Relationship Between Prostate Cancer and Bone Health

June 3rd, 2025 by Fuad Elkhoury

Fortunately, medicine is developing rapidly. Survival rates are increasing. Even men with advanced prostate cancer can overcome the disease. The challenge now is to understand the specific effects of this illness and its treatment on bone health. When bone structure becomes less dense and weaker, the fracture risk increases even with a minor blow. Osteoporosis should be diagnosed as early as possible. Let’s analyze the connection between prostate cancer and osteoporosis.

Prostate Cancer and Bone Health

The prostate is an external secretion gland located in the lower pelvis of men, under the bladder and in front of the rectum. The prostate comprises glandular and muscular tissue that provides two main bodily functions. The first produces substances that are part of the seminal fluid. The second ensures the release of fluid from the glans during ejaculation and the blockage of the urethra during an erection. Prostate cancer is a malignant neoplasm in the prostate gland. As a rule, it is diagnosed in men aged 55-65. The older the man, the higher the likelihood of developing a tumor.

Unfortunately, this type of cancer is one of the most common oncological diseases. Bone metastasis in prostate cancer occurs when the cancer spreads from the prostate to the bones. It’s a common occurrence, especially in advanced stages of prostate cancer. Prostate cancer involves the abnormal growth of cells in the prostate gland. Depends on the intake of androgens, or male hormones, for growth. The primary hormone of androgens is testosterone.

By reducing the level of androgens or stopping their entry into prostate cancer cells, there is a chance of slowing the growth of cancer.

Hormone Therapy for Cancer and Androgen Levels

Hormone therapy for this type of cancer is called androgen suppression therapy or androgen deprivation therapy. It is the first treatment. As a rule, the doctor prescribes it when prostate cancer has spread (metastatic prostate cancer).

But androgen protects the body from bone loss and is important for bone health. Men with low testosterone levels (hypogonadism) have an increased risk of developing osteoporosis and bone fractures.

Of course, with age, the level of this hormone decreases anyway. But let us add to this a sharp decrease in the level of this most important hormone when men take hormone therapy. The combination (age and hormone therapy) can lead to low bone density and, accordingly, an increased risk of osteoporosis and fractures in men with this disease.

Statistics

Prostate cancer is the second most commonly diagnosed cancer in men. Fortunately, modern medicine is helping to prolong the lives of men with this disease. Prostate cancer survival rates have tripled over the past 40 years in the UK. In the US, prostate cancer deaths have fallen by 51% from 1993 to 2016. This is excellent news. It is now essential to study the long-term impact of this illness. It’s proven that prostate cancer and bone complications are connected. Finding treatment that will help maintain normal bones and prevent their destruction is important.

What Hormone Therapies Can Affect Bones?

Typically, the doctor will prescribe hormone therapies for prostate cancer in the form of injections or pills. Some drugs work by attaching to proteins (receptors) on the surface of cancer cells, blocking testosterone from getting into the cancer cells. These drugs are called antiandrogens and are usually sold in pill form. A commonly used antiandrogen is bicalutamide. Some of the therapies “turn off” the production of male hormones by the testicles, thereby reducing the level of the hormone produced by the pituitary gland. These drugs are called gonadotropin-releasing hormone antagonists or pituitary down-regulators. The doctor will usually inject them as a liquid under the skin or into a muscle (leuprorelin) or as pellets under the skin of the abdomen (goserelin).

Bone Health Testing

Men undergoing hormone therapy for this type of cancer should be especially careful about their bone health. Osteoporosis in prostate cancer patients is common. If a person takes action early, they can reduce the chance of the bones breaking down and keep them as strong and fracture-free as possible. The doctor will likely order a bone density scan and prescribe medication for osteoporosis. Continued monitoring is also necessary.

Risk Factors for Osteoporosis

It is important to consider the patient’s complete history. Some factors make bone problems worse, so you should be even more careful in this case.

These factors include:

• Family history of osteoporosis
• Previous fracture (due to a minor blow or fall)
• Age 70 years or older
• Height loss (3 cm or more)
• Bad habits: Smoking or excessive alcohol consumption
• Lack of vitamin D, calcium, or exercise
• Overactive thyroid or parathyroid glands
• Comorbidities, including celiac disease, diabetes, and rheumatoid arthritis
• Low testosterone
• Chronic kidney or liver disease

Certain medications used to treat prostate cancer or breast cancer, glucocorticoids (steroids), and epilepsy drugs

It is important to understand what causes bone problems so that you can take action.

Simple Steps to Maintain Healthy Bones 

Focus on the recommended diet. Your diet must be rich in calcium. It is advisable to consume 1000 mg per day. However, women over 50 and men over 70 are recommended to consume up to 1300.

Vitamin D is essential for bone health. Doctors recommend limited sun exposure—a few minutes a day in the summer and a little longer in the winter. Avoid UV indexes above 3. If your doctor confirms a vitamin D deficiency, you may need supplements. It is essential (unless your doctor prohibits it) to exercise. The right combination of weight, strength, and balance exercises will help you maintain normal bone health.

Conclusions

Are you concerned about your health? It is important to diagnose the problem in time and receive adequate treatment. Our specialists have extensive experience. We are sensitive to each of our patients and practice an individual approach. Our team of experts is certified, trained, and ready to treat patients at the highest level. Come to us and experience a friendly, delicate, and relaxed atmosphere. We look forward to your requests.