By Anita Srikameswaran
Pittsburgh Post-Gazette Men who take prostate cancer medications that suppress testosterone could experience a decade's worth of bone loss after a single year of treatment, a new study has found. Like menopausal women, the men develop osteoporosis and are at increased risk for fractures, said Dr. Susan Greenspan, director of the Osteoporosis Prevention and Treatment Center at the University of Pittsburgh Medical Center Health System. "In a sense, what this medicine does is put them into a male menopause," she said. Many of these patients are surprised to learn they have osteoporosis, she added, because they think of it as a woman's disease. David Slatery, 65, lost bone density, especially in his left wrist, when his prostate cancer was treated with Lupron and Eulexin, two drugs that suppress testosterone levels. He suspects that his wife, who takes the osteoporosis drug Fosamax, now has higher bone density than he does. Prostate cancer growth is stimulated by testosterone, so patients may be given a drug from a class called gonadotropin-releasing hormone agonists, or GnRH-a, which reduce testosterone to negligible levels. Men need testosterone, however, to maintain bone mass. For the study, bone mineral densities and other markers of bone turnover were measured in 60 prostate cancer patients, a third of whom were on the hormone therapy, and 197 healthy men. Cancer patients who weren't on the anti-testosterone therapy had bone density that was similar to the healthy group. The treated men, though, had 17 percent lower bone density than untreated patients, and other tests indicated that their bones were disintegrating twice as quickly. The study, which was conducted with researchers at Beth Israel Deaconess Medical Center, is in this month's issue of the Journal of Clinical Endocrinology and Metabolism. At one time, such therapy was prescribed solely for men in the later stages of prostate cancer when there were indications that the disease had spread beyond the gland itself. Now, however, the drugs are being used earlier, in the hopes of preventing cancer spread or slowing its progression, Greenspan said. She added that many more men are getting broken bones and being referred to centers like hers. For more information about Greenspan's osteoporosis treatment studies in prostate cancer patients, call the Osteoporosis Prevention and Treatment Center at 412-692-2220. (For news and information about Pittsburgh visit www.post-gazette.com.) (Distributed by Scripps Howard News Service, www.shns.com)
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