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According to results recently published in the New England Journal of Medicine, treatment with androgen deprivation therapy increases the risk of bone fractures in men diagnosed with prostate cancer.

Prostate cancer is the second leading cause of cancer deaths among men in the United States. The prostate is a walnut-sized gland that is located between the bladder and the rectum. It is responsible for the formation of components of semen. Prostate cancer cells are thought to be stimulated to replicate excessively by male hormones, particularly testosterone. Therefore, a standard therapeutic approach, particularly in men with advanced stages of prostate cancer, is referred to as hormone therapy or androgen deprivation therapy, in which the levels of testosterone available to cancer cells are drastically reduced. Prior clinical studies have indicated a trend towards loss of bone density and potential increases in the risk of bone fractures in men treated with androgen deprivation therapy. Researchers continue to evaluate data to further understand the association between bone fractures and treatment with androgen deprivation therapy.

Researches from the University of Texas at Galveston recently analyzed data of over 50,000 men with prostate cancer in order to improve understanding of the risk that androgen deprivation therapy might post on incidence of bone fractures. The study included men who were diagnosed with prostate cancer between1992-1997. Overall, men who were treated with androgen deprivation therapy had a rate of bone fractures of nearly 20%, whereas those not treated with androgen deprivation therapy had a rate of approximately 13%. Higher doses of androgen deprivation therapy, as well as increased age, also increased the risk of bone fractures. The rate of hospitalization due to bone fractures was 5.2% for patients treated with androgen deprivation therapy and only 2.4% for those not treated with androgen deprivation therapy.

The researchers concluded that androgen deprivation therapy for the treatment of prostate cancer increases a patient’s risk of developing bone fractures. Patients undergoing androgen deprivation therapy may wish to speak with their physician about possible ways in which to reduce their risk of a bone fracture, or how to recognize early symptoms indicative of a possible bone fracture.

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Reference: Shahinian VB, Kuo Y-F, Freeman JL, et al. Risk of Fracture after Androgen Deprivation for Prostate Cancer. New England Journal of Medicine. 2005;352:154-164.

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