A large study provides more evidence that androgen deprivation therapy (ADT)—an important treatment for men with or at risk for metastatic prostate cancer— weakens bones. It also identifies the types of fractures most likely to occur.
Researchers analyzed medical records for nearly 180,000 men (average age, 79). Of that group, 6,954 had prostate cancer and were treated with ADT; another 13,128 had prostate cancer, but had not received ADT. Over the following years, the men suffered 10,916 bone fractures.
Compared to cancer-free men, ADT users were 40 percent more likely to experience any fracture. Also, ADT-treated prostate cancer patients, in comparison to their non-ADT-treated counterparts, were 38 percent more likely to experience a hip fracture. The risk of a major fracture in the spine or upper or lower arm was also higher in ADT-treated versus non-ADT-treated prostate cancer patients and men who were cancer free. The findings were reported last year in Osteoporosis International.
No bone fracture is good news, but hip fractures often trigger a cascade of adverse health-related problems that can increase the risk of death. Men on ADT should undergo screening to assess bone density. To build bone strength, weight-bearing exercise is recommended along with 1,000 to 1,200 mg of calcium and 800 to 1,000 IUs of vitamin D each day. Treatment with medications that can increase bone density is also recommended for men with osteoporosis who are at an increased risk of fractures due to ADT.