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Bone Health and Prostate Cancer: How Prostate Cancer Treatment Impact Skeletal Health?

03 Oct
By Dr. Anup Ramani

Prostate cancer is one of the most commonly diagnosed cancers in men worldwide and its treatment often involves a multi-pronged approach, which may include surgery, radiation, chemotherapy and hormone therapy. One of the most advanced and Minimal invasive methods of treating prostate cancer is robotic prostate cancer surgery. While this technique offers numerous benefits, it is crucial to understand how prostate cancer treatments, impact the body, particularly bone health. Bone health plays a vital role in the overall well-being of patients and the impact of cancer treatment on skeletal health cannot be understated.

In this article, we will explore how prostate cancer treatment, particularly prostate cancer robotic surgery, affects bone health. We will delve into the mechanisms that may lead to bone density loss, the role of hormone therapy and the recovery process for patients undergoing prostate cancer treatments. Understanding these elements can help develop comprehensive care strategies that support bone health and improve recovery outcomes for patients.

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How Does Prostate Cancer Treatment Impact Bone Health?

Prostate cancer treatments, especially surgical interventions and hormone therapies, can lead to changes in bone metabolism. Several factors associated with prostate cancer treatments can disrupt this delicate balance.

Hormone Therapy and Bone Health

Hormone therapy, commonly used in prostate cancer treatment, reduces the levels of testosterone, which can lead to a decrease in bone density. Testosterone plays a critical role in maintaining bone strength and density in men. When testosterone levels drop due to hormone therapy, patients may experience an accelerated rate of bone loss, increasing the risk of osteoporosis and fractures.

Surgical Treatment and Bone Health

While robotic prostate cancer surgery offers Minimal invasive benefits, the underlying changes in the body’s hormonal balance post-surgery can affect bone health. After prostatectomy, which is the surgical removal of the prostate gland, testosterone levels may be reduced, leading to similar effects on bone density. The combined impact of surgery and subsequent hormone therapy can make bones more fragile and less able to recover from any subsequent injury or stress.

Bone Density Prostate Cancer

What are the Effects of Robotic Prostate Cancer Surgery on Skeletal Health?

Robotic prostate cancer surgery, a Minimal invasive technique, uses robotic assistance to remove the prostate gland with greater precision and fewer incisions than traditional open surgery. While it is associated with faster recovery times, reduced blood loss and shorter hospital stays, it is important to understand the potential long-term effects on bone health.

Post-Surgery Hormonal Changes

Following robotic prostate cancer surgery, some patients may experience a decrease in testosterone production, particularly if the surgery includes the removal of lymph nodes or adjacent tissues. As discussed earlier, reduced testosterone levels can directly contribute to a decline in bone density. This may lead to osteoporosis over time, increasing the risk of fractures and bone pain.

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Musculoskeletal Dysfunction and Physical Activity

Prostate cancer surgery can also result in musculoskeletal dysfunction, which may limit a patient’s ability to engage in physical activity. Regular weight-bearing exercises are essential for maintaining bone density and post-surgery recovery programs that include rehabilitative exercises can help mitigate bone loss. However, if recovery is delayed or hindered, patients may face a higher risk of skeletal complications.

When Should Bone Health Be Monitored in Prostate Cancer Patients?

For patients undergoing prostate cancer treatment, especially those undergoing prostate cancer robotic surgery, proactive monitoring of bone health is essential. Early intervention can prevent complications related to bone loss and improve the long-term quality of life for patients.

Pre-Treatment Baseline Assessment

Before starting prostate cancer treatment, patients should undergo baseline testing for bone health, particularly if they are at risk for osteoporosis or have a history of bone disease. This assessment can include bone density tests, to establish a baseline for future comparisons.

Post-Treatment Monitoring

Bone health should be closely monitored during and after prostate cancer treatment, particularly if hormone therapy is part of the treatment regimen. Bone density tests may be recommended at regular intervals, typically every one to two years, depending on the patient’s risk factors and the intensity of the treatment.

