Bone health in prostate cancer

Men with metastatic prostate cancer are almost always treated with androgen deprivation as the first-line therapy because it is effective and relatively nontoxic. This has been the standard of care worldwide for decades. In recent years, there has been increasing recognition of the potential risks of androgen deprivation, including osteoporosis, loss of muscle mass and strength, fatigue and possible cognitive impairment, aside from the well-known acute effects of hormone loss such as hot flashes. Perhaps the best studied of these complications is bone loss, which has garnered increasing attention due to the use of androgen deprivation in earlier stages of the disease (i.e., nonmetastatic cancer) [1]. In this article, we describe the phenomenon of bone loss with androgen deprivation, the potential risks of ignoring it, and offer a perspective on the management of bone loss in men with prostate cancer. We refer readers to recent reviews on bone loss in men with prostate cancer where these issues are discussed in some detail.