About 1 in 9 men in the United States, roughly 11%, will be diagnosed with prostate cancer in his lifetime, according to the American Cancer Society.

After skin cancer, prostate cancer is the second most common cancer in males, and mostly occurs in men 65 and older. While the disease can be successfully treated in many cases, cancer therapies may lead to weakened bones, a condition known as osteoporosis. This article discusses what prostate cancer is, the risks for osteoporosis after treatment, and ways to prevent and manage osteoporosis.

What is Prostate Cancer?

Prostate cancer is cancer that occurs in the prostate, a small walnut-shaped gland that sits right below the male bladder. The prostate makes seminal fluid. Prostate cancer typically develops slowly, but some types are more aggressive and spread quickly. Prostate cancer found before it has spread, has a greater chance of successful treatment than a tumor that has invaded other parts of the body. Learn more about prostate cancer.

Osteoporosis Risks After Prostate Cancer Treatment

While osteoporosis is often considered a condition that affects women, men can also develop it. Male osteoporosis is becoming more common due to prostate cancer therapies that put men at a greater risk for bone loss. The cancer treatments below may contribute to the development of osteoporosis:

  • Chemotherapy: Chemotherapy is a way to treat cancer with drugs that destroy cancer cells. In some cases, chemotherapy kills the tumor. In other instances, chemo shrinks it or reduces cancer symptoms.
  • Hormone Therapy: Testosterone is the primary male sex hormone, and it plays a strong role in the development of the male reproductive system. It’s also responsible for hair growth, sex drive, and other normal body functions. Since testosterone can fuel prostate cancer growth, men are often treated with hormone therapy to reduce testosterone levels in the body. This treatment is called androgen deprivation therapy (ADT), or androgen suppression therapy (AST). Men typically receive hormone therapy in conjunction with other prostate cancer treatments, depending on the severity of the disease.

Although cancer treatments can lead to bone loss, osteoporosis, and fractures, not all men treated for prostate cancer will develop the complication. Osteoporosis can be prevented and managed through lifestyle and medications.

Osteoporosis Prevention and Management After Surviving Prostate Cancer

Now that you know a little about prostate cancer and the risks of developing osteoporosis after prostate cancer treatment, let’s take a look at how you can possibly prevent osteoporosis when going through treatment and also osteoporosis management after treatment.

Preventing Osteoporosis in Men Diagnosed with Prostate Cancer

Before starting cancer treatment, men should consider having a bone density screening to assess the risk for developing osteoporosis. It’s done through a safe and noninvasive x-ray known as the bone mineral density test or dual energy X-ray absorptiometry (DEXA). The test can diagnose osteoporosis, spot low bone density, determine the risk for future bone fractures, and monitor the effectiveness of osteoporosis treatment. Schedule a bone density screening with our team of experts.

Once bone loss has occurred, it can’t be completely reversed, but it can be slowed and bone density can improve with medications.

Lifestyle Approaches for Prevention

Here are ways men can prevent bone loss:

  • Calcium: Certain foods contain calcium such as dairy products including yogurt, cow’s milk, and cheese. Non-dairy foods such as tofu, dark leafy greens, and salmon are also high in calcium. The daily calcium intake recommendation for men over 50 is 1,000 mg.
  • Vitamin D: Our bodies make vitamin D from the sun’s rays. Vitamin D can also be taken as a supplement. It is recommended that men over 50 get 1,000 IU’s of vitamin D daily. Obese men may need a higher dose.
  • Exercise: Performing regular physical activity can help prevent bone loss, especially weight-bearing exercises. Jogging, stair climbing, lifting weights and dancing are just a few examples.
  • Stop Smoking: Smoking is a risk factor for developing osteoporosis.
  • Limit Alcohol Consumption: A high intake of alcohol has been linked to a higher risk for bone fractures.

Medical Therapies for Prevention and Treatment

If a patient has a high risk for developing osteoporosis or has been diagnosed with the disease, he may be treated with the following medications:

  • Bisphosphonates: These medicines stop the weakening of bone. Some types are taken orally, and others are administered by IV or injection.
  • Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL) Inhibitor: This type of medication works similarly to bisphosphonates. Denosumab is a RANKL inhibitor that prevents bone loss when used with calcium and vitamin D supplements. A study of 10 years of treatment, has shown an increase in spine density of 20% in women. No studies are available in men, but it’s presumed to be similar.
  • Bone Forming Agents: In patients with severe bone loss who have no evidence of tumor invasion of bone or radiation therapy. Several drugs might be used to significantly increase bone density over 1-2 years.


Therapies for prostate cancer may cause osteoporosis in men, but not always, and the condition can be prevented. By having your bone density screened before beginning cancer treatment, you and your doctor can learn your risk for bone loss. Osteoporosis cannot always be cured, but it can be managed through lifestyle and medication. To learn more about the Saint John’s Cancer Institutes approach to treating prostate and other cancers affecting males, please visit our Urology website.

Schedule an appointment for a bone density test by contacting our bone health cancer support team.

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About the Author

Dr. Frederick R Singer

Dr. Singer is the Professor of Endocrinology and the Director of the Endocrine & Bone Disease Program at the Saint John’s Cancer Institute. He specializes in metabolic bone disease and has long-term experience in osteoporosis which develops in cancer patients and individuals with bone metastases. Learn More About Dr. Fredrick Singer.