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Keri Stephens, Contributing Reporter | December 30, 2025
Men with prostate cancer face a hidden threat few anticipate: bone loss that can quietly weaken the spine and lead to fractures.
The risk is highest for those on hormone therapy, yet many never get a baseline bone density check. A new study in
Rheumatic and Musculoskeletal Disease points to a simple way to catch problems early — using the low-dose CT images already captured during routine 18F-fluorocholine (FCh) PET/CT scans.
The study looked at 81 men who had both PET/CT and standard CT scans within six months. Bone density measurements from PET/CT closely matched standard CT, and were lower in older men, those on longer hormone therapy, and those with fractures. Roughly 18 percent had vertebral fractures, and nearly half of men with low bone density had already experienced one.
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Measurements held up across different vertebrae. When one area couldn’t be assessed due to cancer or other changes, nearby vertebrae served as reliable substitutes, says lead author Astrid Dauchez, M.D., of Cochin Hospital in Paris. Results were consistent across different physicians, and repeated measurements by the same physicians were nearly identical over time.
Because PET/CT scans are already part of standard prostate cancer care, checking bone health adds no extra cost, time, or radiation, according to Dauchez and her colleagues. Detecting low bone density early could allow for preventive steps — lifestyle changes or medication — before fractures occur.
The authors call this an “opportunistic” approach; a simple, accessible way to identify men at high risk for fractures without needing dual-energy X-ray absorptiometry. They say it could raise clinician awareness of osteoporosis in prostate cancer and support early preventive treatment; though larger, prospective studies are needed to confirm clinical value, how it can be integrated into routine PET/CT interpretation, and its impact on osteoporosis management.
The study authors conclude that PET/CT scans could serve the dual purpose of tracking cancer while revealing hidden bone risks, and make osteoporosis screening a routine part of care for men with prostate cancer.
