Originally published February 13 2013
Prostate cancer treatment increases risk of fracture, death
by David Gutierrez, staff writer
(NaturalNews) Men who undergo a hormone deprivation treatment for prostate cancer are significantly more likely to suffer from fractures, and many of the men who suffer from fractures are significantly more likely to die, according a study conducted by researchers from the Cancer Institute of New Jersey, the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School and published in the journal BJU International.
The study was funded by the National Cancer Institute and the Robert Wood Johnson Foundation.
"Our findings suggest that treating men having a high baseline risk of fracture with long-term androgen deprivation therapy may have serious adverse consequences," senior author Grace Lu-Yao said.
The study focused on a prostate cancer treatment known as androgen deprivation therapy (ADT), which is often used in men who are considered poor candidates for radiation therapy or surgery. The goal of ADT is to starve the tumor of the hormones that it uses for growth, thereby slowing or halting its progression. Yet prior studies have shown that ADT appears to increase the risk of bone fractures and other skeletal problems, such as lowered bone mineral density.
The researchers analyzed medical and demographic information from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database on 75,994 men over the age of 65 who had been diagnosed with localized prostate cancer between 1992 and 2007. Based on the presence or absence of certain medical conditions (including diabetes, liver disease, paralysis, and alcohol and cigarette use) within one year before cancer diagnosis, the researchers rated the men for risk of skeletal complications such as fracture.
No data was available as to which patients were taking bisphosphonates, which can slow the bone loss associated with ADT. No information on height and weight (which can be related to risk factors) was available, either.
40 percent higher death rateDuring the 12 years following ADT, more than 58 percent of the men classified as high risk developed a fracture, in contrast with only 38 percent of the men classified as low risk. The researchers also found that men at high risk were actually more likely to be assigned to ADT than men at low risk, and that men who received ADT alone typically received a higher dose of hormone-suppressing drugs than men who received ADT in combination with other therapies.
Among men who received a fracture, the risk of death for the following two years was 40 percent higher than for comparable men in the fracture-free group.
The findings will likely add to the ongoing debate over prostate cancer screening and treatment. Growing numbers of health professionals are calling for fewer men to undergo treatment for prostate cancer, since the vast majority of cases consist of slow-growing cancers in older men who will likely die of other causes without ever developing symptoms. For example, a 2010 study published in the Journal of the National Cancer Institute concluded that even without treatment, 97 percent of men diagnosed with early-stage prostate cancer would not die from the disease.
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