Don't Miss Out — Rx Can Strengthen Men's Bones

Prostate cancer patients on androgen deprivation therapy with weak bones were not always prescribed bisphosphonates

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Androgen deprivation therapy (ADT) for men with prostate cancer might make their bones weak. Fortunately, a common medication can make them strong again — if patients can get a prescription.

Bisphosphonates have been shown to strengthen the bones of patients receiving ADT to treat prostate cancer. Still, some doctors were not prescribing these medications to these patients, a new study found.

The authors of this study said bisphosphonates could keep prostate cancer patients on ADT from breaking bones.

Lead study author Shabbir M.H. Alibhai, MD, of the University Heath Network in Toronto, Canada, and colleagues wrote that “although the optimal rate of bisphosphonate use in men on ADT is unknown, it is reasonable that most men with prior osteoporosis or fracture should be taking a bisphosphonate or other effective bone medication.”

Bisphosphonates (brand names Fosamax, Boniva and Actonel) are most often prescribed for osteoporosis. Osteoporosis is a bone disease that happens when a person loses too much bone, makes too little bone or both. As a result, bones become weak and may break.

Dr. Alibhai and team used data from the Institute for Clinical Evaluative Sciences and the Ontario Cancer Registry to review usage rates of bisphosphonate in ADT patients between 1995 and 2012.

A total of 35,487 men with prostate cancer were included. All patients were 66 years or older and began ADT treatment for prostate cancer during the study period.

The primary goal of ADT treatment is to reduce levels of certain male hormones in the body — through medications or surgery — to prevent them from becoming prostate cancer cells. Its negative effects may include weakened bones or bone loss and increased bone fracture risk.

Dr. Alibhai and team looked at how many bisphosphonate prescriptions doctors wrote for the study patients.

These researchers indicated that prostate cancer patients with prior osteoporosis or bone fractures faced a high risk of bone fractures. They found that 3.9 percent of patients with osteoporosis and 2.2 percent of patients with a history of bone fractures were prescribed bisphosphonates during the study.

Overall, bisphosphonate prescriptions were highest between 2007 and 2009. Patients with prior osteoporosis had the highest usage during this period — nearly 12 per 100 patients were taking bisphosphonates, Dr. Alibhai and team found.

This study was published Dec. 3 in JAMA.

Toronto General and the Toronto Western Hospital Research Foundation funded the research. Study author Dr. Angela M. Cheung received payments from Merck Inc., a major pharmaceutical company.

Review Date: 
December 2, 2014
Last Updated:
December 3, 2014