Osteoporosis is another important but under-recognised risk of androgen deprivation therapy. Few guidelines exist to help detect and manage bone loss in these men. As survival from prostate cancer increases, osteoporosis and its complications will probably become more common. A retrospective study of over 50 000 men with prostate cancer found a significant association between number of doses of gonadotrophin releasing hormone agonist and fracture risk. Importantly, fractures in these patients are an independent adverse predictor of survival. Patients and general practitioners should be given clear information and lifestyle advice to reduce the risk of osteoporosis, emphasising the need for exercise, reducing smoking, limiting alcohol consumption, and a diet that includes calcium and vitamin D. Exercise and diet are particularly important because the effects of androgen deprivation include muscle loss and increased body fat.
Language: en
", language="en", issn="0959-8138", doi="10.1136/bmj.c143", url="http://dx.doi.org/10.1136/bmj.c143" }