Many men experience bone loss and joint pain related to their prostate cancer. Communicating with your health care team is important to maintaining healthy bones. There are also lifestyle changes you can make to help keep your bones strong.

This fact sheet answers some commonly-asked questions about prostate cancer and bone health. It also discusses steps you can take to care for your bones.

What causes bone problems when you have prostate cancer?

Bone loss can result from your treatment. Testosterone, the male sex hormone, fuels the growth of prostate cancer. Hormone therapy slows cancer’s growth by lowering the body’s production of testosterone or blocking it from entering cancer cells. However, the lack of testosterone can weaken bones and put men with prostate cancer at increased risk for fractures. Radiation, chemotherapy, and some pain medications can decrease bone strength as well.

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Men with prostate cancer are at risk for bone metastases. Sometimes, prostate cancer travels to other parts of the body. The most common place for it to spread is to the bones, and this can cause bone pain and fractures. The bones most often affected are the spine, hips and ribs. However, bone pain does not always mean that cancer has spread to the bones. Other conditions can cause it. If prostate cancer has spread to your bones, there are many treatment options that can improve your quality of life.

What treatments are available to strengthen and repair my bones?

Bone loss from cancer treatments is treatable. Your doctor may prescribe medicines called bisphosphonates to prevent thinning of the bones. Oral bisphosphonates approved for treating osteoporosis include alendronate (Fosamax) and risedronate (Actonel). An intravenous, or IV, bisphosphonate called zolendronic acid (Zometa) is also available. It has been shown to reduce bone loss and increase bone strength in men receiving treatment for prostate cancer.

Bone metastases can also be treated. Treatment options include hormone therapy and radiation to treat the cancer, and surgery to repair bones that have been damaged. Zolendronic acid can also be used.

Consider enrolling in a clinical trial for additional treatment options. Clinical trials are studies that test new treatments to prove that they are safe and effective. New treatments are also compared to the standard treatments to see if they are better.

What steps can I take to care for my bones?

Schedule an annual bone exam. Bone density scanning, also called DXA or bone densitometry, is the best way for doctors to measure your bone mineral density (BMD). BMD is a measure of bone strength. It is important to get this test before starting hormone therapy so it can serve as a “base line” of your bone health. This lets your doctor compare your results over time and see how your treatment may be affecting your bones.

Make your dentist part of your health care team. If possible, visit your dentist for a complete oral exam before starting treatment. During and after treatment, continue to see your dentist regularly. As always, practice good oral hygiene with regular brushing and light flossing, and avoid mouthwash that contains alcohol.

Strive for a healthy diet. Your bones especially need calcium and vitamin D to stay strong. Low-fat dairy products, like milk and cheese, are good sources of calcium. So are dark leafy greens and beans. Fatty fish such as salmon, tuna and sardines are a good source of vitamin D. Ask your doctor about the benefits of vitamin D and calcium supplements.

Make exercise part of your routine. Exercise maintains bone strength and reduces the loss of calcium in your bones. Regular, weight-bearing exercise, such as walking or light weightlifting is recommended. Such activities encourage your bones to strengthen. Try doing some exercise outdoors, as sunshine is a source of vitamin D. It’s important not to injure your bones, though. Talk to your doctor about the right kind of exercise for you.

This article originally appeared on ONA