Prostate cancer treatment linked to bone loss in men


When people talk about bone loss, they usually refer to older women facing osteoporosis. However, a new study, published in the June issue of the Journal of Clinical Endocrinology & Metabolism, focuses on the same problem in men.

The study pointed out that men who suffer from prostate cancer, the most common visceral malignancy in men, may be at a greater risk for bone loss and that gonadotropin-releasing hormone agonists (GnRH-a) — a common medical treatment for the disease — may actually lead to a higher risk of bone fracture.

The study was conducted by researchers at Beth Israel Deaconess Medical Center and the University of Pittsburgh. "Prostate tumors are testosterone dependent and as a result, doctors commonly treat prostate cancer patients with hormones that deprive the body of testosterone," said Dr. Aubrey Stoch, an endocrinologist and researcher currently at Merck Research Laboratories who served as the lead investigator on the study.

"We already know that testosterone, a form of androgen, is essential for the maintenance of bone mass in men, but our study has determined that androgen deprivation therapies, such as gonadotropin-releasing hormones, put prostate cancer patients at risk for decreases in bone mass and increases in bone turnover, which can result in an increased risk of fracture."

Researchers compared the bone mineral density (BMD), biochemical markers of bone turnover and body composition in 60 men over the age of 60 years who suffer from prostate cancer. The subjects were required to have taken GnRH-a for at least six months. In addition, subjects were excluded if they had any disease or were taking any drugs that would impact their bone mineral metabolism.

The study showed that men who took GnRH-a to treat prostate cancer experienced significantly lower BMD in the spine, hip, forearm and total body. The men treated with GnRH-a also showed signs of elevated bone resorption. Finally, researchers found that the men receiving GnRH-a had a higher percent total body fat and lower percent lean body weight.

"Prostate cancer is one of the most common cancers in men," said Dr. Stoch. "Hopefully, our study will help doctors and patients better understand some of the other risks associated with the disease and its treatments."

SOURCES: Journal of Clinical Endocrinology & Metabolism, June 2001.

"Prostate Cancer Treatment May Cause Bone Loss in Men," The Endocrine Society, June 4, 2001.

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