Are You at Risk for Brittle Bones?
May was Osteoporosis Awareness Month, and it shined a light on brittle-bone risk factors in women and men. Osteoporosis is a condition that weakens bones and often contributes to declining health in those over age 65. While the disease is most often associated with the loss of estrogen in post-menopausal women, men who have undergone androgen deprivation therapy (ADT) to treat advanced prostate cancer may also be at risk. For men who have survived cancer treatment, osteoporosis poses an often-unrecognized threat that potentially can be treated to restore health and improve quality of life.
What Is Osteoporosis?
Throughout your life, bone tissue is continually breaking down and being renewed. Old bone is reabsorbed, which transfers calcium to the blood, and new bone is formed to replace it. When you develop osteoporosis, this renewal process becomes unbalanced, and bone loss outpaces the formation of new bone tissue. The condition usually happens slowly over time, without symptoms, and results in bones that are brittle, weak and prone to fracture. The National Institutes of Health (NIH) identify many risk factors for the disease, including:
- Being thin or having a small frame
- Having a family history of the disease
- Using certain medications, such as glucocorticoids
- Not getting enough calcium
- Not engaging in regular physical activity
- Drinking too much alcohol
In addition, studies indicate that the loss of sex hormones (estrogen for women who are past menopause and androgen hormones in men undergoing prostate cancer therapy) contributes to the development of osteoporosis with advancing age.
ADT Prostate Cancer Therapy & Osteoporosis
Androgen deprivation or suppression has become a standard of advanced prostate cancer treatment, and recent studies have revealed a link between this type of therapy and increased bone loss and fractures in men. Male hormones stimulate the growth of prostate cancer cells, and in some cases lowering their levels effectively shrinks tumor size and slows cancer growth. ADT therapy can be combined with other treatments for more effective prostate cancer treatment. Lowering androgen levels increases bone turnover and decreases bone density, potentially leading to developing osteoporosis and consequent loss of quality of life.
Restoring Bone Health With Effective Treatments
Men at risk for bone loss after hormone deprivation therapy have a variety of options for preventing osteoporosis-related injury. Begin by asking your doctor about a bone mineral density (BMD) test to assess your bone health. Then, consider making these lifestyle changes if you are not currently doing so:
- Eating a well-balanced diet rich in calcium & vitamin D (required to absorb calcium)
- Taking dietary supplements & multivitamins
- Exercising regularly (including weight-bearing activity)
- Ceasing smoking
- Limiting alcohol intake
- Taking physician-recommended medications to improve bone health
Avoid Hormone Deprivation Therapy With Early Prostate Cancer Detection
Although prostate cancer research continues to produce promising and effective treatments for advanced forms of the disease, early detection and intervention still offer the best chance for recovery. PSA screening, followed in men with an abnormal result by a simple blood test, the 4Kscore test, can help detect aggressive prostate cancer early—when treatment options are less invasive and more effective.
The 4Kscore Test measures four prostate-specific kallikreins, along with clinical factors, to determine a man’s risk of aggressive prostate before making a biopsy decision. Results from multiple studies have confirmed the accuracy of 4Kscore in providing the risk of high-grade cancer if a prostate biopsy were performed. If you are deciding whether to have a biopsy following an abnormal PSA test, ask your doctor if the 4Kscore Test could provide the facts you need to make a more informed decision.
National Institutes of Health. https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/osteoporosis-prostate-cancer
American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/treating/hormone-therapy.html