Endocrine therapy caused significant bone loss that increased with treatment duration in premenopausal women with breast cancer. Zoledronic acid 4 mg every 6 months effectively inhibited bone loss. Regular BMD measurements and initiation of concomitant bisphosphonate therapy on evidence of bone loss should be considered for patients undergoing endocrine therapy.

These data confirm the benefit of extending adjuvant tamoxifen therapy beyond 5 years with anastrozole compared with no further treatment. Further research is required to define the optimum length of extended adjuvant therapy and to investigate the possibility of tailoring this period to suit different disease types.

The relationship between total testosterone and prostate cancer has been an area of interest among physicians for decades. Conflicting results have been reported on the relationship between total testosterone and subsequent prostate cancer. Much of this controversy appears to be based on conflicting study designs, definitions and methodologies. To date no prospective study with sufficient power has been published to unequivocally resolve the issue. The preponderance of studies of the safety of exogenous testosterone in men with a prostate cancer history suggests that there is little if any risk. However, because the risk has not proved to be zero, the most prudent course is to follow such men with regular prostate specific antigen measurements and digital rectal examinations.

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Importance There is extensive evidence suggesting that Black men with localized prostate cancer (PCa) have worse cancer-specific mortality compared to their non-Hispanic White (nHW) counterparts. Objective To evaluate racial disparities in the use, quality of care, and outcomes of radical prostatectomy (RP) in elderly men with non-metastatic PCa. Design Inclusion of patients with localized PCa who underwent RP within the first year of PCa diagnosis in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database between 1991 and 2009. Setting Retrospective analysis of outcomes stratified according to race (Black vs. nHW). Participants 2,020 (7.6%) Black and 24,462 (92.4%) nHW elderly men with localized PCa who underwent RP. Main Outcomes and Measures Process of care (i.e. time to treatment, lymph node dissection), as well as outcome measures (i.e. complications, emergency department visits, readmissions, PCa-specific and all-cause mortality, costs) were evaluated using Cox proportional hazards regression. Multivariable conditional logistic regression and quantile regression were used to study the association of racial disparities with process of care and outcome measures. Results 59.4% of Blacks vs. 69.5% of nHWs underwent RP within 90 days (p<.001); the top 50% of Blacks had an 8-day treatment delay compared to nHW (p<.001). Blacks were less likely to undergo lymph node dissection and to receive blood transfusions, but more likely to experience postoperative complications, subsequent emergency department visits, and readmissions (all p<.05). The surgical treatment of Black patients was associated with a higher incremental annual cost (top 50% spent $1185.5 more). There was no difference in PCa-specific mortality (p=.16) or all-cause mortality (p=.64) between Black and nHW men. Conclusions and Relevance Blacks treated with RP for localized PCa are more likely to experience adverse events and incur higher costs compared to nHW men, however this does not translate into a difference in PCa-specific or all-cause mortality.

While a higher rate of side effects, albeit mild to moderate, was detected with 1/3 dose bacillus Calmette-Guérin compared to gemcitabine, our study failed to show significant differences between the 2 drugs in terms of quality of life.

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