Osteoarthritis (OA) is something that I have been battling for over 20 years. It reached a point where, in 2006, my left hip was so sore that the pain was unbearable. I had the hip replaced and what a difference it made. Night and day—I was able to resume skiing and biking within the year. In 2023, my other hip reached the same state of pain and wear and tear. It was a no-brainer to have it, too, replaced. Why is this important regarding my stage IV prostate cancer, you ask?
I recently started my second round of Androgen Deprivation Therapy (ADT). This round may last for a year or more. During my research on the side effects of ADT, I found that the risk of osteoporosis (OP) and osteoporotic fractures occur in 20% of men by five years after starting ADT. Having already a history of OA, I was worried that this would put me further at risk. Given my lifestyle and activities, suffering a osteoporotic fracture was not going to be a good thing.
After much research, I realized that there is no direct connection between OA and an increased risk of OP. OA and OP are different conditions. OA affects joint cartilage and bone, causing pain and stiffness, primarily due to wear and tear. OP is characterized by weakened bones and an increased risk of fractures. While they often coexist, one does not directly cause the other. This was some good news, at least for me, that even before the ADT I would not be predisposed to having OP.
However, ADT can significantly impact bone density, increasing the risk of osteoporosis due to reduced testosterone levels, which are vital for bone health. Had I not been able to resume my activities and opportunities for weight-bearing exercise, which is beneficial for maintaining bone density, then there could have been a greater concern.
Fortunately, my active lifestyle and ongoing management of OA through hip replacements and physical activities provide a buffer against the potential bone density loss from ADT. To mitigate risks, I will continue to focus on weight-bearing exercises, calcium and vitamin D intake, and regular bone density monitoring.
In conclusion, while ADT does increase the risk of osteoporosis, understanding the differences between OA and OP, along with my proactive approach to managing my health, gives me confidence in minimizing potential issues. It’s all about staying informed and taking the right steps to maintain overall well-being.
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