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BOSTON, MASSACHUSETTS. Men with advanced prostate cancer undergoing hormone treatment or
castration (androgen-deprivation therapy) experience rapid bone loss markedly exceeding that associated
with menopause in women. This bone loss, in turn, leads to a two- to six-fold increase in bone fractures
especially those involving the hip. Medical doctors at the Massachusetts General Hospital now warn that
the osteoporosis and fracture risk is magnified by the fact that many men with advanced prostate cancer
have osteoporosis or low bone density before they even start androgen-deprivation therapy.
The study involved 41 men with locally advanced, lymph node positive or recurrent prostate carcinoma with
no evidence of bone metastases. The men underwent dual-energy x-ray absorptiometry (DXA) and
quantitative computed tomagraphy (QCT) to determine their bone density. The prostate cancer patients
tended to have significantly lower bone density in the hip and lumbar spine area than did age-matched
controls and young adult men. The QCT values for trabecular bone mineral density of the lumbar spine
indicated that 63 per cent of the 41 men had osteoporosis. Seventeen per cent of the men had a vitamin D
deficiency and 59 per cent had a calcium intake below the recommended daily intake of 800 mg/day. The
researchers point out that a vitamin D deficiency is a risk factor for both prostate cancer and osteoporosis.
They also emphasize that there is no established causal relation between prostate cancer risk and calcium
intake above 800 mg/day. They conclude that prostate cancer patients should be routinely screened for
bone mineral density before androgen-deprivation therapy is initiated.
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