Bone metastases are highly prevalent in patients with prostate cancer, and they commonly present a therapeutic challenge for urologists. Metastatic bone lesions can reduce the structural integrity of the skeleton, resulting in skeletal complications such as pathologic fractures and severe bone pain which adversely affect the quality of life. Palliation of bone pain due to metastases can be achieved with radiation, radioisotopes, hormonotherapy and bisphosphonates.
Androgen deprivation therapy (ADT) is one of the most important risk factor for developing skeletal complications in prostate cancer patients. It has been increasingly recognized that patients undergoing ADT for treatment of prostate cancer are at higher risk of bone loss. Progress has been made in identifying the role of therapies like bisphosphonates to prevent bone loss in these patients. Bisphosphonates have found to be safe and effective for preventing or treating the bone loss and skeletal complications secondary to ADT or bone metastases.