Prostate cancer patients undergoing chronic treatment with luteinizing
hormone-releasing hormone agonists should have their bone mineral density and
levels of bone metabolic markers measured periodically, Japanese researchers
Chronic treatment with luteinizing hormone-releasing hormone
agonists (LHRH-a) for prostate cancer lowers testosterone levels and reduces
bone mineral density. This increases the risk of secondary osteoporosis.
Researchers in Tokyo and Kanagawa enrolled 218 prostate cancer patients
treated for at least six months with LHRH-a. Of these, six percent suffered a
bone fracture during LHRH-a administration, on average 28 months from the start
of treatment. No patient experienced a fracture at a metastasitic site.
The authors measured bone density in the third lumbar vertebra using
quantitative computed tomography. They also measured the following metabolic
markers: osteocalcin, 1,25-(OH)2 vitamin D, urinary type 1 collagen
cross-linked N-telopeptides, parathyroid hormone and calcitonin.
density was significantly lower in patients who had a fracture than in those who
did not. Moreover, levels of urinary type 1 collagen cross-linked N-telopeptides
was higher in those who had a fracture.
The authors conclude that
patients receiving long-term LHRH-a for prostate cancer require periodic
measurement of bone mineral density and bone metabolic markers. Such patients
also need to be evaluated for secondary osteoporosis.