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Androgen deprivation therapy (ADT) is associated with significant bone mineral density loss. A variety of options should be utilized together in order to manage this side effect, states Stephen J. Freedland, MD, from the Duke University School of Medicine.
A few approaches to promote bone health, that urologists often forget to recommend, include exercise and vitamins. Exercise has been shown to preserve bone and bone density, specifically in men on ADT. Moreover, supplementation with calcium and 800 IU of vitamin D helps maintain bone health. These measures are still important, even when utilizing pharmaceuticals, such as denosumab (Xgeva).
In general, bone mineral loss begins the moment ADT is begun, making prophylactic measures more important. Moderator, Raoul S. Concepcion, MD, from Urology Associates, PC, suggests beginning denosumab at the same time as LHRH therapy. In generally, Concepcion believes, many urologists overlook bone health, representing a major education hurdle.