primary cancer) spread to other parts of the body. So, it is still known as prostate cancer.

What happens to my bones?

• The cancer cells cause the bone to grow more quickly. So, they thicken and become weak and inflexible. This means that the bones are more likely to break (fracture).
• Bone pain is often the first symptom of bone metastases. The pain may come and go but is often continuous. It can be worse at night.

• Radium-223 looks for areas where bone is growing quickly. 
• It is even more attracted to the damaged part of the bone.
• Once it reaches the damaged area of bone, it gives off energy (radiation).
• The radium-223 only has a short range. So, it kills the cancer cells that are close by. But it does less damage to the healthy cells around it.

• You will have 6 treatments. One treatment every 4 weeks (every month) for 6 months. 
• The dose you get will depend on your body weight. Your doctor will calculate the correct dose for you. 

• You will have a pre-treatment check about two weeks before you have your radium-223. You will: 
  • Have a blood test. This is to check whether your levels of red cells and platelets are normal. Platelets are a type of blood cell that help your blood to clot.
  • Be weighed. This is so that the doctor can calculate the amount of radium you will need.
• You may be advised to:
  • Stop taking any calcium supplements for seven days before your treatment
  • Drink plenty of fluids the day before each treatment.

• You should not feel any pain during the treatment. You may have some short-lived pain a week or two after treatment.

• You will need to take time off to go for your six treatments. 
• Having the treatment may affect your ability to work in certain jobs. Talk to your doctor about going back to work.

• Radium-223 is given as an injection into the vein in the back of your hand. A healthcare professional will put a small, flexible, plastic tube into the vein in the back of your hand using a needle. This is called a cannula. This will feel the same as having a blood test. 

• The radium-223 is then given slowly through the cannula. The cannula is then taken out. The whole process can take up to one hour. You should be able to go home straight away. The time it takes may differ between hospitals. 

• If you are having hormone therapy injections, you will carry on having them. 
• If you aren‘t having hormone therapy injections, you will be offered them. Go to our hormone therapy page (this link will open in a new tab) for more information.

• For the first seven days after treatment, you might have some radiation in your pee, poo and other bodily fluids. 
• You can still have normal contact with adults. Talk to your doctor if you think you may have contact with pregnant women and children.
• There are some things that you will be asked to do:
  • Sit on the toilet. Do not use a urinal. You will need to flush the toilet twice. Wash your hands well when you have finished.
  • Wash any soiled bedlinen or clothes in a separate wash. 
  • If you need to touch any bodily fluids (e.g. spillages), always use gloves. If you use toilet tissues to clean up, flush them down the toilet.
  • You may get a card to keep with you while you are having your course of treatment. This will give details of the treatment you are having. You will need to show this to any healthcare professional that you see. You will get the contact details of someone that you can contact if you start to feel unwell.
  • If you should die within four weeks of treatment, your relatives will need to tell your doctors as soon as possible. There may need to be a delay before a post-mortem or cremation. This is because some radiation may still be present in your body.