Prostate Cancer and Bone Health

When weighing prostate cancer treatment options, potential side effects such as urinary control and sexual potency are the hot buttons. Seldom discussed, though significantly more damaging, is bone disease. Early diagnosis of prostate cancer, and the right treatment path, can drastically reduce a man’s risk of developing prostate cancer-related bone disease.

World renowned prostate surgery and robotic surgeon, Dr. David Samadi, pushes for comprehensive patient education, “Men are largely unaware of how prostate cancer can affect their bones.”

As reported in the Bone Health In Focus Prostate Cancer report, which aims to increase awareness of prostate cancer-related bone disease, only one third of prostate cancer patients claim to have discussed bone health and the risk of bone metastases with their physician. Shocking for a secondary disease that can significantly impair quality of life and ultimately decrease survival by more than three years.

Prostate cancer-related bone disease results from either:

1)    Cancer Treatment-Induced Bone Loss (CTIBL)

“Seldom are men made aware of the damaging affects of androgen deprivation therapy (ADT) on their bones,” says Dr. Samadi. “Hormone therapy for prostate cancer is proven to significantly decrease bone mass and cause bone weakening.”

Also in the Bone Health In Focus Prostate Cancer report are statistics indicating less than half of men with non-metastatic prostate cancer were even aware that hormone therapy could damage their bones. One study found incidence of bone fracture in nearly one in five men within five years of beginning ADT.

“This lack of information can be seriously detrimental as a man weighs his prostate cancer treatment options,” cautions Dr. Samadi. “Men who opt for hormone therapy may be further jeopardizing their health and their power to fight prostate cancer. Robotic prostatectomy surgery removes the cancerous prostate and significantly reduces the risk of metastases.”

2)    Bone Metastases

Prostate cancer is an unpredictable disease and can spread quickly, without warning and without symptoms. Men who skip their annual PSA blood test are putting themselves at risk for late-stage diagnosis. Others may be diagnosed early, but choose not to treat their prostate cancer, opting instead for watchful waiting.

“Delaying diagnosis or treatment of prostate cancer opens the door to bone disease and unnecessarily exposes men to another life-threatening condition,” cautions Dr. Samadi. Bone disease skeletal-related events (SREs) such as fracture or spinal cord injury are serious alone, but they can also interfere with a man’s prostate cancer treatment.

“Unfortunately, many men are unaware that late-stage diagnosis of prostate cancer has implications beyond the cancer itself,” Dr. Samadi explains. “Prostate cancer-related bone disease is further evidence of the irresponsible nature of the U.S. government task force’s recommendation against the PSA test.”

Roughly 75 percent of men diagnosed with an advanced form of prostate cancer will develop bone metastases.

“Men don’t have to fear bone disease, but they do have to be knowledgeable about it,” says Dr. Samadi. “It is not inevitable. Early diagnosis beginning with the PSA test and swift treatment through robotic prostate removal surgery can help eliminate prostate cancer long before the bones are affected.”

Dr. David Samadi is Vice Chairman of the Department of Urology and Chief of Robotics and Minimally Invasive Surgery at Mount Sinai Medical Center, and creator of the SMART (Samadi Modified Advanced Robotic Technique) robotic prostatectomy surgery.