Exercise, Diet Can Boost Bone Health in Prostate Cancer

Androgen deprivation therapy (ADT), also known as hormone therapy, for prostate cancer can have a negative impact on bone health, but a healthy lifestyle can mitigate skeletal side effects and promote overall wellbeing.

“The foods you choose to eat and the amount of physical activity you get can impact your health, as well as your prostate cancer risk, recovery, and survival,” said Dr. Cassandra N. Moore of the Mayo Clinic, at the CURE®Educated Patient® Prostate Cancer Summit.

Exercise for bone health

ADT can increase body fat, insulin resistance, and can affect blood vessels. It can also increase a patient’s likelihood of developing diabetes, cardiovascular disease, and fractures – especially in men undergoing continuous ADT for six months or longer.

“These treatments for prostate cancer, although they benefit the cancer treatment, can have a negative impact on your body,” Moore said. “So not only does the normal aging process (affect health), but also hormone therapy can lead to a loss of muscle mass and bone density, which can possibly result in osteoporosis.”

To combat bone deterioration, it is advised that patients do not smoke or drink alcohol in excess, as both can individually contribute to poor bone health. Additionally, participating in weight-bearing aerobic and resistance exercises can improve bone density. Exercise also improves muscle strength, physical function, and balance in men with prostate cancer – thus reducing fall risk and improving quality of life.

“An active lifestyle through exercise is essential to bone health and men with prostate cancer on hormone therapy,” Moore said. “Both weight-bearing aerobic and resistance exercises are beneficial in improving bone density in men with normal bone density, and also in those who are at risk of osteoporosis.”

Moore explained that exercise has been shown to have positive impacts on quality of life, fatigue, lean muscle mass, muscle strength, physical function, and balance in patients with prostate cancer.

Nutrition is important

Getting the proper nutrients every day can also contribute to bone health, Moore emphasized.

Particularly, patients should be sure that they are getting enough calcium and vitamin D – preferably together, as vitamin D (which may improve muscle strength and function) helps the body absorb calcium and phosphorous (which are good for bone health). Data have shown that a daily dose of vitamin D (800 IU) reduced hip fractures for people aged 65 or older.

“General recommendation for while you are on hormone therapy is to have a bone mineral density test every one to two years. And it will be important to discuss with your doctor as to your particular health conditions if it is safe to increase your total daily dietary supplemental calcium intake to 1500 (milligrams) and vitamin D to 800 IUs a day,” Moore said.

While vitamin supplements can be beneficial, Moore said that it is best for people to get their nutrients from whole foods, including at least five servings of fresh fruits and vegetables daily, whole-grains, healthy sources of protein (such as fish, eggs, and beans), and healthy fats, like olive oils, nuts, and avocados.

Sugar-sweetened drinks, like sodas and many fruit juices and excess salt should be avoided.

“It’s more important to aim for a healthy eating pattern rather than focusing on specific foods,” Moore said. “We really don’t have data to support any one specific food. It’s just better to aim at an overall healthy eating pattern.”