Johns Hopkins Health Alert
First Prostate Cancer, Now Osteoporosis
It seems unfair that trying to treat your prostate cancer can make you vulnerable to bone loss and fractures, but that's exactly what could happen with long-term hormone therapy. Also known as androgen deprivation therapy, or ADT, hormone therapy reduces levels of testosterone and estrogen, both of which help maintain bone density in men.
Although not all men using androgen deprivation therapy will develop osteoporosis (bone loss), an estimated 50 percent will be affected by their fourth year of treatment, and more than 80 percent will be affected after 10 years. Using androgen deprivation therapy for a year or more increases fracture risk as well. A study in The New England Journal of Medicine reported that among men with prostate cancer who lived for at least five years after their diagnosis, the risk of a fracture was nearly 20 percent among androgen deprivation therapy users, compared with 13 percent for nonusers.
As the use of long-term androgen deprivation therapy broadens to include some cancers confined to the prostate (not just those that have metastasized) even more men will be at increased risk for osteoporosis and broken bones -- problems that can cause pain and loss of mobility, reduced quality of life and even death. The good news is that medication and lifestyle measures can help increase the strength of your bones, although you'll need to undergo periodic monitoring.
When medication is required to halt bone loss in androgen deprivation therapy users with prostate cancer, bisphosphonates are the first-choice treatment. Selective estrogen receptor modulators (SERMs) offer a secondline option, and a new alternative, a monoclonal antibody called denosumab (Prolia), holds great promise.
Posted in Prostate Disorders on September 29, 2011
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Then again, one could take saw palmetto and bypass all these problems. But that is the province of alternative medicine and, even though it works, you would never risk offending the pharmaceutical industry by recommending its use.
Posted by: allmymarbles | October 1, 2011 11:43 AM