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Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
Preventing Bone Loss in Men with Prostate Cancer
20 March 2007 | Volume 146 Issue 6 | Page I-72
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
The summary below is from the full report titled "Effect of Once-Weekly Oral Alendronate on Bone Loss in Men Receiving Androgen Deprivation Therapy for Prostate Cancer. A Randomized Trial." It is in the 20 March 2007 issue of Annals of Internal Medicine (volume 146, pages 416-424). The authors are S.L. Greenspan, J.B. Nelson, D.L. Trump, and N.M. Resnick.
What is the problem and what is known about it so far?
Prostate cancer is often treated with surgery or drugs to lower levels of testosterone and similar hormones called androgens. These hormones stimulate cancer cells to grow, so lowering their levels usually slows or stops the growth of cancer. However, these hormones also maintain the density and strength of men's bones, so lowering their levels also leads to weaker bones and more fractures. Drugs used to treat osteoporosis prevent weak bones and fractures, and therefore, they might be useful in preventing weak bones and fractures in men with prostate cancer who receive hormone-lowering treatment.
Why did the researchers do this particular study?
To see whether alendronate, a drug used to treat osteoporosis, slows the weakening of bones in men with prostate cancer who receive hormone-lowering treatment.
Who was studied?
112 men with prostate cancer who underwent surgery or were given drugs to lower their hormone levels.
How was the study done?
The researchers measured the bone density of the men at the beginning of the study. They then randomly assigned each to receive alendronate or placebo once weekly for 1 year. After a year, they measured the men's bone density and compared changes between the 2 groups. They also measured and compared blood markers of bone stability in the 2 groups.
What did the researchers find?
Bone density increased in men who received alendronate. It decreased in men who received placebo. Blood tests showed that bones became more stable in men who received alendronate compared with those who received placebo.
What were the limitations of the study?
It was not designed to show whether alendronate reduces fractures.
What are the implications of the study?
Alendronate stabilized and strengthened the bones of men with prostate cancer who were receiving hormone-lowering treatment. Men with prostate cancer taking hormone-lowering treatments should probably have their bone density measured. They can use the information to decide with their doctors whether they should take a drug used to treat osteoporosis to prevent bone loss.
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  M. Aapro, P. A. Abrahamsson, J. J. Body, R. E. Coleman, R. Colomer, L. Costa, L. Crino, L. Dirix, M. Gnant, J. Gralow, et al. Guidance on the use of bisphosphonates in solid tumours: recommendations of an international expert panel Ann. Onc., March 1, 2008; 19(3): 420 - 432. [Abstract] [Full Text] [PDF]
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 A. M. Brufsky Cancer Treatment-Induced Bone Loss: Pathophysiology and Clinical Perspectives Oncologist, February 1, 2008; 13(2): 187 - 195. [Abstract] [Full Text] [PDF]
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 S. L. Greenspan Approach to the Prostate Cancer Patient with Bone Disease J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 2 - 7. [Abstract] [Full Text] [PDF]
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 Other articles noted Evid. Based Med., August 1, 2007; 12(4): 127 - 128. [Full Text] [PDF]
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 T. J. Wilt and K. E. Ensrud The If's, And's, or But's Regarding Bisphosphonates for Prostate Cancer J Natl Cancer Inst, May 16, 2007; 99(10): 744 - 745. [Full Text] [PDF]
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 Alendronate's Effect on Bone Loss in Men Treated with Hormonal Therapy for Prostate Cancer Journal Watch Oncology and Hematology, April 2, 2007; 2007(402): 1 - 1. [Full Text]
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