Signs and Symptoms of Bone Problems

Patients should be educated on recognizing the signs of bone issues, such as unexplained bone pain, fractures or limited mobility. Early recognition of these symptoms can help in initiating treatments like calcium and vitamin D supplementation, bisphosphonates or other medications to support bone health.

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Conclusion

Understanding the impact of prostate cancer treatments, particularly robotic prostate cancer surgery, on bone health is essential for improving patient outcomes and ensuring long-term recovery. The combination of hormone therapy, surgical interventions and post-treatment rehabilitation can all affect skeletal health, making it crucial for patients to actively manage their bone health throughout their cancer journey.

By taking a proactive approach to monitoring bone density, engaging in physical rehabilitation and utilizing appropriate medications, patients can minimize the negative effects of prostate cancer surgery on their skeletal health.

FAQs About Prostate Cancer Treatment

Hormone therapy for prostate cancer reduces testosterone levels, which can lead to bone density loss. This increases the risk of osteoporosis and fractures. Monitoring and management of bone health are important during and after hormone therapy.

Yes, robotic prostate cancer surgery can impact bone density, particularly if it is followed by hormone therapy. The decrease in testosterone levels can lead to bone thinning and increase the risk of fractures.

Prostate cancer patients can maintain bone health through regular physical activity, including weight-bearing exercises, taking calcium and vitamin D supplements and monitoring bone density with their healthcare provider.

Bone health should be monitored before treatment as a baseline and regularly throughout the treatment process. Follow-up assessments may be conducted annually or as recommended by the healthcare team, especially if hormone therapy is involved.

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Dr. Anup Ramani is one of the best Uro oncologist, Surgeon in Mumbai, India providing Robotic Surgery and Treatment for Prostate Cancer, Kidney Tumor Surgery/Stone Removal, Urinary Bladder Cancer and Adrenal Gland Treatment, Enlarged Prostate Surgery and treatment, Penis Cancer/Partial Penectomy/Robotic Pyeloplasty Surgery and Treatment.

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PARTIAL PENECTOMY
  • Partial penectomy is done in cases where glans and distal penis is involved with carcinoma. 
  • Partial penectomy is a type of organ-preserving surgery. Preservation of sexual and micturational function depends on the surgical dissection and reconstruction of residual urethra.
Kidney Stone Removal
  • Patients who develop stones in the kidney or ureter, often experience severe pain.
  • This condition usually needs a procedure to remove the kidney stones.
  • This procedure is called ureteroscopy and is performed very commonly.
  • It does not require any cuts and hence it is painless.
  • The procedure is performed with an endoscope inserted through the penis under spinal anesthesia.
  • The scope is inserted through the penis into the kidney and stones are dissolved with a laser.
  • The procedure takes about 40-50 minutes. 
  • A catheter (urine pipe) is kept after the procedure to drain the bladder. A stent is kept in the kidney at the same time.
  • Patient is mobile and walking in the room the same evening.
  • Hospital stay is one night and patient is discharged the next day after removal of the catheter.
  • Patient has to come back after six weeks to remove the stent in the kidney.
  • Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
  • We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
  • Men with an enlarged prostate, which is a normal ageing changes, often experiencing difficulty passing urine. This condition usually needs a procedure to trim the prostate and relieve the blockage.
  • This procedure is called TURP and is performed very commonly.
  • It does not require any cuts and hence it is painless.
  • The procedure is performed with an endoscope inserted through the penis under spinal anaesthesia.
  • The overgrown prostate is dissolved with a laser bloodlessly.
  • The procedure takes about 40 minutes.
  • A catheter (urine pipe) is kept after the procedure to drain the bladder.
  • Patient is mobile and walking in the room the same evening.
  • Hospital stay is two nights and patient is discharged with the catheter, which is removed after 4 days.
  • Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
  • We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
ROBOTIC ADRENALECTOMY FOR ADRENAL GLAND TUMOUR

  • Robotic adrenalectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.

  • Once the anesthesia is done, and patient positioned, three micro cuts (3mm each) are made in the patient’s abdomen.

