Understanding the Importance of Bone Health for Prostate Cancer Patients


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.

  • Radiation & chemotherapy may also reduce patient bone health.

Patients may also be prescribed preventative treatments by their doctors for bone health including:

  • Calcium supplements
  • Vitamin D supplements
  • Regular exercise & dieting along with limiting alcohol and smoking consumption is also recommended.

Recommended treatments for bone health management to reduce the risk of complications in prostate cancer patients

  • Denosumab (Xgeva)
    • Administered via Injection in the upper arm, thigh or abdomen
  • Zolendronic acid (Zometa)
    • Administered via intravenous injection

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)

* Treatment with denosumab (Xgeva) is listed as preferred over zolendronic acid by the National Comprehensive Cancer Network (NCCN) Prostate Cancer Treatment Guidelines.

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.

This side effect occurs in less than 20% of prostate cancer patients.

The most common methods of Diagnosing Bone Issues

  • Bone Scan
  • X-ray
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan
  • Bone biopsy

     Questions to ask your Doctor about Bone Health Treatment

  • What treatments are you recommending?
  • What is the purpose of this treatment?
  • Do I have cancer in my bones?
  • When do you recommend we start treatment?
  • How much time before I can expect to see results from the treatment?

    Make a plan with your Doctor to manage your Bone Health

  • Talk openly with your doctor about your bone health
  • Learn your options
  • Act now, don’t wait for symptoms
  • Find out what’s recommended

 





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