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Preserving bone health in patients with hormone‐sensitive prostate cancer: the role of bisphosphonates
Author(s) -
Saad Fred,
Abrahamsson PerAnders,
Miller Kurt
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2009.08952.x
Subject(s) - zoledronic acid , medicine , prostate cancer , androgen deprivation therapy , osteoporosis , bisphosphonate , bone mineral , oncology , bone density conservation agents , bone disease , cancer , bone metastasis , urology
Men with prostate cancer initiating androgen‐deprivation therapy (ADT) may have multiple factors that threaten their skeletal health, including increased fracture risk from bone loss during ADT and the propensity to develop bone metastases, which may lead to skeletal‐related events (SREs). Bisphosphonates have utility in oncology for patients with bone metastases to prevent bone loss during hormonal therapy and in the benign setting to treat osteoporosis. These agents have an emerging role in patients with hormone‐sensitive prostate cancer (HSPC). Etidronate, alendronate, pamidronate, and zoledronic acid have all shown efficacy in preventing ADT‐related bone loss. Alendronate and zoledronic acid have also been shown to increase bone mineral density vs baseline during ADT. Patients with bone metastases from HSPC who received 4 mg zoledronic acid every 3 or 4 weeks had a low incidence of skeletal complications, although controlled study data have not been reported. Bisphosphonate treatment in men with HSPC may be effective for the prevention of ADT‐related bone loss, underscoring the importance of treating early to avoid SREs and potentially delay disease progression to metastatic bone disease.