Androgen deprivation therapy (ADT) and bone complications are the two near universals for men with advanced prostate cancer. A long-term follow up of fifteen (15) years after diagnosis of a population-based cohort of prostate cancer survivors proved to be very informative.
The Prostate Cancer Outcomes Study, which enrolled 3533 men diagnosed with prostate cancer between 1994 and 1995, was used for this analysis. This analysis included men with non-metastatic disease at the time of diagnosis who completed 15-year follow-up surveys to report development of fracture, and use of bone-related medications. The relationship between ADT duration and bone complications was assessed.
Among 961 surviving men, 157 (16.3%) received prolonged ADT (greater than 1 year), 120 (12.5%) received short-term ADT (less than 1 year) and 684 (71.2%) did not receive ADT.
The analysis found that men receiving prolonged ADT had higher odds of fracture, bone mineral density testing and bone medication use than untreated men. Half of these men also reported bone medication use.
Men receiving short-term ADT reported rates of fracture similar to untreated men.
This analysis clearly showed that prolonged ADT use was associated with substantial risks of fracture, whereas short-term use was not associated. When considering your treatment options this information should be weighed.
Prostate Cancer Prostatic Dis. 2014 Dec;17(4):338-42. doi: 10.1038/pcan.2014.31. Epub 2014 Aug 19; K Morgans, K-H Fan, T Koyama, P C Albertsen, M Goodman, A S Hamilton, R M Hoffman, J L Stanford7, A M Stroup and D F Penson
Joel T. Nowak, M.A., M.S.W.