When prostate cancer progresses to an advanced stage, it can spread to the bones. To better understand what is happening in your body and to guide treatment, doctors use a very common imaging test: the bone scan.
This article explains:
- What a bone scan is
- How the test is performed
- When it is recommended
- What a bone scan can reveal
- Its advantages and limitations
- Its role in monitoring prostate cancer
Medical review by uro-oncologist Dr. Nawar Hanna, December 2025
What is a bone scan?
A bone scan is a medical imaging test that allows doctors to visualize bone activity throughout the body. To do this, a radioactive tracer is injected, which mainly accumulates in areas of increased bone activity—such as regions where cancer may have spread to the bones.
The resulting images can show areas of increased uptake, indicating regions where higher cellular activity may be secondary to bone damage caused by cancer.
How is a bone scan performed?
Tracer injection: A healthcare professional injects a radioactive substance (the tracer) into a vein. Although the term “radioactive” may sound alarming, the amount used is small and safe.
Tracer uptake: The tracer needs 2–4 hours to bind to bone, especially in areas with high cellular activity. It is recommended to drink plenty of water during this time to help flush out excess tracer.
Imaging with the gamma camera: You lie on an exam table while a special camera, called a gamma camera, takes images of the skeleton to detect areas where the tracer has accumulated. The test takes about 30–45 minutes, and staying still ensures high-quality images.
Interpreting the results: A nuclear medicine specialist analyzes the images, looking for areas of increased uptake that may correspond to metastases but can also indicate benign conditions. Careful analysis takes time, so results are not available immediately.
When is a bone scan recommended?
Bone scans are primarily used:
- At diagnosis: When prostate cancer has a high risk of having spread to the bones
- In case of recurrence: If PSA levels rise after treatment and cancer is suspected, but other tests show no abnormalities
- When experiencing bone pain: Especially in the back, hips, or ribs, when no other cause is identified
- Before targeted treatment: To plan interventions such as radiation therapy or certain advanced therapies by precisely locating affected areas
Why have a bone scan?
Bone scans are valuable because they help to:
- Detect and locate bone metastases
- Monitor disease progression, especially in patients who already have bone metastases
- Evaluate treatment effectiveness by observing changes in bone activity after therapies such as radiation or chemotherapy
Advantages and limitations of bone scans
Advantages:
- Widely available in Quebec
- Part of the standard workup for detecting bone metastases
- Non-invasive and relatively quick
Limitations:
- Not specific: Increased uptake does not always indicate metastases. Other conditions, such as infections or old fractures, can also cause tracer accumulation
- Sometimes additional imaging, such as MRI or CT, is needed to confirm results
- Risk of false negatives, especially for very small lesions
Bone scans: an essential tool for monitoring
Bone scans remain a reference test for detecting and evaluating bone metastases in advanced prostate cancer. They help doctors understand the extent of the disease and tailor treatments accordingly.
If you have questions or concerns about this test, discuss them with your doctor. Understanding the process can make each step less stressful.
At PROCURE, we believe that better understanding leads to better living with the disease. Our professionals are here to support you and answer your questions, seven days a week. Contact us at 1-855-899-2873 or visit our website procure.ca
