It is a seeming axiom that androgen deprivation therapy in men with prostate cancer will accelerate bone loss. This seeming axiom arose in the early 1990s when it was shown that orchiectomy and LHRH analogs were associated with low bone density in men being treated for metastatic prostate cancer. The observation was similar to the observation of osteopenia in hypogonadal young men and in other laboratory and clinical situations. Now comes a study that suggests that the axiom may be limited.
Investigators in Japan have shown that bone density is not different in Japanese men who have had androgen deprivation. Specifically, the bone mineral densities (BMDs) of the hormone-naive and ADT-treated patients showed that had only small percentages of the patients in each group had osteoporosis and that the difference betsweeen the two groups failed to achieve statistical significance (P = 0.294). Univariate and multivariate analyses indicated that ADT was not a significant risk factor for decreased BMD.
In addition to shedding light on the effects of hormone deprivation, the study reinforces The “New” Prostate Cancer InfoLink’s frequent cautions about broad generalization. This issue came up in a recent discussion on our Social Network. In that discussion we reviewed the observation that PSA measurements can stratify long-term risk of prostate cancer. That seminal and very interesting observation by Lilja et al was made in Swedish men. Is it valid in non-Swedes? We do not know. The study showing that the relationship between hormone suppression and bone loss varies by race suggests we’d generally be very careful about generalizing across the oceans.
Filed under: Living with Prostate Cancer, Management, Treatment Tagged: | Add new tag, androgen, bone loss, cancer, deprivation, prostate
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