Prostate cancer

Androgen deprivation therapy is often used to treat prostate cancer. This rapidly reduces serum testosterone concentration, increasing bone loss and risk of fractures. All men should have a baseline assessment of fracture risk and BMD before starting therapy.

Ensure the patient’s calcium intake is sufficient and that they are vitamin D replete, and provide advice on lifestyle measures to prevent minimal-trauma fracture.

All men with prostate cancer who receive androgen deprivation therapy and who have a history of minimal-trauma fracture should start therapy with a bisphosphonate or denosumab. Therapy should also be considered in men with a reduced BMD (T-score lower than or equal to –2) at the hip or spine.