Hip Fractures in Men With Prostate Cancer Treated With Orchiectomy

Dickman, Paul W.; Adolfsson, Jan; Åström, K.G.O.; Steineck, Gunnar

doi:10.1097/01.ju.0000143930.73016.c6

Cited by 42 publications

(32 citation statements)

References 16 publications

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“…Furthermore, localised prostate cancer may be associated with a prolonged survival [43] and thus a sustained risk of even late metastases to the skeleton and detrimental effects of long-term androgen deprivation therapy [1,44]. Dickman et al [45] reported an early and sustained increase in the risk of hip fractures in patients who underwent bilateral orchiectomy for prostate cancer, In our study the increase was seen later in the cause of the prostate cancer and this may be due to the fact that not all patients underwent orchiectomy or received androgen deprivation therapy. Furthermore, patients treated with orchiectomy may have more advanced prostate cancer than those not undergoing orchiectomy, and this may also contribute to the differences between our results and those of Dickman et al [45].…”

Section: Discussionmentioning

confidence: 99%

Fracture risk in patients with different types of cancer

2009

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Section: Discussionmentioning

confidence: 99%

Fracture risk in patients with different types of cancer

2009

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“…Cette diminution s'accompagne d'une augmentation significative de la survenue de fractures : dans une large étude Medicare incluant 50 613 patients porteurs d'un cancer de prostate, le taux de fracture était de 19,5 % à cinq ans chez ceux ayant reçu une hormonothérapie dans les six mois suivant le diagnostic contre 12,6 % chez les autres (p < 0,001) [39]. Les patients orchidectomisés ont un risque de fracture du col fémoral de 12 % à dix ans contre seulement 5 % pour la population générale [10]. La comparaison de 3 887 patients présentant un cancer non métastatique et traités par analogue de la LH-RH à 7 774 patients sans hormonothérapie met en évidence une augmentation significative du risque fracturaire associé à la dépri-vation androgénique (7,88 fractures pour 100 années-personnes dans le groupe sous analogues de la LH-RH versus 6,51 pour les autres patients ; p < 0,001) [44].…”

Section: Syndrome Métaboliqueunclassified

Side effects of androgen deprivation and their management

et al. 2012

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The knowledge of secondary effects of androgen deprivation has improved. Besides hot flushes and erectile dysfunction, cardiovascular and bone complications must be taken into consideration once medication has been indicated and also during treatment. The onset of diabetes can occur early, within six months after the start of treatment, with dyslipidaemia being far rarer. An increase in the frequency of cardiovascular events and cardiac mortality remains controversial. There is now sufficient evidence to show that androgen deprivation moderately increases the risk of osteoporotic-type bone disorders. A greater understanding of the secondary effects will require an initial clinical and paraclinical study, as well as the monitoring of longterm hormone therapy. To cite this journal: Oncologie 14 (2012).

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“…Bilateral orchiectomies are also associated with increased fracture risk in men with prostate cancer (31,32).…”

Section: Gnrh Agonists and Fracture Riskmentioning

confidence: 99%

Treatment-Related Osteoporosis in Men with Prostate Cancer

Smith

2006

Clinical Cancer Research

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The intended therapeutic effect of gonadotropin-releasing hormone (GnRH) agonists is hypogonadism, a major cause of acquired osteoporosis in men. Consistent with this observation, GnRH agonists increase bone turnover and decrease bone mineral density, a surrogate for fracture risk. Large claims-based analyses and other retrospective studies provide compelling evidence that GnRH agonists increase risk of clinical fractures. Estrogens play a central role in homeostasis of the normal male skeleton, and estrogen deficiency rather than testosterone deficiency seems to be primarily responsible for the adverse skeletal effects of GnRH agonists. In randomized controlled trials, bisphosphonates (pamidronate and zoledronic acid) and selective estrogen receptor modulators (raloxifene and toremifene) increased bone mineral density in GnRH agonist^treated men. Two ongoing large randomized placebo-controlled studies will prospectively define fracture outcomes in men with prostate cancer and assess the efficacy of novel pharmacologic interventions (AMG162, toremifene) during GnRH agonist treatment.

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Hip Fractures in Men With Prostate Cancer Treated With Orchiectomy

Cited by 42 publications

References 16 publications

Fracture risk in patients with different types of cancer

Fracture risk in patients with different types of cancer

Side effects of androgen deprivation and their management

Treatment-Related Osteoporosis in Men with Prostate Cancer

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