title: Bone health in patients with prostate cancer.
abstract: BACKGROUND
  In patients with prostate cancer, bone health is compromised by advanced age at diagnosis, androgen suppression treatments and the developmentofbone metastases. In this paper the medical literature is reviewed in order to update the state of the art on their incidence, prevention and management.
  
  
  METHODS
  A literature review about bone involvement in patients with prostate cancer in different clinical settings is performed.
  Decreased bone mineral density is higher in patients diagnosed of prostate cancer before starting treatment than in healthy men with the same age. During the first year of treatment, a severe loss bone density is reported due to androgen suppression therapy. From then on, loss bone density seems to slow down, persisting at long-term. It is important to know the starting point and the dynamics of loss bone in order to prevent its progression. The skeletal events have an important impact on quality of life in patients with prostate cancer. Both Denosumab and Zoledronic Acid have proven effective in reducing loss bone.
  
  
  CONCLUSIONS
  The prevention and management of bone involvement in patients with prostate cancer is critical to quality of life in these patients and requires an individualized approach. Before starting a prolonged androgen deprivation, baseline risk of fracture should be evaluated in order to adopt the proper protective measures. In patients with metastases, early treatments reducing the risk of bone events should be taken into account.
authors.affiliation: Servicio de Urología, Hospital Morales Meseguer, Universidad Católica San Antonio, UCAM, Murcia, España. Electronic address: bernardino.minana@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Miñana
authors.affiliation: Servicio de Urología, Hospital Virgen de las Nieves, Granada, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Cózar
authors.affiliation: Servicio de Urología, Hospital Clínic, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Alcaraz
authors.affiliation: Servicio de Urología, Hospital Vall de Hebrón, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Morote
authors.affiliation: Servicio de Urología, CHUAC, A Coruña, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Gómez-Veiga
authors.affiliation: Servicio de Urología, IVO, Valencia, España.
authors.forename: E
authors.initials: E
authors.lastname: Solsona
authors.affiliation: Servicio de Urología, Hospital Doce de Octubre, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez-Antolín
authors.affiliation: Servicio de Urología, Hospital Puerta de Hierro, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Carballido
mesh_terms: D000465:Algorithms; D000726:Androgen Antagonists / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D001847:Bone Diseases / Q000209:etiology*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000209:etiology; D017410:Practice Guidelines as Topic; D011471:Prostatic Neoplasms / Q000150:complications* / Q000188:drug therapy
chemical_list: D000726:Androgen Antagonists; D000970:Antineoplastic Agents
keywords: Anticuerpo monoclonal; Bifosfonatos; Bisphosphonates; Bone metastases; Castración; Castration; Cáncer de próstata; Fractura; Fracture; Metástasis ósea; Monoclonal antibody; Osteopenia; Osteoporosis; Prostate cancer