help button home button Endocrine Society JCEM JCEM Call for Nominations for EIC
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a related Letter to the Editor
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Copyright Permission
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Stoch, S. A.
Right arrow Articles by Greenspan, S. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Stoch, S. A.
Right arrow Articles by Greenspan, S. L.
The Journal of Clinical Endocrinology & Metabolism Vol. 86, No. 6 2787-2791
Copyright © 2001 by The Endocrine Society

Other Original Studies

Bone Loss in Men with Prostate Cancer Treated with Gonadotropin-Releasing Hormone Agonists1

S. Aubrey Stoch, Robert A. Parker, Liping Chen, Glenn Bubley, Yoo-Joung Ko, Aimee Vincelette and Susan L. Greenspan

Division of Bone and Mineral Metabolism, Department of Medicine (S.A.S., A.V., S.L.G.), Biometrics Center (R.A.P., L.C.), and Division of Hematology/Oncology, Department of Medicine (G.B., Y.-J.K.), Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215; and Divisions of Endocrinology and Gerontology, Department of Medicine, University of Pittsburgh Medical Center (S.L.G.), Pittsburgh, Pennsylvania 15213

Address all correspondence and requests for reprints to: S. Aubrey Stoch, M.D., Merck Research Laboratories, Merck & Co., Inc., Ry 32–549, 126 East Lincoln Avenue, Rahway, New Jersey 07065-0914. E-mail: aubrey_stoch{at}merck.com

Abstract

Prostate cancer is the most common visceral malignancy in men. As the tumor is testosterone dependent, a frequent treatment modality involves therapy with GnRH agonists (GnRH-a) resulting in hypogonadism. Because testosterone is essential for the maintenance of bone mass in men, we postulated that GnRH-a therapy would negatively impact skeletal integrity. We compared bone mineral density (BMD), biochemical markers of bone turnover, and body composition in 60 men with prostate cancer (19 men receiving GnRH-a therapy and 41 eugonadal men) and BMD in 197 community-living healthy controls of similar age. BMD was assessed by dual energy x-ray absorptiometry and ultrasound. Biochemical markers of bone turnover, included markers of bone resorption (urinary N-telopeptide) and bone formation markers (bone-specific alkaline phosphatase and osteocalcin). Body composition (total body fat and lean body mass) was assessed by dual energy x-ray absorptiometry.

Significantly lower BMD was found at the lateral spine (0.69 ± 0.17 vs. 0.83 ± 0.20 g/cm2; P < 0.01), total hip (0.94 ± 0.14 vs. 1.05 ± 0.16 g/cm2; P < 0.05), and forearm (0.67 ± 0.11 vs. 0.78 ± 0.07 g/cm2; P < 0.01) in men receiving GnRH-a compared with the eugonadal men with prostate cancer. Significant differences were also seen at the total body, finger, and calcaneus (all P < 0.01). BMD values in eugonadal men with prostate cancer and healthy controls were similar. Markers of bone resorption (urinary N-telopeptide) and bone formation (bone-specific alkaline phosphatase) were elevated in men receiving GnRH-a therapy compared with those in eugonadal men with prostate cancer. Men receiving GnRH-a also had a higher percent total body fat (29 ± 5% vs. 25 ± 5%; P < 0.01) and lower percent lean body weight (71 ± 5% vs. 75 ± 5%; P < 0.01) compared with eugonadal men with prostate cancer. In conclusion, men with prostate cancer receiving androgen deprivation therapy have a significant decrease in bone mass and increase in bone turnover, thus placing them at increased risk of fracture.




This article has been cited by other articles:


Home page
 ANN INTERN MEDHome page
A. Qaseem, V. Snow, P. Shekelle, R. Hopkins Jr., M. A. Forciea, D. K. Owens, and for the Clinical Efficacy Assessment Subcommittee
Screening for Osteoporosis in Men: A Clinical Practice Guideline from the American College of Physicians
Ann Intern Med, May 6, 2008; 148(9): 680 - 684.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
H. Liu, N. M. Paige, C. L. Goldzweig, E. Wong, A. Zhou, M. J. Suttorp, B. Munjas, E. Orwoll, and P. Shekelle
Screening for Osteoporosis in Men: A Systematic Review for an American College of Physicians Guideline
Ann Intern Med, May 6, 2008; 148(9): 685 - 701.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
S. L. Greenspan
Approach to the Prostate Cancer Patient with Bone Disease
J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 2 - 7.
[Abstract] [Full Text] [PDF]

