What is a major risk factor for pathological fractures in prostate cancer patients?

Elevated PSA levels are indeed a significant indicator in the context of prostate cancer, but they specifically reflect the presence and activity of prostate cancer rather than a direct risk factor for pathological fractures. However, PSA levels can lead to more aggressive disease or metastasis, which may ultimately contribute to fracture risk.

When considering the overall context of prostate cancer and its complications, low exercise levels often lead to decreased bone density and increased frailty, which can raise the risk of fractures. Similarly, increasing age inherently brings about a decline in bone density and strength, presenting an elevated fracture risk. Previous fractures, while they can indicate an underlying risk of future fractures due to weakened bone, are typically viewed in relation to overall bone health rather than being a fundamental risk factor associated with prostate cancer itself.

In essence, while elevated PSA levels indicate disease progression, they are not as directly linked to the risk of pathological fractures as factors like increasing age or low levels of physical activity, which are more closely associated with the general frailty and bone health decline observed in both cancer patients and older adults.