Osteoporosis management in prostate cancer patients treated with androgen deprivation therapy

doi:10.1007/s11606-007-0291-4

Comparative Study

. 2007 Sep;22(9):1305-10.

doi: 10.1007/s11606-007-0291-4. Epub 2007 Jul 17.

Osteoporosis management in prostate cancer patients treated with androgen deprivation therapy

Ellen F T Yee¹, Robert E White, Glen H Murata, Christine Handanos, Richard M Hoffman

Affiliations

PMID: 17634780
PMCID: PMC2219777
DOI: 10.1007/s11606-007-0291-4

Comparative Study

Osteoporosis management in prostate cancer patients treated with androgen deprivation therapy

Ellen F T Yee et al. J Gen Intern Med. 2007 Sep.

. 2007 Sep;22(9):1305-10.

doi: 10.1007/s11606-007-0291-4. Epub 2007 Jul 17.

Authors

Ellen F T Yee¹, Robert E White, Glen H Murata, Christine Handanos, Richard M Hoffman

Affiliation

¹ Department of Medicine, New Mexico Veterans Affairs Health Care System, Albuquerque, NM, USA. eyee@unm.edu

PMID: 17634780
PMCID: PMC2219777
DOI: 10.1007/s11606-007-0291-4

Abstract

Background: The use of androgen deprivation therapy (ADT) for prostate cancer has increased substantially in recent years, exposing more men to potential treatment complications, including osteoporosis and fractures.

Objective: To determine whether men treated with ADT for prostate cancer received osteoporosis screening, prevention, or treatment.

Design: Cross-sectional observational study using a retrospective review of electronic medical records.

Subjects: One hundred seventy-four patients with prostate cancer on ADT or status-post orchiectomy enrolled in primary care at the New Mexico Veterans Affairs Health Care System as of July 2005.

Measurements: Patient demographics, tumor characteristics (Gleason score, stage, last PSA value, documented bone metastases), history of hip or vertebral fracture, osteoporosis risk factors (number of ADT shots, diabetes, smoking, heavy alcohol use or prescriptions for corticosteroids, thyroid hormone or dilantin). We defined recommended management as performing DXA scans or prescribing bisphosphonates, calcitonin, calcium or vitamin D.

Results: Just 60 of 174 (34%) patients received recommended osteoporosis management based on DXA scans (13%) or treatment with oral or IV bisphosphonates (21%), calcitonin (1%), calcium (16%) or vitamin D (10%). On multivariate analysis, bone metastases, higher last PSA, and younger age at diagnosis were associated with recommended management, whereas Hispanic race/ethnicity was inversely associated.

Conclusions: Most men treated with ADT for prostate cancer did not receive osteoporosis screening, prevention or treatment. Evidence for advanced cancer though not risk factors for osteoporosis or fracture-was associated with receiving osteoporosis management. Further research is needed to identify optimal strategies for screening, prevention, and treatment in this population.

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References

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[2] {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '16514137', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/16514137/'}]}

[3] Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin. 2006; 56:106–30. - PubMed

[4] {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1001/jama.294.2.238', 'is_inner': False, 'url': 'https://doi.org/10.1001/jama.294.2.238'}, {'type': 'PubMed', 'value': '16014598', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/16014598/'}]}

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[5] {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1001/jama.294.2.238', 'is_inner': False, 'url': 'https://doi.org/10.1001/jama.294.2.238'}, {'type': 'PubMed', 'value': '16014598', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/16014598/'}]}

[6] Sharifi N, Gulley JL, Dahut WL. Androgen deprivation therapy for prostate cancer. JAMA. 2005;294:238–44. - PubMed

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Cooperberg MR, Lubeck DP, Meng MV, Mehta SS, Carroll PR. The changing face of low-risk prostate cancer: trends in clinical presentation and primary management. J Clin Oncol. 2004;22:2141–9. - PMC - PubMed

[8] {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1200/JCO.2004.10.062', 'is_inner': False, 'url': 'https://doi.org/10.1200/jco.2004.10.062'}, {'type': 'PMC', 'value': 'PMC2997214', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC2997214/'}, {'type': 'PubMed', 'value': '15169800', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15169800/'}]}

[9] Cooperberg MR, Lubeck DP, Meng MV, Mehta SS, Carroll PR. The changing face of low-risk prostate cancer: trends in clinical presentation and primary management. J Clin Oncol. 2004;22:2141–9. - PMC - PubMed

[10] {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S0090-4295(02)01560-1', 'is_inner': False, 'url': 'https://doi.org/10.1016/s0090-4295(02)01560-1'}, {'type': 'PubMed', 'value': '12231037', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12231037/'}]}

Meng MV, Grossfeld GD, Sadetsky N, Mehta SS, Lubeck DP, Carroll PR. Contemporary patterns of androgen deprivation therapy use for newly diagnosed prostate cancer. Urology. 2002;60(Suppl 3A):7–12. - PubMed

[11] {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S0090-4295(02)01560-1', 'is_inner': False, 'url': 'https://doi.org/10.1016/s0090-4295(02)01560-1'}, {'type': 'PubMed', 'value': '12231037', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12231037/'}]}

[12] Meng MV, Grossfeld GD, Sadetsky N, Mehta SS, Lubeck DP, Carroll PR. Contemporary patterns of androgen deprivation therapy use for newly diagnosed prostate cancer. Urology. 2002;60(Suppl 3A):7–12. - PubMed

[13] {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S0022-5347(05)64985-3', 'is_inner': False, 'url': 'https://doi.org/10.1016/s0022-5347(05)64985-3'}, {'type': 'PubMed', 'value': '11992038', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/11992038/'}]}

Berruti A, Dogliotti L, Terrone C, et al. Changes in bone mineral density, lean body mass and fat content as measured by dual energy x-ray absorptiometry in patients with prostate cancer without apparent bone metastases given androgen deprivation therapy. J Urol. 2002;167:2361–7. - PubMed

[14] {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S0022-5347(05)64985-3', 'is_inner': False, 'url': 'https://doi.org/10.1016/s0022-5347(05)64985-3'}, {'type': 'PubMed', 'value': '11992038', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/11992038/'}]}

[15] Berruti A, Dogliotti L, Terrone C, et al. Changes in bone mineral density, lean body mass and fat content as measured by dual energy x-ray absorptiometry in patients with prostate cancer without apparent bone metastases given androgen deprivation therapy. J Urol. 2002;167:2361–7. - PubMed

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Osteoporosis management in prostate cancer patients treated with androgen deprivation therapy

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Osteoporosis management in prostate cancer patients treated with androgen deprivation therapy

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