Osteoporosis is one of the side effects of endocrine therapy (also known as androgen deprivation therapy). Although not every patient will develop osteoporosis, it is advisable to undergo bone density screening during endocrine therapy. It is also recommended that all patients preparing for long-term endocrine therapy have their hip bone mineral density measured by dual-energy x-ray absorptiometry before treatment.
- Bone densitometry screening uses x-ray imaging to noninvasively and safely diagnose osteoporosis, measure bone density, assess treatment effectiveness, and predict the risk of future fractures.
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In addition, the following ways can help delay and prevent osteoporosis:
- Calcium and vitamin D supplementation: 1200 to 1500 mg of calcium and 400 to 800 IU of vitamin D daily are recommended.
- Exercise: Regular exercise, especially some weight-bearing exercises such as jogging, dancing, and stair climbing, can help prevent bone loss; endurance training, such as weight lifting, can also help strengthen bones.
- Take bisphosphonates: Bisphosphonates are usually given intravenously and sometimes orally to stop or even reverse endocrine therapy-induced osteoporosis. Treatment with the highly effective bisphosphonate zoledronic acid is recommended.
- Stop smoking and limit alcohol consumption.
In addition, patients with prostate cancer on long-term endocrine therapy may also experience complications such as hot flashes, gynecomastia, sexual dysfunction, cognitive decline, and anemia; the vast majority of patients do not have severe complication profiles. Patients may consult their physicians to prescribe medications to relieve symptoms or to adjust their endocrine therapy regimen if any of these conditions worsen.