Drug Cuts Hormone Therapy Induced Bone Loss In Prostate Cancer Patients
By Rachael Myers Lowe, cancerpage.com
September 26, 2001) - One of the side effects of the hormone therapy used to fight prostate cancer is bone loss and the resulting increased risk of fractures.
The results of new research published in the September 27 edition of the New England Journal of Medicine provide hope for men undergoing hormone therapy. Researchers at Massachusetts General Hospital and the Dana Farber Cancer Institute say they can cut bone loss by as much as 6.6% with the use of the drug pamidronate (pa-mi-DROE-nate) in addition to the androgen-deprivation hormone therapy.
In normal bones, imperfections are regularly repaired through the process of resorption. Osteoclasts dissolve or resorb the area for repair and new bone grows to fill it. Hormone therapy however speeds up the activity of the osteoclasts resulting in more bone material being destroyed than can be replaced.
Pamidronate is a bisphosphonate. Bisphosphonates slow the process of bone resorption. Pamidronate is currently used to treat other malfunctions in bone resorption such as hypercalcemia or too much calcium in the blood and osteolytic bone metastases in breast cancer and multiple myeloma patients.
Dr. Matthew Smith and associates randomly assigned 47 prostate cancer patients to one of two groups. Group one received leuprolide hormone therapy and group two received leuprolide hormone therapy and intravenous pamidronate. The men recruited had locally advanced prostate cancer with no metastases to the bone. The patients received treatment over 48 weeks at 12-week intervals.
The group receiving hormone therapy alone had measurable drops in bone mineral density and increased metabolic activity indicating increased bone turnover. There was no significant change in bone mineral density in the group that got leuprolide and pamidronate.
The researchers could not say whether the use of pamidronate cut down on fractures suffered by prostate patients undergoing androgen-deprivation therapy and recommended larger scale studies. In addition, researchers point out that most of their subjects were white so it’s not clear from this study whether similar results would be achieved in other racial groups.
The American Cancer Society estimates 198,000 American men will be diagnosed with prostate cancer this year. According to results of a soon to be released report by LifeMetrix Information Services, (the parent company of cancerpage.com) hormone therapy (androgen-deprivation therapy) was the second most widely prescribed treatment for prostate cancer in nearly 10,000 patients followed during a two year period.
New England Journal of Medicine: 2001, vol. 345, no.13, 948-955
LifeMetrix Information Services, Inc, OncologyInsight – Prostate Cancer: 2001, September
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