Which cancer is among the most common to metastasize to the vertebrae and cause back pain?

• A. Prostate
• B. Breast
• C. Lung
• D. Kidney

Answer: (A)

Cancers that spread to bone often target the spine because the Batson venous plexus provides a direct, valve-free route from the pelvis and chest to vertebrae, allowing tumor cells to seed the axial skeleton, which explains why back pain can be an early sign of spinal metastasis. Prostate cancer has a particularly high propensity to metastasize to bone, especially the spine and pelvis, and these metastases are classically painful and can lead to spinal cord compression if advanced. Among the options, prostate cancer is the most common source of vertebral metastases presenting with back pain. Breast cancer also frequently spreads to bone and can involve the spine, but the strong association of prostate cancer with axial skeleton metastases makes it the best answer; kidney and lung cancers can metastasize to bone as well, but their spine involvement is less characteristic in this context.