We all know that one of the common problems many of us will confront when fighting prostate cancer is experiencing bone fractures. Somtimes these fractures happen for little or no obvious cause. Why are bone fractures, especially spontaneous fractures (without any evident reason) so common in prostate cancer?

Spontaneous fracture may be develop because:

1. The bone is one of the most common targets for the development of tumors in prostate cancer. If tumors do develop in the bone, they can cause weakness at that site which can easily lead to subsequent fractures, even with minimal trauma to the bone. Some people actually experience these types of fractures simply by just performing an everyday task like walking!

2. Hormone therapy (ADT) promotes the development of osteopenia and osteoporosis (thinning and weakening of the bone structure). Either chemical (through the use of ADT drugs) or surgical castration in men with prostate cancer is usually followed by greatly accelerated bone loss which may be superimposed on a bone mass already depleted before hormonal therapy.

3. The natural aging process will cause osteopenia and osteoporosis. Additionally, baseline bone mass and subsequent bone loss may be influenced by obesity, age and exercise habits.

What can you do?

Treatment of bone density loss should begin with early recognition of the problem and by taking preventive measures. These measures include smoking cessation, starting a regime of weight bearing exercise, and taking vitamin D and calcium supplements. Additionally, men receiving ADT should discuss with their physicians the possibility of also taking bisphosphonate therapy such as Zoledronic Acid.

Anemia, a condition of low red blood cells (hemoglobin), may be because of the lack of testosterone stimulation of the red blood cell precursors in the bone marrow in men receiving ADT. In advanced prostate cancer, tumor growth in bone marrow further compromises the red blood cell production.

Joel T Nowak, M.A., M.S.W.