The latest research on bone density and prostate cancer treatment

Like women, men need their hormones to maintain the density of their bones. Men who lose androgens, male hormones, are at risk of developing osteoporosis and osteoporotic fractures. The medical goal is to prevent the loss of bone both during aging and for treatment of prostate cancer.

To that end, a group of Australian researchers followed 12 men with prostate cancer who were receiving total androgen suppressive treatment. They were also given intermittent doses of etidronate, an anti-osteoporosis medication widely studied in postmenopausal women. Before receiving the etidronate, the men experienced significant losses in bone mineral density in their spines and hips. After starting the etidronate, spinal bone density increased in the men by an average of 8%, with lesser but still significant increases in the bone density of their hips. Of course, these results must be replicated in larger groups, and more studies are needed to determine if the increase in bone density seen with etidronate therapy decreases the risk of fracture in men with prostate cancer on androgen suppression.

Researchers at the Massachusetts General Hospital studied a group of 47 men with prostate cancer who were to be treated with leuprolide, a form of androgen suppression. About half received leuprolide alone, and the other half received leuprolide and pamidronate, one of the bisphosphonates, which are drugs that increase bone density. The investigators followed the men's bone density with dual-energy x-ray absorptiometry. Those receiving leuprolide alone were noted to have a decrease in bone density of 3.3% in the spine and 2.1% in the hip. The men who received the pamidronate showed no decrease in bone mineral density in any area studied. Thus, pamidronate was shown to preserve bone density in men with prostate cancer receiving treatment with leuprolide.