Treatment-induced bone loss

It starts within the first year of androgen deprivation and increases the longer treatment goes on. In 50,613 men, 19.4 percent of those on androgen deprivation who survived at least five years had a fracture against 12.6 percent of those not on it. NICE NG131 says not to offer bisphosphonates routinely to prevent it, to consider assessing fracture risk, to offer bisphosphonates to men who already have osteoporosis, and to consider denosumab where bisphosphonates are not suitable. A DEXA scan measures it.