Prostate cancer is the most common tumor and second most common cause of cancer death in American men. Advanced prostate cancer patients commonly have painful skeletal bony metastases. Although hormonal therapy is very effective initially, hormone-refractory prostate cancer may be associated with bone pain and other symptoms such as urinary obstruction. Aside from oral and parenteral non-narcotic and narcotic medications, several recent FDA-approved outpatient medications are effective for palliation of painful bony metastases. Mitoxantrone chemotherapy in combination with glucocorticoids and the radioisotopes strontium-89 and samarium-153-lexidronam are now available. Urologic nursing personnel should be familiar with these new and complementary modalities.