Bone Health in Men with Prostate Cancer: Review Article

Curr Osteoporos Rep. 2019 Dec;17(6):527-537. doi: 10.1007/s11914-019-00536-8.

Abstract

Purpose of review: The improvement in prostate cancer survival over time, even in those with advanced disease, has led to an increasing recognition of the impact of prostate cancer and its treatment on bone health. Cancer treatment-induced bone loss (CTIBL) is a well-recognized entity but greater awareness of the risks associated with CTIBL and its treatment is required.

Recent findings: The principal culprit in causing CTIBL is hormonal ablation induced by prostate cancer treatment, including several new agents which have been developed in recent years which significantly improve survival, but may cause CTIBL. This review discusses the impact of prostate cancer and its treatment on bone health, including published evidence on the underlying pathophysiology, assessment of bone health, and strategies for prevention and treatment. It is important to recognize the potential cumulative impact of systemic prostate cancer treatments on bone health.

Keywords: Androgen deprivation therapy; Bone health; Osteoporosis; Prostate cancer.

Publication types

  • Review

MeSH terms

  • Androgen Antagonists / therapeutic use*
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Bone Density
  • Bone Diseases, Metabolic / drug therapy
  • Bone Diseases, Metabolic / etiology
  • Bone Diseases, Metabolic / metabolism
  • Bone Diseases, Metabolic / prevention & control
  • Bone Neoplasms / secondary*
  • Bone Resorption / etiology
  • Bone Resorption / metabolism*
  • Glucocorticoids / therapeutic use*
  • Gonadotropin-Releasing Hormone / agonists
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors
  • Humans
  • Male
  • Orchiectomy*
  • Osteoporosis / drug therapy
  • Osteoporosis / etiology
  • Osteoporosis / metabolism*
  • Osteoporosis / prevention & control
  • Osteoporotic Fractures / etiology
  • Osteoporotic Fractures / metabolism
  • Osteoporotic Fractures / prevention & control
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / metabolism
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / therapy*
  • Prostatic Neoplasms, Castration-Resistant / complications
  • Prostatic Neoplasms, Castration-Resistant / drug therapy

Substances

  • Androgen Antagonists
  • Antineoplastic Agents, Hormonal
  • Glucocorticoids
  • Gonadotropin-Releasing Hormone