Bone Health and Prostate Cancer
Prostate cancer and prostate cancer treatment might cause numerous bone-related complications. Sometimes the prostate cancer treatments can cause these complications as well. If prostate cancer is not stopped in time, it will spread to the bone and cause pain and discomfort. 
Whenever prostate cancer spreads beyond the prostate, the condition is called bone metastases. Bone metastases are tumors that form on your bones. It happens after prostate cancer has progressed to the advanced stages and spread beyond the prostate to the bone. Unfortunately, most men who have advanced prostate cancer will have to deal with bone metastases eventually.
The good news is treatments are available to help men deal with the symptoms of bone loss and bone metastases. These treatments are formulated to improve their bone density and stop any further bone loss. Some treatments are more successful than others, though.
For instance, doctors like to administer hormonal therapy to men who have prostate cancer. However, hormonal therapy will cause bone loss because it reduces testosterone levels in the body. If too much bone mass is lost, it will diminish the strength of the bones. Once that happens, the person is at risk of fracturing their bones. That would cause them to feel excruciating pain.  
Available Treatment Options
When men experience bone loss due to prostate cancer, several treatment options are available, such as radiation, pain medications, chemotherapy, and androgen deprivation therapy (ADT) hormonal injections. These might be reasonable short-term treatment solutions, but they can cause unwanted side effects if they’re used too long.
For instance, ADT will reduce testosterone levels in men, so it should not be administered on a long-term basis. Otherwise, it will weaken the bones and cause fractures, broken bones, and other unwanted injuries. Those other treatments, such as radiation and chemotherapy, can weaken the bones too. So, you must be careful with how long you have these treatments.
How to Diagnose Low Bone Density
When you start to have bone loss, you won’t notice any symptoms right away. Only a bone density scan can be done to detect whether you have bone loss. The official name is a DEXA scan, which detects bone mass thickness in the body. If the thickness level is lower than what is considered a normal thickness level, there is low bone density. A few other tests that can be done to detect low bone density are MRI and CT scans. 
Making Bones Stronger
It is possible to increase bone density if you take the right medicines and make specific alterations to your lifestyle, such as:
– Weight-bearing exercises, muscle strengthening exercises, and other physical activities will go a long way in improving muscle strength and bone mass. 
– Bisphosphonate medicines like Zometa and Zolendronic acid are useful for building bone mass and preventing bone loss. 
Of course, it is wise to consult with a physician to determine which treatment option is best for your particular condition. Your doctor will put a personalized treatment plan together to help you better manage the spread of cancer and the painful symptoms associated with it. 
Diagnosing Bone Metastases
A bone scan is used to diagnose bone metastases. It is a nuclear medicine test, like a PET scan. The doctor injects dye into the patient’s body, which lights up the bone’s prostate cancer cells. Sometimes a different imaging test might be conducted, but the most effective test is the bone scan. 
If your diagnosed prostate cancer is relatively recent, it is wise to undergo a baseline fracture risk assessment of some kind. You could use a DEXA scan, but it might not be enough by itself to determine fracture risk. 
The FRAX® algorithm, on the other hand, is much more sufficient for conducting a fracture risk assessment. It is designed to determine the likelihood of whether you will develop a significant osteoporotic fracture over the next ten years. 
A major osteoporotic fracture would be somewhere involving the shoulder, hip, forearm, or spine. When assessing the risk level of your hip area, the FRAX® algorithm considers your age, smoking history, body weight, family history, and the level of glucocorticoid exposure.
When assessing the risk of the femoral neck, a bone mineral density measurement is not required. When using the FRAX® algorithm, androgen deprivation therapy is deemed to be secondary osteoporosis. 
Bone Metastases Effects and Complications
Since bone metastases cause prostate cancer to spread its way to the bone, the pain inflicted could limit your ability to conduct usual daily activities. As cancer progresses, you’ll likely experience more skeletal-related events that cause more pain and discomfort. Then you’ll need more treatments for the problem.
Skeletal-related events refer to the possible complications that could occur once the prostate cancer cells get in the bone. Some of these complications might include the following:
– Bone fracture (when the bone breaks)
– Bone instability (requires surgery to fix) 
– Bone pain (requires radiation to treat)
– Cord compression: When prostate cancer makes its way to the spinal nerves, you’ll feel tingling and numbness in your legs and arms.
Treatments for Bone Complications
Medicines like denosumab and bisphosphonates can increase bone strength and reduce the likelihood of experiencing skeletal-related events. It is essential to sustain bone health with supplements, such as vitamin D (800 to 1000 iu) and calcium (1,200 mg). 
Treatments for Bone Metastases
Bone metastases pain can be treated, and life can be extended with the following treatments:
Radiopharmaceuticals – Radioactive drugs administered into the vein. As the drugs circulate through the vein and discover the prostate cancer in the bone, it emits a radioactive material (aka. Smart bomb) to eliminate cancer. But remember, this treatment only works if the prostate cancer is in the bone. It won’t work if the cancer has spread to other organs of the body. 
Strontium / Samarium – Radiopharmaceuticals formulated to be pain relievers.
Radium-223 / Xofigo – Another radiopharmaceutical formulated to be a pain reliever and extend the life of men.  
External Beam Radiation Therapy – Direct radiation is applied to reduce pain in one particular body area. It does not prolong a man’s life, though. But at least it will enhance the equality of their life. 
Healthy Diet – Eat nutritious foods with Vitamin D and calcium in them. Avoid too much alcohol and tobacco.  
Side Effects
You might experience some possible side effects if you use treatments with denosumab or bisphosphonates in them. These side effects are as follows:
– Reduced calcium levels
– Abnormal heart rhythm
– Jaw Osteonecrosis – When you seek treatment for this side effect, it is essential to notify your doctor of any oral infections or other dental issues you might have.