Prostate Therapy May Be Bad to the Bone

Prostate cancer patients may have a higher risk of bone fracture if receiving hormone treatment

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Some prostate cancer patients who are unable to have surgery or radiation treatment may turn to hormone therapy for treatment. However, hormone therapy may increase the chance of bone fracture.

New research has found that those who already had a strong likelihood of bone damage before they started hormone therapy had an even greater risk of fracture.

"Ask your doctor when to start prostate cancer screening."

Grace Lu-Yao, PhD, MPH, cancer epidemiologist at The Cancer Institute of New Jersey and professor of medicine at Robert Wood Johnson Medical School and of epidemiology at UMDNJ-School of Public Health in New Brunswick, served as senior author on the study.

Dr. Lu-Yao and her team reviewed data on 75,994 men aged 66 and older who were diagnosed as having localized prostate cancer from 1992 to 2007.

Cancer Treatment Centers of America defines localized cancer as cancer that is confined to the site of the primary (original) tumor, and has not spread to any surrounding tissue or organs. This is opposed to advanced cancer that has spread to other parts of the body.

Investigators referred to patient information from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database.

Researchers looked for the presence of certain conditions during the year prior to the patient’s cancer diagnosis. These conditions included diabetes, alcohol and cigarette use, paralysis and liver disease.

These conditions are indicators of possible “skeletal complications.” Based on the presence of these factors, researchers could establish which patients were at higher risk of fracture and which were at lower risk.

Dr. Lu-Yao and her colleagues discovered that more than 58 percent of men who were identified as having high fracture risks prior to treatment went on to suffer at least one broken bone during a 12-year follow up. About 38 percent of those with low fracture risk had at least one fracture in that same time period.

About 52 percent of the men at higher risk had received hormone treatment called long-term androgen deprivation therapy (ADT). Of those at low risk of fracture, 38 percent received ADT.

ADT reduces levels of male hormones (called androgens) or it prevents the hormones from reaching prostate cancer cells. According to the American Cancer Society, ADT often makes prostate tumors shrink or grow more slowly for a time.

Previous studies have already shown a link between ADT and an increased risk of bone fracture and other skeletal complications, such as a decrease in bone mineral density.

The authors reported that the risk of death was found to be 40 percent higher within two years after experiencing a fracture.

“Our findings suggest that treating men having a high risk of fracture with long-term ADT may have serious adverse consequences,” said Dr. Lu-Yao. “We anticipate the results of this study will prompt further examination of a patient’s baseline risk of fracture and skeletal complications prior to administering this course of therapy.”

The study was published online in January in BJU International, the journal of the British Association of Urological Surgeons. The research was supported by grants from the National Cancer Institute and the Robert Wood Johnson Foundation.

Reviewed by: 
Review Date: 
January 22, 2013
Last Updated:
January 24, 2013