By Liz Szabo, USA TODAY Prostate cancer (news – web sites) patients treated with hormone therapy are 40% more likely to fracture a bone than patients treated in other ways, researchers announced Monday.
The risk increases the longer men take hormones, especially for those who use them more than three years, said Matthew Smith, an assistant professor at Harvard Medical School (news – web sites), who presented his findings at the annual meeting here of the American Society of Clinical Oncology (news – web sites).
In a review of the medical records of more than 11,000 men whose prostate cancer had not spread, doctors found that 83% of those given hormones fractured a bone, compared with 56% of men who did not take hormones. The rates of bone density loss are similar to those of women going through menopause, Smith said.
About 500,000 men a year are treated for prostate cancer with hormones, which reduce testosterone. Hormones, once prescribed when tumors had spread, are now sometimes used to shrink tumors before surgery or radiation, or after those treatments to prevent cancer from returning.
Prostate cancer is the most common cancer in men. There are more than 230,000 new cases each year.
Treatments are highly successful, and 99% of patients live at least five years. As men live longer after diagnosis, researchers said, doctors should help them preserve a high quality of life into old age.
Because many prostate cancer patients are elderly, falls can be “particularly devastating,” said Robert Mayer of Boston’s Dana-Farber Cancer Institute.
Smith suggested that men treated with hormones should be routinely screened for osteoporosis. Doctors can help men increase bone density with drugs called bisphosphonates, which includes the well-known Fosamax, taken by many older women to treat osteoporosis.
Women also face an increased risk of osteoporosis from certain breast cancer treatments, said Clifford Hudis, chief of breast cancer medicine at New York’s Memorial Sloan-Kettering Cancer Center. Aromatase inhibitors, sometimes given to postmenopausal women, reduce estrogen, which protects bones.
In other studies presented Monday at the cancer conference:
â€¢ Researchers said that chemotherapy may be as effective as radiation in treating testicular cancer.
In a study of nearly 1,500 men who had already undergone surgery, patients were equally likely to survive when treated with radiation or the drug carboplatin. After four years, however, men treated with chemotherapy were slightly less likely to develop cancer in the remaining testicle. Doctors said they would like to follow the men for another decade to see if that trend continues.
â€¢ Researchers also presented encouraging results of research into brain tumors that may change the way patients are treated and provides clues about new therapies for the future.
A large international study found that adding chemotherapy to radiation treatments helps patients live longer, although the disease is still usually fatal. At the end of two years, 26% of those treated with a combination of chemotherapy and radiation were still alive, compared with 10% of those treated with radiation alone.