Long-Term Hormone Therapy Increases Risk of Bone Fractures in Prostate Cancer

Long-Term Hormone Therapy Increases Risk of Bone Fractures in Prostate Cancer

According to results presented at the 2004 annual meeting of the American Society of Clinical Oncology (ASCO), hormone therapy, also referred to as androgen deprivation therapy, increases the risk of bone fractures in men with prostate cancer that has not spread to distant sites in the body.

Prostate cancer is the most commonly diagnosed cancer in men in the United States. The prostate is a walnut-sized gland that is located between the bladder and rectum and is responsible for the formation of components of semen. Patients with prostate cancer often have several treatment options from which to choose, including surgery, radiation therapy, chemotherapy and/or hormone therapy.

Hormone therapy is a type of therapy that reduces the amount of testosterone or other male hormones available to cancer cells. These male hormones are responsible for a growth stimulus in prostate cancer and their reduction through therapy prevents cancer cells from growing. Hormone therapy is typically used in patients with more advanced prostate cancer; however, some men are treated with hormone therapy in the earlier stages of their disease. Unfortunately, one side effect of hormone therapy is an increased risk of developing osteoporosis (decrease in bone density) and increased bone loss.

Recently, researchers reviewed data from over 10,000 patients diagnosed with prostate cancer that had not spread to distant sites in the body, some of whom were treated with hormone therapy and others who were not treated with hormone therapy. The patients in the group that was treated with hormone therapy had started their hormone treatment, consisting of a gonadotropin-releasing hormone (GnRH) agonist, between 1992 and 1994. Patients treated with hormone therapy had a significantly increased risk of developing both hip or thigh fractures, as well as spinal fractures, particularly if they were receiving treatment for one year or longer. Overall, patients were at an approximate 16% increase of a fracture if they were treated for one year or longer with hormone therapy compared to patients who were not treated with hormone therapy.

The researchers concluded that patients with prostate cancer who are receiving hormone therapy, particularly if therapy has been administered for one year or longer, are at an increased risk of developing bone fractures and should undergo preventive measures against fractures. Patients with prostate cancer who are receiving treatment with hormone therapy should speak with their physician about their individual risks and benefits of bone fracture, as well as possible preventive interventions.

Reference: Smith M, Lee W, Krupski T,et al. Association between androgen deprivation-therapy and fracture risk: a population-based cohort study in men with non-metastatic prostate cancer. Proceedings from the 40th annual meeting of the American Society of Clinical Oncology. 2004; 23: Abstract #4507.

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