title: Preventing bone complications in prostate cancer.
abstract: OBJECTIVE
  Bone metastases alone or in combination with androgen deprivation therapy-related bone loss places prostate cancer patients at greater risk for skeletal morbidities, including pain, pathologic fracture and spinal cord compression. These events significantly impair the patient's quality of life and place a significant burden on health-care resources.
  
  
  RESULTS
  This review focuses on the management options for reducing skeletal morbidity in patients with prostate cancer, including life-style modifications, food supplementation, osteoclast-targeted therapy and selective estrogen-receptor modulators.
  
  
  CONCLUSIONS
  The use of osteoclast-targeted therapy (denosumab and zoledronic acid) is supported by the strongest evidence and has been US Food and Drug Administration-approved for the treatment of patients with PCa at high risk of osteoporotic fractures and for the reduction of the risk of skeletal-related events in patients with castration-resistant prostate cancer. Ongoing trials are studying the potential role of osteoclast-targeted therapy in other settings throughout the course of the disease.
authors.affiliation: Centre de recherche du Centre hospitalier de l'Université de Montréal and Institut du cancer de Montréal, Montreal, Quebec, Canada.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bishr
authors.forename: Fred
authors.initials: F
authors.lastname: Saad
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001847:Bone Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D001859:Bone Neoplasms / Q000473:pathology / Q000517:prevention & control* / Q000556:secondary; D001842:Bone and Bones / Q000473:pathology*; D000069448:Denosumab; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D011471:Prostatic Neoplasms / Q000150:complications* / Q000473:pathology; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D000077211:Zoledronic Acid
chemical_list: D000726:Androgen Antagonists; D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D020845:Selective Estrogen Receptor Modulators; D000069448:Denosumab; D000077211:Zoledronic Acid