Home page
 ptjournalHome page
C. A Clay, S. Perera, J. M Wagner, M. E Miller, J. B Nelson, and S. L Greenspan
Physical Function in Men With Prostate Cancer on Androgen Deprivation Therapy
Physical Therapy, October 1, 2007; 87(10): 1325 - 1333.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Cancer Res.Home page
J. S. Johansen, K. Brasso, P. Iversen, B. Teisner, P. Garnero, P. A. Price, and I. J. Christensen
Changes of Biochemical Markers of Bone Turnover and YKL-40 Following Hormonal Treatment for Metastatic Prostate Cancer Are Related to Survival
Clin. Cancer Res., June 1, 2007; 13(11): 3244 - 3249.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
S. L. Greenspan, J. B. Nelson, D. L. Trump, and N. M. Resnick
Effect of Once-Weekly Oral Alendronate on Bone Loss in Men Receiving Androgen Deprivation Therapy for Prostate Cancer: A Randomized Trial
Ann Intern Med, March 20, 2007; 146(6): 416 - 424.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
M. R. Smith, H. Lee, and D. M. Nathan
Insulin Sensitivity during Combined Androgen Blockade for Prostate Cancer
J. Clin. Endocrinol. Metab., April 1, 2006; 91(4): 1305 - 1308.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Endocrinol. Metab.Home page
N. A. Sims, K. Brennan, J. Spaliviero, D. J. Handelsman, and M. J. Seibel
Perinatal testosterone surge is required for normal adult bone size but not for normal bone remodeling
Am J Physiol Endocrinol Metab, March 1, 2006; 290(3): E456 - E462.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
S. L. Greenspan, P. Coates, S. M. Sereika, J. B. Nelson, D. L. Trump, and N. M. Resnick
Bone Loss after Initiation of Androgen Deprivation Therapy in Patients with Prostate Cancer
J. Clin. Endocrinol. Metab., December 1, 2005; 90(12): 6410 - 6417.
[Abstract] [Full Text] [PDF]

Home page
 J Am Acad Orthop SurgHome page
K. Templeton
Secondary Osteoporosis
J. Am. Acad. Ortho. Surg., November 1, 2005; 13(7): 475 - 486.
[Abstract] [Full Text] [PDF]

Home page
 Endocr. Rev.Home page
J. M. Kaufman and A. Vermeulen
The Decline of Androgen Levels in Elderly Men and Its Clinical and Therapeutic Implications
Endocr. Rev., October 1, 2005; 26(6): 833 - 876.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
D. A. Galvao and R. U. Newton
Review of Exercise Intervention Studies in Cancer Patients
J. Clin. Oncol., February 1, 2005; 23(4): 899 - 909.
[Abstract] [Full Text] [PDF]

Home page
 Endocr. Rev.Home page
D. Vanderschueren, L. Vandenput, S. Boonen, M. K. Lindberg, R. Bouillon, and C. Ohlsson
Androgens and Bone
Endocr. Rev., June 1, 2004; 25(3): 389 - 425.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
P. Szulc, B. Claustrat, F. Marchand, and P. D. Delmas
Increased Risk of Falls and Increased Bone Resorption in Elderly Men with Partial Androgen Deficiency: The MINOS Study
J. Clin. Endocrinol. Metab., November 1, 2003; 88(11): 5240 - 5247.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
C. A. Thompson, T. D. Shanafelt, and C. L. Loprinzi
Andropause: Symptom Management for Prostate Cancer Patients Treated With Hormonal Ablation
Oncologist, October 1, 2003; 8(5): 474 - 487.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
M. Benito, B. Gomberg, F. W. Wehrli, R. H. Weening, B. Zemel, A. C. Wright, H. K. Song, A. Cucchiara, and P. J. Snyder
Deterioration of Trabecular Architecture in Hypogonadal Men
J. Clin. Endocrinol. Metab., April 1, 2003; 88(4): 1497 - 1502.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
M. J. Morris and H. I. Scher
Clinical Approaches to Osseous Metastases in Prostate Cancer
Oncologist, April 1, 2003; 8(2): 161 - 173.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
P. Taxel, P. M. Fall, P. C. Albertsen, R. D. Dowsett, M. Trahiotis, J. Zimmerman, C. Ohannessian, and L. G. Raisz
The Effect of Micronized Estradiol on Bone Turnover and Calciotropic Hormones in Older Men Receiving Hormonal Suppression Therapy for Prostate Cancer
J. Clin. Endocrinol. Metab., November 1, 2002; 87(11): 4907 - 4913.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
D. Mittan, S. Lee, E. Miller, R. C. Perez, J. W. Basler, and J. M. Bruder
Bone Loss following Hypogonadism in Men with Prostate Cancer Treated with GnRH Analogs
J. Clin. Endocrinol. Metab., August 1, 2002; 87(8): 3656 - 3661.
[Abstract] [Full Text] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
A. L. Potosky, B. B. Reeve, L. X. Clegg, R. M. Hoffman, R. A. Stephenson, P. C. Albertsen, F. D. Gilliland, and J. L. Stanford
Quality of Life Following Localized Prostate Cancer Treated Initially with Androgen Deprivation Therapy or No Therapy
J Natl Cancer Inst, March 20, 2002; 94(6): 430 - 437.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
M. R. Smith, J. S. Finkelstein, F. J. McGovern, A. L. Zietman, M. A. Fallon, D. A. Schoenfeld, and P. W. Kantoff
Changes in Body Composition during Androgen Deprivation Therapy for Prostate Cancer
J. Clin. Endocrinol. Metab., February 1, 2002; 87(2): 599 - 603.
[Abstract] [Full Text] [PDF]

Home page
 J. Gerontol. A Biol. Sci. Med. Sci.Home page
A. M. Matsumoto
Andropause: Clinical Implications of the Decline in Serum Testosterone Levels With Aging in Men
J. Gerontol. A Biol. Sci. Med. Sci., February 1, 2002; 57(2): M76 - 99.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Endocrinology Endocrine Reviews J. Clin. End. & Metab.
Molecular Endocrinology Recent Prog. Horm. Res. All Endocrine Journals
Copyright © 2001 by The Endocrine Society