Doctors generally do not take measures to prevent or treat osteoporosis, the loss of bone mass, in men with prostate cancer being treated with hormone therapy, even when other risk factors are present, according to new research.
Androgen deprivation therapy is associated with accelerated rates of osteoporosis and fracture, Dr. Tawee Tanvetyanon, of Loyola University Chicago Medical Center, notes in the journal Cancer. To see if doctors are properly addressing the increased risk, he reviewed the medical records of 184 patients who were treated with goserelin injections for one year or longer. Imaging scans had been ordered for 8.7 percent of the subjects in the past three years. A similar percentage of men were receiving calcium and vitamin D supplements. Less than five percent of the patients were given bisphosphonate, a drug used to treat or prevent osteoporosis, over the previous year. None of the patients were receiving estrogen or calcitonin. Other osteoporosis risk factors — such as smoking and alcohol abuse — did not affect the likelihood that patients were being checked and treated for osteoporosis. “Theoretically, these patients have higher risks of osteoporotic fracture and should be deemed a priority,” Tanvetyanon writes. The only risk factor that was associated with treatment for osteoporosis was the presence of bone metastasis. “Primary care physicians provided the greatest number of interventions and cancer-related specialists provided the fewest,” Tanvetyanon adds. He suggests that guidelines for assessing and treating osteoporosis are necessary for prostate cancer patients undergoing hormone therapy. (Source: Loyola University Chicago Medical Center, Cancer, Reuters Health, 2005)