Androgen deprivation therapy and bone metastases both raise fracture risk. When starting ADT, assess fracture risk (FRAX or local tool), check vitamin D and calcium, and consider bone density measurement. Advise weight-bearing exercise, and start a bone-protective agent where risk is high or metastatic bone disease is present, following local guidance.
- Assess fracture risk when starting ADT, including previous fractures and falls.
- Check vitamin D and calcium, and correct deficiency.
- Consider bone density measurement at baseline for men on long-term ADT.
- Discuss bone-protective therapy for high-risk men and those with bone metastases.
Why it matters
Fractures cause admissions that are partly preventable in men on long-term ADT.
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