13 December 2004
Prostate Cancer Treatment Linked To Osteoporosis
by George Atkinson

Researchers have warned that men being treated for prostate cancer using androgen deprivation therapy may be under-recognized for their risk of developing osteoporosis. The study, appearing in the journal CANCER, says few patients get tested for osteoporosis during treatment. And men with other risk factors for osteoporosis, such as smoking or receiving the hormone treatment for a long time, are still unlikely to receive prevention or treatment.

Osteoporosis is a disease characterized by brittle, easily fractured bones and is caused by disruption of the hormone-regulated bone remodeling system. Risk factors for male osteoporosis include age-associated hormone changes, alcoholism, smoking and those medications used in the treatment of prostate cancer. Osteoporosis can be prevented and treated using a wide range of therapies but there is no established national consensus guiding doctors of when and what to prescribe. To discover how clinicians were managing osteoporosis risk and identify factors that might predict who gets treated, Tawee Tanvetyanon from Loyola University Chicago Stritch School of Medicine, reviewed the records of prostate cancer patients who received androgen deprivation therapy, which is known to raise the risk of osteoporosis.

Tanvetyanon found that the majority of patients undergoing androgen deprivation therapy did not receive osteoporosis prevention or treatment, even when they reported other risk factors such as smoking. Only about one in seven eligible patients received any sort of osteoporosis management. Only one in twenty was prescribed a remedial bisphosphonate treatment. The only factor that predicted clinical management of osteoporosis risk and disease was the presence of prostate cancers that had spread to the bones. The study also showed that primary care physicians were the most vigilant at managing osteoporosis while cancer specialists were the least.

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