  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).

  • Dr. Ramani then sits in the controlling console to perform the surgery.

  • On an average, a robotic adrenalectomy takes one hour.

  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.

  • A urine catheter and bag to drain the bladder is inserted during surgery.

  • A tiny drain pipe may be inserted in the surgical side of the abdomen, connected to a bag.

  • Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.

  • The drain pipe, if kept, is removed in the room on day 2 after surgery.

  • The catheter is removed on day two after surgery.

  • Total hospital stay for robotic adrenalectomy is 4 nights (including night before surgery).

  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.

RETURN TO ACTIVITY

  • On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. Almost all patients are back to work within 2 weeks of surgery.

  • Heavy activities like running, weight lifting can be resumed after a month

FOLLOW UP AFTER SURGERY

  • Follow up after an adrenalectomy is in the form of CT scans, once a year for 5 years.
    Local patients usually meet Dr. Ramani after two weeks to discuss report.

  • Outstation patients are counselled on a phone consultation.

ROBOTIC SURGERY FOR BLADDER CANCER
  • Dr. Ramani is one of the very few surgeons in India who has the expertise to perform a robotic surgery for bladder cancer, which includes removing the urinary bladder and reconstructing a new bladder robotically.
  • Robotic radical cystectomy is an extremely sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
  • Once the anaesthesia is done, and patient positioned, six micro cuts (3mm each) are made in the patient’s abdomen.
  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
  • Dr. Ramani then sits in the controlling console to perform the surgery.
  • On an average, a robotic radical cystectomy with an ileal conduit takes 3-4 hours.
  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
  • A urine catheter and bag to drain the new bladder is inserted during surgery.
  • Two tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
  • Patient is kept nil-by-mouth for 4 days after surgery with IV supplementation of patient’s daily requirements of calories, fats, carbohydrates, proteins and electrolytes.
  • The drain pipes are removed in the room on day 3-5 after surgery.
  • Total hospital stay for radical cystectomy is 8 nights (including night before surgery).
  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
  • On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
  • Almost all patients are back to work within 6 weeks of surgery. Heavy activities like running, weight lifting can be resumed after two months.
FOLLOW UP AFTER SURGERY

  • Follow up after a radical a cystectomy is in the form of CT scans, once a year for 5 years.

  • Histopathology report: Local patients usually meet Dr. Ramani after two weeks to discuss report.

  • Outstation patients are counselled on a phone consult. Depending on the report, patient may or may not need chemotherapy after surgery.

  • If chemo is needed, patients may choose to get it done with a medical oncologist of their choice or avail the services of one of the four medical oncologists on our team.

ROBOTIC RADICAL/PARTIAL NEPHRECTOMY FOR KIDNEY CANCER
  • Robotic partial nephrectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications. Robotic radical (total) nephrectomy is
  • relatively easier but still requires significant experience to consistently deliver results.
  • Once the anaesthesia is done, and patient positioned, five micro cuts (3mm each) are made in the patient’s abdomen.
  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
  • Dr. Ramani then sits in the controlling console to perform the surgery.
  • On an average, a robotic radical nephrectomy takes one hour and a robotic partial nephrectomy takes about an hour and half.
  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
  • A urine catheter and bag to drain the bladder is inserted during surgery.
  • A tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
  • Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
  • The drain pipe is removed in the room on day 3 after surgery. The catheter is removed on day two after surgery.
  • Total hospital stay for radical/partial nephrectomy is 4 nights (including night before surgery).
  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
  • On the day of discharge, patient is totally self- sufficient. 
  • They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. 
  • Almost all patients are back to work within 2-3 weeks of surgery.
  • Heavy activities like running, weight lifting can be resumed after a month.
FOLLOW UP AFTER SURGERY
  • Follow up after a radical/partial Nephrectomy is in the form of CT scans, once a year for 5 years.
  • Local patients usually meet Dr. Ramani after two weeks to discuss report. 
  • Outstation patients are counselled on a phone consultation.