Pathophysiology of Prostate Cancer Bone Metastases Prostate cancer, when metastasized, preferentially spreads to the bone, resulting in morbidity and mortality from skeletal complications such as pain, fracture, anemia, and spinal cord compromise. ??The pathophysiology of bone metastases is such that prostate cancer cells, osteoclasts, and osteoblasts signal each other via cytokines and growth fac