Bone mineral density in patients with prostatic cancer treated with orchidectomy and with estrogens

Eriksson, S; Eriksson, Anders; Stege, Reinhard; Carlström, Kjell

doi:10.1007/bf00298427

Cited by 180 publications

(71 citation statements)

References 16 publications

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“…Maillefert et al found that, after 1 year of ADT, there was a 4.6% decrease in BMD at the lumbar spine and a 3.9% decrease at the femoral neck [13]. Orchiectomy also resulted in substantial changes, with a 15% decrease in trochanter BMD after 1 year reported in one study [25]. After 1 year of ADT, 15 men with adenocarcinoma of the prostate had significantly lower BMD at the total hip and ultradistal radius than age-and sex-matched controls.…”

Section: Unique Aspects Of Cancer Therapyassociated Bone Lossmentioning

confidence: 92%

Bone Loss and Fracture Risk Associated with Cancer Therapy

2006

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Background. Cancer patients experience osteoporosis resulting from accelerated loss of bone mineral density (BMD) caused by their treatment. Such bone loss greatly increases the risk for fracture and can have other serious effects on quality of life.Methods. In the current report, the author focuses on studies of cancer therapy-associated bone loss, its prevalence and pathogenesis, and resulting clinical impact. Options for management and prevention are also reviewed, including treatment guidelines where available.Results. A variety of cancer therapies, including hormonal therapy, chemotherapy, and glucocorticoids, affect gonadal hormone production, which increases bone resorption and decreases BMD. Such bone loss occurs more rapidly and to a greater degree than normal age-related osteoporosis, increases the risk for fracture

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Section: Unique Aspects Of Cancer Therapyassociated Bone Lossmentioning

confidence: 92%

Bone Loss and Fracture Risk Associated with Cancer Therapy

2006

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“…BMD significantly decreased in the patients who underwent orchiectomy but did not change in the estrogen group. Treatment was tolerated well in both groups [78]. More recent studies revisited estrogen therapy, given the better understanding of the importance of estrogens in bone metabolism.…”

Section: Osteoporosismentioning

confidence: 92%

Andropause: Symptom Management for Prostate Cancer Patients Treated With Hormonal Ablation

2003

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Andropause, or the age-related decline in serum testosterone, has become a popular topic in the medical literature over the past several years. Andropause includes a constellation of symptoms related to lack of androgens, including diminished libido, decreased generalized feeling of well-being, osteoporosis, and a host of other symptoms. The andropause syndrome is very prominent in men undergoing hormonal ablation therapy for prostate cancer. Most significant in this population are the side effects of hot flashes, anemia, gynecomastia, depression, cognitive decline, sarcopenia, a decreased overall quality of life, sexual dysfunction, and osteoporosis with subsequent bone fractures. The concept of andropause in prostate cancer patients is poorly represented in the literature. In this article, we review the current literature on the symptoms, signs, and possible therapies available to men who cannot take replacement testosterone. The Oncologist 2003;8:474-487 The Oncologist 2003;8:474-487 www.TheOncologist.comCorrespondence: Charles L. Loprinzi, M.D., Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA. Telephone: 507-284-2511; Fax: 507-266-4972; e-mail: cloprinzi@mayo.edu Received January 14, 2003; accepted for publication July 11, 2003. ©AlphaMed Press 1083-7159/2003 ANDROPAUSEAndropause is defined as an age-related decline in serum testosterone levels in older men to below the normal range in young men, which is associated with a clinical syndrome consistent with androgen deficiency. The syndrome may include decreased muscle strength and/or endurance, decreased pubic and axillary hair, reduced physical function, diminished libido, fatigue, depressed mood, decreased generalized well-being, hot flashes, osteoporosis/osteopenia, and anemia [1].In men, four hormones significantly decrease with age: testosterone, estradiol, dehydroepiandrosterone (DHEA)/ DHEA sulfate (DHEA-S), and growth hormone (GH) [2]. A longitudinal study showed that mean total testosterone levels decreased by 30% between the ages of 25 and 75 and mean free-testosterone levels decreased by as much as 50% [3]. This decline in testosterone is secondary to a decrease in the number of testicular Leydig cells, a decrease in testicular perfusion, and changes in the hypothalamic-pituitary axis [4]. Serum estradiol also decreases in aging men, likely The Oncologist ® LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Explain the side effects of hormonal ablation therapy for prostate cancer.2. Provide a list of potential non-hormonal therapies for treatment of vasomotor symptoms.3. Appreciate the impact of hormonal ablation therapy on bone mineral density.Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME This material is protected by U.S.

