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CME: Prediction and management of bone complications in prostate cancer

Activity Description / Statement of Need:

In this online, self-learning activity:

Each year, over 268,000 cases of prostate cancer are diagnosed. Although early prostate cancer may be cured with surgery or radiation therapy, more than 50% of men will experience recurrence after definitive treatment. New treatment options for advanced prostate cancer have further improved survival and increased the number of patients living with castration-resistant prostate cancer (CRPC). But despite the established improvements in survival, a cornerstone of treatment, androgen deprivation therapy (ADT), has been associated with well-characterized negative effects on bone health like skeletal-related events (SREs) and bone metastases. These complications the primary drivers of morbidity and mortality among people with CRPC. Maintaining bone health in patients with CRPC requires routine monitoring and proactive management. Bone mineral density (BMD) loss places men with CRPC at elevated risk for osteoporosis and future fractures.

Target Audience:

The following healthcare professionals: Urologists, medical and radiation oncologists, primary care physicians, nuclear medicine specialists, radiologists, and endocrinologists; physician assistants, nurse practitioners, and pharmacists who treat prostate cancer; and any other healthcare professionals who commonly care for patients with prostate cancer.

Commercial Support Disclosure: This program is supported by an educational grant from Bayer.

This activity is free of charge.

Release Date: November 29, 2022 -- Expiration Date: November 29, 2024

Faculty: Jun Gong, MD


Faculty introduction, disclosures

Introduction content

  • Epidemiology
  • Defining clinical features
  • Defining disease states in prostate cancer
  • Risk factors
  • Prostate cancer and bone health
  • Androgen deprivation therapy and bone mineral density loss
  • Bone metastases: incidence, morbidity, and mortality

Imaging in prostate cancer

  • Conventional imaging
  • Recommended frequency in castration-resistant and castration-sensitive disease; Bone scan, CT, MRI; limitations of conventional imaging
  • Next-generation imaging: new and emerging options; sensitivity and specificity

Treatment options

  • Present pharmacotherapy, clinical trial findings, and guideline updates
    • SRE prevention
      • Key considerations: Efficacy, safety, effects on health-related quality-of-life, complications, and duration of therapy
      • RANKL inhibition
      • Bisphosphonates
    • Treatment of symptomatic bone metastases and prevention of their complications
      • Radioisotopes
      • Bisophosphonates
      • Other therapies: supportive, radiotherapeutic, chemotherapeutic, surgical
  • Patient cases

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Identify patients with prostate cancer who are at risk for SREs.
  • Review the role of conventional and next-generation imaging for the identification of SREs and bone metastases in patients with prostate cancer.
  • Recall when to initiate bone-targeted pharmacotherapy in patients with prostate cancer.
  • Compare the safety and efficacy of medications to prevent SREs and treat symptomatic bone metastases in patients with prostate cancer.
  • Formulate a plan to delay or prevent the development of SREs or treat symptomatic bone metastases in patients with prostate cancer.


ACCME Activity #202355865

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.


ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-22-072-H01-P. This is an Application (A)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosure of Faculty: Jun Gong, MD, Medical Oncologist, Cedarsā€Sinai Medical Center, has received financial compensation for consulting work from EMD Serono, Elsevier, Exelixis, QED Therapeutics, Natera, Basilea, HalioDx, Eisai, Janssen, Aveo, Seagen, Pfizer, and Bayer.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty will NOT discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Bayer.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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