Prostate cancer is one of the most common human cancers and bone metastasis is a frequent finding in the natural history of several types of cancers. The molecular mechanisms that makes prostate cancer metastasize to bone have recently been identified, and provide new molecular targets for drug development, several biochemical by-products that provide insight into the tumorbone interaction, with potential to enhance the clinical management of patients with bone metastases, have been reported during the past decade, however, its anticipated risk, diagnosis and response to therapy are still challenging to assess in clinical practice. In this article, we will discuss these challenges with an emphasis on the communication pathways between each cell type involved and the roles of Wnts, sclerostin, RANKL, PTHrP and macrophages