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“…As regards bone, oestrogens do not exhibit toxicity. This is because their use, as opposed to surgical orchiectomy or LHRH analogue use, does not have a significant lowering effect on bone density [77], and may even exhibit a protective action on bones [78]. LHRH analogues currently constitute an alternative -one widely used and preferred by patients -to surgical orchiectomy [79].…”

Section: Hormone Therapy In Prostate Cancermentioning

confidence: 99%

Bone tissue as the site of action of oncological drugs

Leśniewski-Kmak¹,

Radecka²,

Litwiniuk³

2011

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Anticancer therapy has multiple, sometimes life-threatening side effects, and their influence on bone is not seen as important. Data have been published confirming the existence of side effects chemotherapy has on bone, which affect patients' quality of life. They influence a bone tissue not only in a direct way, but also when suppressing the activity of gonads. We have no information on the impact of drugs on bone belonging to the "targeted therapies". There are, however, some attempts to create antibodies that target proteins involved in bone physiology. Relatively well known is the impact of anti-cancer hormone therapy on bone metabolism. Bone tissue is of special importance in the pathophysiology and the clinical course of neoplastic diseases. Metastases to bones do not pose a direct threat to the patient's life, yet they markedly lower the quality of life and may be associated with complications leading to severe disability and, in consequence, to shortening of the patient's life. In the clinical picture of certain neoplasms, such as multiple myeloma, prostate cancer, thyroid cancer or sometimes breast cancer, the dominating symptoms are those related to bone infiltration. On the other hand, there are also effects of the oncological treatment on the bone -both those concerning the physiological bone cycle (of increasing importance with the observed prolongation of patient life) and the interactions between the neoplastic cells and bone cells. Below, we present a literature review on this subject. The issue of steroid therapy's effects on bones is not addressed here as the multitude of usages of this drug class resulted in the subject being already extensively discussed in other publications. ChemotherapyAdverse effects of chemotherapy concerning bones may in a longer-term perspective lead to health complaints markedly lowering the quality of life, particularly in patients with good prognosis, even more so because this approach is often combined with different hormone and radiation therapies. As early as in 1965, a report was published presenting the results of a study on the effects of methotrexate (MTX) treatment on calcium metabolism, demonstrating elevated levels of this element in urine and stool, its lowered levels in blood serum, and indirectly its increased bone resorption [1]. The above data have been reflected in a clinical setting, in patients treated with MTX for acute myeloid leukaemia, where there have been observed pain and difficult uniting of fractures during the course of treatment and remission upon its completion [2][3][4][5][6][7][8]. Although the high doses of steroids have been of significance, the cytostatic agents have been deemed to play an important role here. Reduction in the bone mineral density (BMD) has been observed as well as qualitative features of osteopenia, seen in radiograms as shrinking of the cortical bone, lower Singh index, more distinct (due to thinning) trabeculae or -in contrast -lack of the trabecular structure in imaging. Similar reports have been published base...

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Bone mineral density in patients with prostatic cancer treated with orchidectomy and with estrogens

Cited by 180 publications

References 16 publications

Bone Loss and Fracture Risk Associated with Cancer Therapy

Bone Loss and Fracture Risk Associated with Cancer Therapy

Andropause: Symptom Management for Prostate Cancer Patients Treated With Hormonal Ablation

Bone tissue as the site of action of oncological drugs

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