Bone metastases are present in the majority of patients with prostate cancer and are the main cause of mortality in these patients. Here, Andrew Armstrong, MD, from Duke University, Durham, NC, discusses the role of osteomimicry in the formation of bone metastases, and the challenges concerning their treatment. From the 2018 Genitourinary Cancers Symposium, held in San Francisco, CA, Dr Armstrong outlines potential research pathways for exploration.