January 2020 Bone Health Alert
The link between Prostate Cancer and Bone Loss
A very important, but often overlooked, aspect of treating Prostate Cancer in patients is the management of bone health. Patients receiving androgen deprivation (hormone) therapy to treat their disease are at an increased risk to develop osteoporosis and experience fractures and other skeletal related events from weakened bones.
What leads to Bone Loss in Prostate Cancer Patients?
When Prostate Cancer begins to spread in patients (metastatic) the most common place it is seen is in the bones. This can weaken bones and lead to pain in the lower back and joints of effected patients that may lower quality of life.
In addition, hormone therapies have bone loss, fractures & joint pain as common side effects. This is because these therapies work by blocking testosterone production in the body, which is an important factor for bone health. This can lead to a decrease in bone density in males receiving these treatments and as a result take them longer to recover from bone fractures than other men.
Patients may also be prescribed preventative treatments by their doctors for bone health including:
Recommended treatments for bone health management to reduce the risk of complications in prostate cancer patients
Studies show that Denosumab (Xgeva) demonstrated a longer period of time before patients experienced their first skeletal event than those taking zolendronic acid ( 20.7 months for Xgeva vs 17.1 months for zolendronic acid, an 18% risk reduction for patients).
Patients taking zolendronic acid also experienced higher complications related to kidney failure (African American patients are at highest risk for kidney failure with a 3-times higher risk and represent 35% of all patients in the US on dialysis)
A potential bone complication for Prostate Cancer patients being treated with Xgeva or Zometa is known as osteonecrosis of the jaw. This condition can cause the jaw bone to deteriorate and lead to a number of dental issues. It is recommended for patients to see a dentist and have any work done on their teeth before starting these treatments.
The most common methods of Diagnosing Bone Issues
Questions to ask your Doctor about Bone Health Treatment
Make a plan with your Doctor to manage your Bone Health