> Imprima

Is there a link between hormonal therapy for prostate cancer and bone fractures?

Li Liu, MD
Ultima Vez Modificado: 1 de noviembre del 2001

Question
My father-in-law was diagnosed with prostate cancer. The doctor recommended hormonal therapy. He is very concerned of potential bone fracture as the side effect of hormonal therapy. Can you help him with this?  
Thanks.
P


Answer
Li Liu, MD, OncoLink editorial assistant, responds:

Dear P:
This is an excellent and important question.

The most common hormonal agents used in the treatment of prostate cancer are luteinizing hormone-releasing hormone (LH-RH) agonists, such as goserelin (Zoladex) and leuprolide (Lupron). LH-RH agonists are substances that closely resemble LH-RH, which controls the secretion of sex hormones. However, LH-RH agonists affect the body differently than does LH-RH. LH-RH agonists eventually cause a decrease and cessation in the secretion of sex hormones.

Older men with lower secretion of sex hormones (hypogonadism) more frequently have lower bone density (osteoporosis) than other men of similar age (Am J Med Sci 1992 Jul;304(1):4-8). This association has been used to explain the much higher frequency of osteoporotic fractures in men following orchiectomy for prostate cancer than in similar men who have not been surgically castrated (J Urol 1997 Feb; 157(2): 439-44). However, bone loss following "chemical castration" is poorly defined. One small study from France demonstrated that the use of LH-RH agonists in men induced an accelerated bone loss (J Urol 1999 Apr; 161(4): 1219-22). Some researchers suggested that bone loss induced by chemical or surgical castration in men with prostate cancer might also be influenced by host obesity, older age, and less frequent exercise habits (J Urol 2000 Jan; 163(1): 181-6).

In some men receiving castration therapy for prostate cancer, bone density analysis may be indicated to help evaluate need for interventions designed to diminish the risk of osteoporotic fractures. Unfortunately, the indications for these interventions have not been established and the most appropriated therapy has not been identified to our knowledge. As always, you should ask your father-in-law to discuss his concerns with his oncologists.

Blogs

I wish u knew... Understanding prostate cancer screening
by Timothy J. Hampshire
December 06, 2012

Is Ayurveda the Answer to Women’s Health Issues?
by The 4Wholeness Team
September 01, 2015

Related News

New imaging technique may help ID men at risk for fractures from androgen deprivation therapy

Oct 11, 2010

New imaging technique may help ID men at risk for fractures from androgen deprivation therapy


Bone mineral density test followed by selective alendronate found to improve resource use

May 20, 2010

Bone mineral density test followed by selective alendronate found to improve resource use


Bipolar Androgen Therapy May Boost Hormonal Tx in Prostate CA

Jan 9, 2015

Small study suggests alternating testosterone levels may make hormonal therapy work longer