Too Few Males with Prostate Most cancers Get Bone Density Check

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Too Few Men with Prostate Cancer Get Bone Density Test

Prostate cancer is the second most common cancer in men in the United States. One in nine men will be diagnosed with the disease at some point in their life. It's also one of the most treatable when caught early enough. A treatment for more advanced prostate cancer, androgen suppression therapy, can lead to weaker bone health later in life, but not enough men get tests to measure their bone density measurement (BMD), said authors of a new study from McGill University in Montreal Canada.

Androgen suppression therapy, also called hormone therapy, is not first-line therapy if a man is diagnosed with early-stage cancer. It is used to treat advanced prostate cancer, such as:

  • When the cancer has spread and not responding to surgery or radiation
  • In addition to radiation as an initial treatment if there is a higher risk of the cancer returning
  • Before the irradiation to shrink the tumor
  • When the cancer has returned after surgery or radiation therapy

Androgen, a male hormone, provides fuel for cancer cells to grow. By suppressing androgen in the body, it makes it harder for cancer cells to spread throughout the body.

However, androgen suppression therapy can weaken the bones, leading to osteoporosis and fractures.

The researchers found that while more prostate cancer patients who received hormone therapy had BMD tests, the overall number was still quite low. The numbers were lowest among men who:

  • Were older
  • Had other illnesses
  • Lived in rural areas
  • Had metastatic disease (cancer had spread)

"While we expected BMD test rates to be quite low given the previous literature, we were somewhat surprised that they have not increased in recent years," senior author Alice Dragomir, MSc, PhD, said in a press release . "Bone density tests help doctors assess fracture risk and determine which patients would benefit from additional monitoring and interventions such as lifestyle changes and / or medication. It is possible that the low testing rate will change in the years to come as bone health problems recur in the EU clinical oncology is considered. It might be interesting to re-examine BMD test rates in a few years. "

The study

The researchers searched a government database and identified over 22,000 men who had been treated for prostate cancer. Of these, only 3,910 men had a BMD test at any point during the 15-year study period.

"While we have known for many years that androgen deprivation therapies used to treat prostate cancer have an increased risk of osteoporosis, this study identifies certain populations that may not receive recommended screening prior to hormone-based therapies," said Joshua M. Lang, MD MS, said in the same press release. Dr. Lang is an associate professor of medicine at the University of Wisconsin's Carbone Cancer Center and was not involved in the study. "These populations are particularly at risk, including our elderly patients in rural areas of the country."

Dr. Lang pointed out that this screening is important because there are treatments that can slow the progression of osteoporosis. "The NCCN Prostate Cancer Guidelines strongly recommend screening for these patients. This report shows that more work is needed to advocate and implement screening of vulnerable patient populations."

The dangers of osteoporosis

Osteoporosis is often viewed as a disease that affects women as they are at risk after menopause, but men can and do develop the disease too.

Often referred to as "bone thinning", osteoporosis occurs when bones lose their density or bone cells do not regenerate quickly enough. These bones weaken over time and are prone to fracture from even the slightest fall if the condition is sufficiently advanced.

Fractures can cause many other serious conditions. They can limit your mobility and your ability to work or work, but they can also lead to pneumonia and other complications.

Take that away

If you're on hormone therapy to treat prostate cancer and your doctor hasn't mentioned tests to check your bone health, bring them up at your next appointment or telemedicine exam.

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